Discoid lupus erythematosus (DLE) is a chronic cutaneous disease characterized by inflammatory plaques that, in the absence of prompt diagnosis and treatment, may lead to disfiguring scarring and skin atrophy. However, there is limited evidence for which treatments are most effective. Currently, no medications have been approved specifically for the treatment of DLE. Many of the drugs described in the literature were developed for use in other immune disorders. This review will summarize current therapeutic options for DLE and their supporting evidence with discussion of prevention, topical measures, physical modalities, and systemic therapies, including newer potential therapies.
I. Analysis of the structure-function relationship in the linear scale with the broken-stick model We also applied the broken-stick model to the VF data and the MDB structural parameters both in the linear scale. When the VF TD data was transformed to the linear scale, the observation that "the structurefunction relationship displayed a plateau, with neuroretinal rim thickness values being unrelated to VF values" was not readily visualized in some of quadrants/ sectors (Figure S1). Further statistical evaluation shows that the slopes above the tipping point are not significantly different from 0, as shown in Table S1. We added in a model-agnostic lowess smoothing curve to compare with the fitted broken-stick model on the data of unlogged VF TD against the MDB. The broken stick model fit didn't match with the lowess fit for the Temporal-Inferior region and the Inferior quadrant. Furthermore, the breakpoint didn't exist for the nasal and temporal quadrants and the TS and NI octants, as shown in the table below where the pvalues are greater than 0.05 (Table S1). For the breakpoints which did exist (i.e. the global value, superior and inferior quadrants, TI and NS sectors), the fitted breakpoints in the linear scale were different for the breakpoints obtained in the logarithmic fits and not encompassed by their respective confidence intervals from the logarithmic scale. As a final remark, indeed the question of whether the structure-function relationship between the VF data and the neuroretinal rim data should be established as a logarithmic-linear scale or as a linear-linear scale has been actively studied in the past two decades. 1-4 A variety of models have been employed to describe the structure-function relationship in both the linear and curvilinear regimes. With this rich history of research on this topic behind us, we primarily presented the data by looking at the VF in the logarithmic scale (or in its native "untransformed" form) since it is more clinically utilized. Also, the logarithmic scale helps to distinguish among the moderate and severe glaucomatous patients.
Purpose To assess the structure-function relationship in glaucoma using Humphrey visual field (HVF) perimetry and a three-dimensional neuroretinal rim parameter derived from spectral domain optical coherence tomography (SD-OCT) volume scans. Methods Structure-function correlation was analyzed globally and regionally (four quadrants and four sectors). Structural data included peripapillary retinal nerve fiber layer (RNFL) thickness and minimum distance band (MDB) neuroretinal rim thickness, defined as the shortest distance between the inner cup surface and the outer retinal pigment epithelium/Bruch's membrane complex. Logarithmic regression analyses were performed and Pearson correlation coefficients determined to assess relationship strength. Results The study consisted of 102 open-angle glaucoma patients and 58 healthy subjects. The Pearson correlation coefficient for global MDB thickness ( R = 0.585) was higher than for global RNFL thickness ( R = 0.492), but the difference was not statistically significant ( P = 0.18). The correlation coefficients for regional MDB thicknesses and corresponding HVF sensitivities were higher than those for regional RNFL thicknesses and HVF in six out of eight regions ( P = 0.08 to 0.47). In the remaining two out of eight regions, the correlation coefficients were higher for RNFL thickness than for MDB thickness ( P = 0.15 to 0.20). Conclusions Three-dimensional MDB neuroretinal rim thickness relates to visual function as strongly as the most commonly used SD-OCT parameter for glaucoma, two-dimensional peripapillary RNFL thickness. Translational Relevance This paper illustrates the potential for 3D OCT algorithms to improve in vivo imaging in glaucoma.
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