| 1. |
|
|
| 2. |
- Chauhan, B C, et al.
(författare)
-
Practical Recommendations for Measuring Rates of Visual Field Change in Glaucoma
- 2008
-
Ingår i: British Journal of Ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 92, s. 569-573
-
Tidskriftsartikel (refereegranskat)abstract
- Statement of Interest Assessment of visual field damage is the major index of the functional impact of glaucoma with direct relevance to quality of life measures. Visual field change was used as a primary endpoint for progression in the recent glaucoma trials and its measurement is the cornerstone of glaucoma management influencing therapeutic decisions. The objective of this perspective is to provide practical recommendations for measuring clinically relevant rates of glaucomatous visual field progression to help identify patients at risk for visual impairment. They focus on the frequency of examinations required for detecting various amounts and rates of visual field change.
|
|
| 3. |
- Heijl, Caroline, et al.
(författare)
-
Incidence of malignancy in patients treated for antineutrophil cytoplasm antibody-associated vasculitis: follow-up data from European Vasculitis Study Group clinical trials.
- 2011
-
Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 70, s. 1415-1421
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: /st> Because standard immunosuppressive treatment for antineutrophil cytoplasm antibody-associated vasculitis (AAV) (granulomatosis with polyangiitis (Wegener's) (GPA) and microscopic polyangiitis (MPA)) has been associated with a significant risk of developing cancer, the cancer incidence of treated AAV patients was assessed. METHODS: /st> This analysis concerned 535 patients with newly diagnosed AAV from 15 countries who had been enrolled between 1995 and 2002 in four European clinical trials. Over the period 2004-7, study participants' follow-up events were updated, including cancers diagnosed. Age, sex and area-standardised incidence ratios (SIR) and their 95% CI were calculated by linkage to five national cancer databases. RESULTS: /st> During the 2650 person-years' observation period, 50 cancers were diagnosed in 46 patients. SIR (95% CI) were 1.58 (1.17 to 2.08) for cancers at all sites, 1.30 (0.90 to 1.80) for cancers at all sites excluding non-melanoma skin cancer (NMSC), 2.41 (0.66 to 6.17) for bladder cancer, 3.23 (0.39 to 11.65) for leukaemia, 1.11 (0.03 to 6.19) for lymphoma and 2.78 (1.56 to 4.59) for NMSC. Subgroup SIR for cancers at all sites were 1.92 (1.31 to 2.71) for GPA and 1.20 (0.71 to 1.89) for MPA. CONCLUSIONS: /st> Cancer rates for AAV patients treated with conventional immunosuppressive therapy exceeded those expected for the general population. This cancer excess was largely driven by an increased incidence of NMSC. The smaller cancer risk magnitude in this cohort, compared with previous studies, might reflect less extensive use of cyclophosphamide in current treatment protocols. Longer follow-up data are warranted to appraise the risk of developing cancers later during the course of AAV.
|
|
| 4. |
- Henricsson, M., et al.
(författare)
-
Mortality in diabetic patients participating in an ophthalmological control and screening programme
- 1997
-
Ingår i: Diabetic Medicine. - 0742-3071. ; 14:7, s. 576-583
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this follow-up study has been to assess retinopathy and change of treatment to insulin therapy as risk factors for mortality in diabetic patients participating in a control and screening programme for retinopathy. A total of 3220 diabetic patients, 483 with an age at diagnosis <30 years, and 2737 with an age at diagnosis ≤30 years, were included. Retinopathy was graded on fundus photographs using the Wisconsin Scale, and the visual acuity was assessed. The average HbA(1c) value was calculated for each patient for the previous 8 years to estimate long-term glycaemic control. Mortality data were obtained from death certificates. Two hundred and sixty-three diabetic patients (8.2 %) died during the mean follow-up time of 3.4 years, 13 (2.7 %) of those with younger-onset (<30 years) and 250 (9.1%) of those with older-onset (≤30 years) diabetes. Of them, 148 (56.3 %) died from cardiovascular and 23 (8.7 %) from cerebrovascular disorders. After adjusting for differences in age and sex, more severe retinopathy and the use of antihypertensive drugs were associated with a decreased overall survival rate as well as an increased mortality from cardiovascular and cerebrovascular diseases. A statistically significant association between HbA(tc) values in the highest quartile, i.e. ≤8.4 %, and cardiovascular and all cause mortality did not remain when retinopathy was entered into the multivariate analyses. Duration of diabetes, but not change of treatment to insulin therapy, was associated with higher cardiovascular mortality in patients whose diabetes was diagnosed after the age of 30 years. We conclude that severe retinopathy, use of antihypertensive drugs, and poor glycaemic control predicted death from cardiovascular disease in diabetic patients participating in an ophthalmological screening programme.
