Citation: Fard MA, Afzali M, Abdi P, et al. Optic nerve head morphology in nonarteritic anterior ischemic optic neuropathy compared to open-angle glaucoma. Invest Ophthalmol Vis Sci. 2016;57:4632-4640. DOI:10.1167/ iovs.16-19442 PURPOSE. To compare optic nerve head (ONH) morphology of optic nerve atrophy between eyes with primary open-angle glaucoma (POAG) and eyes with a history of nonarteritic anterior ischemic optic atrophy (NAION) using enhanced depth imaging (EDI) with spectraldomain optical coherence tomography (SD-OCT). METHODS.In this cross-sectional study, 121 eyes of 91 patients consisted of moderate to severe POAG (n ¼ 32 eyes), visual field mean deviation-matched NAION (n ¼ 30 eyes) and their fellow eyes (n ¼ 30 eyes), and healthy controls (n ¼ 29). The optic discs were scanned using SD-OCT and measurements were obtained using HEYEX software 6.0. Lamina cribrosa (LC) thickness and anterior lamina cribrosa depth (ALD) at three scans (midsuperior, central, and midinferior) were determined and compared. In addition, prelaminar tissue thickness was measured at three points of a single central scan.RESULTS. There was no significant difference in the visual field mean deviation (MD) between the NAION and POAG groups (P > 0.99), but both groups had a significantly worse MD than the healthy group (P < 0.001). The NAION and POAG groups had similar peripapillary retinal nerve fiber layer (pRNFL) thickness (P < 0.99). Eyes with POAG had greater ALD and thinner LC than control eyes and NAION eyes in all regions of the ONH (P < 0.001 for both). There was a marked prelaminar tissue thinning in POAG eyes compared to control and NAION eyes (P < 0.001). Lamina cribrosa thickness and ALD of NAION eyes were not different from their fellow eyes and control eyes. Although prelaminar thickness was thinner in NAION eyes compared to their fellow eyes (P ¼ 0.005), it was thicker than in control eyes (P < 0.001).CONCLUSIONS. Despite profound thinning and posterior displacement of LC in POAG, the thickness and position of LC in NAION eyes are similar to those seen in healthy control and their fellow eyes.Keywords: open-angle glaucoma, nonarteritic anterior ischemic optic atrophy, lamina cribrosa, optic nerve head, optic atrophy B oth open-angle glaucoma (OAG) as chronic progressive optic neuropathy and nonarteritic anterior ischemic optic neuropathy (NAION) as acute optic neuropathy with inflammation-associated axonal loss cause irreversible damage to the optic nerve.1-3 In contrast to NAION, which presents with disc pallor after an ischemic event, OAG results in the enlargement of the optic disc cup. Optic nerve head (ONH) morphologic features differ in NAION and OAG. While a small disc area and smaller cupping are predisposing risk factors for the development of NAION, [3][4][5]
Single long scleral technique was efficacious with no occurrence of tube exposure in relatively long period of follow-up. In this method, there is no need to harvest any additional material, and in situations with limited access to patch grafts, it is performable with the minimal facilities.
Purpose: To assess the longitudinal changes of choroidal thickness using enhanced depth imaging optical coherence tomography (EDI-OCT) during pregnancy and postpartum. Methods: The study included 23 eyes of 23 healthy pregnant women and 23 eyes of 23 healthy nonpregnant women. Choroidal thickness was measured manually with EDI-OCT at seven locations: The fovea, 500, 1000, and 1500 μm temporal (T) from the fovea and 500, 1000, and 1500 μm nasal (N) from the fovea. Measurements were obtained at each pregnancy trimester and 6 weeks postpartum and in the follicular phase of the menstrual cycle for the control group. Results: The mean subfoveal choroidal thickness was 410.2 ± 82.4 μm, 434.8 ± 79.6 μm, 433.5 ± 80.3 μm, and 395.0 ± 71.1 μm in the first, second, and third trimesters and 6 weeks postpartum, respectively. In all seven measured locations, statistically significant changes were noted during pregnancy and postpartum in the choroidal thickness ( P < 0.001). Choroidal thickness increased from the first trimester to the second and third trimester, after which it decreased at postpartum. Choroidal thickness was greater in the pregnant group during pregnancy and postpartum compared to the control group ( P < 0.001). Conclusions: This study indicated significant change in choroidal thickness at seven locations measured with EDI-OCT throughout pregnancy and 6 weeks after delivery. We showed that 6 weeks after delivery, choroidal thickness remains significantly higher than nonpregnant subjects.
Purpose: Viscocanalostomy represents an alternative to standard penetrating glaucoma surgery. The aim of this study is to compare the outcomes of combined phacoemulsification and viscocanalostomy in eyes with primary open-angle glaucoma (POAG) versus eyes with pseudoexfoliation glaucoma (PEXG). Methods: In this prospective non-randomized comparative study, eyes with cataract and POAG or PEXG were enrolled. Pre- and postoperative data including best corrected visual acuity (BCVA), intraocular pressure (IOP), and the number of antiglaucoma medications administered were recorded at each visit. All patients underwent phacoviscocanalostomy. Complete success was defined as the IOP of 21 mmHg or less without the administration of medication while a qualified success reported the same IOP parameters either with or without the administration of medication. Results: Fifty-four eyes with POAG and fifty-four with PEXG underwent phacoviscocanalostomy. The mean follow-up time was 23.36 ± 8.8 months (range, 6–40 months). The mean postoperative IOP reduced significantly in both groups, although the mean IOP reduction was significantly greater in PEXG eyes (14.7 ± 8.9 vs 10.1 ± 7.7 mmHg) (P = 0.05). At the final follow-up visit, the mean postoperative IOP was 14.1 ± 2.1 and 16.6 ± 3.5 mmHg in the PEXG and POAG eyes, respectively (P = 0.001). A complete success rate of 88.9% and 75.9% was achieved in PEXG and POAG eyes, respectively (P = 0.07). The qualified success rate was 100% in the PEXG and 85.2% in POAG groups (P = 0.03). Conclusion: Phacoviscocanalostomy achieved significant IOP reduction and visual improvement in both POAG and PEXG patients. Our results indicated that in terms of IOP reduction, this procedure was more effective in treating PEXG.
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