Purpose To evaluate Damato Multifixation Campimetry Online (DMCO), a free-of-charge internet-based visual field test. DMCO exists in three versions: DMCO BASIC, DMCO STANDARD, and DMCO ADVANCED. The main focus was (i) to investigate the sensitivity and the specificity of the existing DMCO versions in the detection of glaucomatous visual field loss and (ii) to define and evaluate algorithms for the interpretation of DMCO results. Methods The study design was an evaluation of a diagnostic test and included 97 individuals performing DMCO and whiteon-white perimetry. Interpretation algorithms were devised to define abnormality, and these were evaluated using the Glaucoma Staging System as gold standard. Receiver operating characteristic (ROC) curves and area under the ROC (AUC) were calculated. Results AUCs from 15 algorithms ranged from 0.79 to 0.90. The most promising algorithm combined results from two successive DMCO STANDARD tests. The sensitivity was highly dependent on the severity of glaucoma. Hence, for eyes with mild, moderate, advanced, and severe glaucoma, the DMCO test demonstrated a sensitivity of 11.8, 71.4, 100, and 100%, respectively. The specificity was as high as 98.1%. Median duration per eye to complete the DMCO STANDARD test was 86 s for the control group and 125 s in participants with glaucoma. Conclusions DMCO shows promise as a freeof-charge online tool to identify glaucomatous visual field defects in a preselected population. Ongoing studies are evaluating the use of DMCO in a nonselected population.

A prospective study of the influence of pregnancy on diabetic retinopathy was started at Rigshospitalet, Copenhagen in 1979. At present 145 women with insulin-dependent diabetes have been included. Preliminarily, it seems that women belonging to White classes B and C do not develop persistant retinopathy as a consequence of pregnancy. Women with retinopathy at the onset of pregnancy deteriorate in 50% of the cases, but post-partum regression is common. Development of proliferative changes is exceptional, and proliferations developed during pregnancy in most cases disappear spontaneously after delivery. Consequently, treatment with photocoagulation during pregnancy and in the early post-partum period should be restricted. Close ophthalmological supervision during pregnancy is essential and the ophthalmologist must be aware of the spontaneous course of diabetic retinopathy in relation to pregnancy. At present it is still uncertain whether pregnancy in women with insulin-dependent diabetes (IDD) influences the spontaneous course of retinopathy and to what extent it is justified to treat retino¬ pathy with photocoagulation during pregnancy or shortly after delivery. Also, the correlation be¬ tween the ophthalmological status and the clinical course of pregnancy has not been fully elucidated. Previous studiesIn 1950 Beetham reported on 200 women with IDD. He found that the presence of any degree of retinopathy reduced the chances of a successful outcome of pregnancy to less than 47%. All patients with proliferative retinopathy at the onset of pregnancy had stillborn or neonatally dead infants and their vision decreased during preg¬ nancy.In 1965 White summarized her results from the Joslin Clinic and concluded that malignant retinopathy (proliferative retinopathy) might pro¬ gress during pregnancy whereas benign retino¬ pathy (simplex retinopathy) reverted after delivery. During the last years, seven reports have been published on retinopathy and diabetic pregnancy. In 1980 Horvat et al. published a large prospec¬ tive study of 279 women examined through 346 pregnancies. One hundred and seventy-two had manifest diabetes and 107 were latent diabetics.The average course of proliferative retinopathy was found to be unaffected by pregnancy. It was emphasized that treatment with photocoagulation during pregnancy of patients with deteriorating proliferative retinopathy improved the prognosis with respect to retinal changes. Further, prolifera¬ tive retinopathy was associated with more than twice the fetal loss as that seen in patients with only background retinopathy.Hercules et al. (1980) followed 11 diabetic women with proliferative retinopathy during 13 pregnancies and a group of non-pregnant women with IDD served as controls. No control group of pregnant diabetics was included. The authors found that photocoagulation given during preg¬ nancy or in the early post-partum period signifi¬ cantly improved the proliferative status at the optic disc. Therapeutic abortion was thus not justified for ophthalmological reasons. La...

Chromosome studies were carried out in a girl because of psychomotor retardation and difficulty in swallowing. The girl was admitted to hospital for the first time when 25 months old. The most characteristic signs revealed by the physical examination were short distal ulnar phalanges, clitoral hypertrophy, and very thin outer ear cartilages. An interstitial deletion of the long arm of chromosome 7 was observed: 7q22::7q31. Laboratory investigations revealed a remarkably high levels of IgG, immunoglobulin, and an elevated value of serum FSH. No evidence of gene loci located at the deleted part of chromosome 7 were found.

Fundus affliction with generalized scleroderma was studied in 21 patients by ophthalmoscopy, fundus ocular photography and fluorescein angiography. Slitlamp examination of the anterior chamber, the iris and the lens revealed no evident affections. Neither did ophthalmoscopy reveal obvious abnormalities related to scleroderma. Abnormalities of pigmentation were not noted. Visual acuity was normal in 20 patients, and 1 patient had reduced visual acuity due to macular degeneration. Fundus fluorescein angiography was within normal physiological variation in 14, and definitely abnormal in 7 patients as assessed independently by 2 ophthalmologists. Angiographic abnormalities consisted of variable hyperfluorescence of the pigment epithelium layer, and, additionally, in 2 cases minute hyperfluorescence of the retinal layer. These angiographic abnormalities indicated affection of the retinal pigment epithelium probably caused by a vascular lesion of the choroidal layer. Retinal vessels were in general not affected. In conclusion, the choroidal vasculature appears affected in 1/3 of patients with generalized scleroderma as assessed by fundus fluorescein angiography.

Summary A case of localized scleroderma ‘en coup de sabre’ in the right side of the front associated with myopathy of external eye muscles (levator palpebrae and rectus superior) at the same line is reported. It is discussed whether a predisposition to the disease might be laid down in the mesenchyme in early foetal life before the differentiation of the anatomical structures.