|
|
| 5. |
- Airaksinen, P J, et al.
(författare)
-
Visual field and retinal nerve fibre layer in early glaucoma after optic disc haemorrhage
- 1983
-
Ingår i: Acta Ophthalmologica. - : Wiley. - 0001-639X .- 1755-375X. ; 61:2, s. 94-186
-
Tidskriftsartikel (refereegranskat)abstract
- Computerized visual field testing with the Competer automatic perimeter including automatic profile perimetry revealed early glaucomatous field loss in 9 of 10 eyes with photographically demonstrable retinal nerve fibre layer (RNFL) defects after optic disc haemorrhages despite the fact than conventional routine perimetry had failed to do so. In 7 of these cases the Competer central pattern test was abnormal; in 2 cases field defects could be shown only when automatic high-resolution static profile perimetry was performed and directed according to the information present in wide-angle RNFL photographs. A field defect was also found in one of five eyes with no photographic RNFL changes. Visual field defects seem to occur in a higher proportion of cases with RNFL defects than was previously thought, but they can be very subtle and hard to find. There are, however, cases where in spite of the presence of an indisputable RNFL defect no visual field defects can be shown even with painstaking technique and conversely field defects may be present without RNFL defects. Automatic perimetry and RNFL photography complement each other in early detection and quantitation of glaucomatous damage.
|
|
| 6. |
- Asman, P, et al.
(författare)
-
Arcuate cluster analysis in glaucoma perimetry
- 1993
-
Ingår i: Journal of Glaucoma. - 1057-0829. ; 2:1, s. 13-20
-
Tidskriftsartikel (refereegranskat)abstract
- Typical glaucomatous visual field defects are often contiguous areas of diminished differential light sensitivity presenting as clusters of abnormally depressed points in the visual field chart. We investigated the value of recognizing arcuate cluster patterns, corresponding to the anatomy of the normal retinal nerve fiber layer. Cluster sizes were quantified using cluster volume and surface area. Clusters were analyzed separately in different regions of the visual field. Central 30 degrees static threshold fields from 87 eyes of 87 normal subjects and 101 eyes of 101 patients with glaucoma were studied. The two groups were discriminated with logistic regression. Central and nasal clusters were more indicative of glaucoma than were equally large clusters in other areas. Discrimination of normal and glaucoma eyes was significantly better with arcuate cluster analysis than with a traditional cluster analysis, which did not take cluster shape into account. Thus, arcuate cluster analysis was more sensitive to early central, paracentral, or nasal glaucomatous field loss and at the same time capable of deemphasizing common test artifacts and nondiagnostic field disturbances. Arcuate cluster volume gave better classification than did arcuate surface area. The results indicate that analysis of arcuate clusters offers substantial advantages as compared with traditional cluster analysis for recognition of early glaucomatous visual field loss.
|
|
| 7. |
- Asman, P, et al.
(författare)
-
Evaluation of adaptive spatial enhancement in suprathreshold visual field screening
- 1988
-
Ingår i: Ophthalmology. - 0161-6420. ; 95:12, s. 62-1656
-
Tidskriftsartikel (refereegranskat)abstract
- Sixty-three normal subjects and 94 abnormal patients, most of whom had glaucoma, were tested in the central visual field using a threshold-related, eccentricity-compensated, spatially adaptive suprathreshold screening program and a full-threshold program on the Humphrey field analyzer. The initial stimulus locations on the screening test were identical to those of the threshold test; additional screening stimuli were presented surrounding each missed initial stimulus. Surprisingly, this spatial enhancement strategy did not improve sensitivity or specificity rates of the screening beyond that achieved by considering the initial stimulus locations alone. Points missed during screening often showed a depressed sensitivity rate (measured threshold greater than 6 dB below the age-corrected normal reference value) in the same area of the threshold field. This was true in fields from abnormal and normal subjects. This finding of persistent shallow defects in the same test session among otherwise normal persons has disturbing implications for the importance of "confirmed" defects in the diagnosis of disease.
|
|
| 8. |
- Asman, P, et al.
(författare)
-
Evaluation of methods for automated Hemifield analysis in perimetry
- 1992
-
Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 110:6, s. 6-820
-
Tidskriftsartikel (refereegranskat)abstract
- A new aid to perimetric analysis, the Glaucoma Hemifield Test, primarily evaluates up-down differences in automated static visual field tests. We analyzed the visual fields of 163 eyes of 163 normal subjects and 77 eyes of 77 patients with glaucoma diagnosed on bases other than perimetry using the Glaucoma Hemifield Test and a similar, previously developed, hemifield analysis method. The performance of the Glaucoma Hemifield Test was compared with that of the earlier method and the differences in test design were evaluated individually. The Glaucoma Hemifield Test allowed significantly improved separation between the normal group and the group with glaucoma than did the earlier method. This improvement was due to an increase in sensitivity, and was associated with the use of test point significances instead of threshold values, and a large normal database alone in the determination of normal limits.
|
|
| 9. |
- Asman, P, et al.
(författare)
-
Glaucoma Hemifield Test. Automated visual field evaluation
- 1992
-
Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 110:6, s. 9-812
-
Tidskriftsartikel (refereegranskat)abstract
- We have developed an algorithm, the Glaucoma Hemifield Test (GHT), for automated evaluation of single static threshold visual field test results in glaucoma. The GHT uses empirically determined limits of normality for up-down differences in the Statpac probability maps of the Humphrey Field Analyzer to detect localized visual field loss. It is also constructed to detect field loss that is symmetric around the horizontal meridian. Analysis is done in five corresponding pairs of sectors that are based on the normal anatomy of the retinal nerve fiber layer. Deviations from the age-corrected normal threshold in the most sensitive portions of the visual field are used to detect general reductions of sensitivity or abnormally high sensitivities. The GHT provides brief visual field evaluations printed on the field chart as plain text. The aim of this article is to describe the fundamentals of the analysis program and to provide clinical examples.
|
|
| 10. |
- Asman, P, et al.
(författare)
-
Spatial analyses of glaucomatous visual fields; a comparison with traditional visual field indices
- 1992
-
Ingår i: Acta Ophthalmologica. - 0001-639X. ; 70:5, s. 86-679
-
Tidskriftsartikel (refereegranskat)abstract
- Interpretation of numeric automated threshold visual field results is often difficult. A large amount of data is obtained for every single field tested. Various approaches to summarize this data have been suggested, most commonly the mean and standard deviation of departures from age-corrected normal threshold values. These visual field indices differ substantially from subjective field interpretation where spatial relationships are important. We have previously devised two methods for automated field interpretation which take spatial information into account--regional up-down comparisons and arcuate cluster analysis. We now studied the merits of using these new spatial methods and compared them to traditional visual field indices for discrimination between normal and glaucomatous field results. Central static 30 degree field results in 101 eyes of 101 normal subjects and 101 eyes of 101 patients with glaucoma were discriminated using logistic regression analysis. The best field classification was obtained with a spatial visual field model combining up-down differences and arcuate clusters. The advantages of the spatial model were confirmed in an independent material of 163 eyes of 163 normal subjects and 76 eyes of 76 patients with glaucoma where eyes with large field defects had been removed. In this material the spatial model gave 87% sensitivity and 83% specificity while the best non-spatial model gave 82% sensitivity and 80% specificity. Visual field interpretation in glaucoma may be significantly enhanced if detection is focused on circumscribed field loss rather than on averages of differential light sensitivities and similar indices which do not take spatial relationships into consideration.
|
|
