| 1. |
- Asman, P, et al.
(författare)
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Evaluation of methods for automated Hemifield analysis in perimetry
- 1992
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Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 110:6, s. 6-820
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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.
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| 2. |
- Asman, P, et al.
(författare)
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Glaucoma Hemifield Test. Automated visual field evaluation
- 1992
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Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 110:6, s. 9-812
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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.
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| 3. |
- Aspberg, Johan, et al.
(författare)
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Estimating the Length of the Preclinical Detectable Phase for Open-Angle Glaucoma
- 2023
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Ingår i: JAMA Ophthalmology. - : American Medical Association (AMA). - 0003-9950 .- 2168-6165. ; 141:1, s. 48-54
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: A 50% reduction of glaucoma-related blindness has previously been demonstrated in a population that was screened for open-angle glaucoma. Ongoing screening trials of high-risk populations and forthcoming low-cost screening methods suggest that such screening may become more common in the future. One would then need to estimate a key component of the natural history of chronic disease, the mean preclinical detectable phase (PCDP). Knowledge of the PCDP is essential for the planning and early evaluation of screening programs and has been estimated for several types of cancer that are screened for.OBJECTIVE: To estimate the mean PCDP for open-angle glaucoma.DESIGN, SETTING, AND PARTICIPANTS: A large population-based screening for open-angle glaucoma was conducted from October 1992 to January 1997 in Malmö, Sweden, including 32 918 participants aged 57 to 77 years. A retrospective medical record review was conducted to assess the prevalence of newly detected cases at the screening, incidence of new cases after the screening, and the expected clinical incidence, ie, the number of new glaucoma cases expected to be detected without a screening. The latter was derived from incident cases in the screened age cohorts before the screening started and from older cohorts not invited to the screening. A total of 2029 patients were included in the current study. Data were analyzed from March 2020 to October 2021.MAIN OUTCOMES AND MEASURES: The length of the mean PCDP was calculated by 2 different methods: first, by dividing the prevalence of screen-detected glaucoma with the clinical incidence, assuming that the screening sensitivity was 100% and second, by using a Markov chain Monte Carlo (MCMC) model simulation that simultaneously derived both the length of the mean PCDP and the sensitivity of the screening.RESULTS: Of 2029 included patients, 1352 (66.6%) were female. Of 1420 screened patients, the mean age at screening was 67.4 years (95% CI, 67.2-67.7). The mean length of the PCDP of the whole study population was 10.7 years (95% CI, 8.7-13.0) by the prevalence/incidence method and 10.1 years (95% credible interval, 8.9-11.2) by the MCMC method.CONCLUSIONS AND RELEVANCE: The mean PCDP was similar for both methods of analysis, approximately 10 years. A mean PCDP of 10 years found in the current study allows for screening with reasonably long intervals, eg, 5 years.
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| 4. |
- Austeng, Dordi, et al.
(författare)
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Incidence of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden
- 2009
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Ingår i: Archives of ophthalmology (1960). - : American Medical Association (AMA). - 0003-9950. ; 127:10, s. 1315-1319
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine the incidence of retinopathy of prematurity (ROP) in extremely preterm infants born before 27 weeks' gestation in Sweden during a 3-year period. METHODS: A national, prospective, population-based study was performed in Sweden from April 1, 2004, to March 31, 2007. The ophthalmologic part of the study was separately organized, and screening for ROP was performed beginning postnatal week 5. The criteria for the treatment of ROP agreed with the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group. RESULTS: During the study, 506 of 707 live-born infants survived until the first eye examination. Of these, 368 (72.7%) had ROP: 37.9% had mild ROP and 34.8% had severe ROP. Ninety-nine infants (19.6%) were treated. Gestational age at birth was a stronger predictor of ROP than was birth weight. A log-linear relationship between severe ROP and gestational age at birth was found in the present cohort, and the risk of ROP was reduced by 50% for each week of increase in gestational age at birth. CONCLUSIONS: Today, extremely preterm infants are surviving, and this population-based study with ROP as a primary outcome shows a higher incidence of this condition than in previously reported national cohorts.
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| 5. |
- Austeng, Dordi, et al.
(författare)
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Natural history of retinopathy of prematurity in infants born before 27 weeks' gestation in Sweden
- 2010
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Ingår i: Archives of ophthalmology (1960). - : American Medical Association. - 0003-9950. ; 128:10, s. 1289-1294
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the natural history of retinopathy of prematurity (ROP) in 506 extremely preterm infants born before 27 weeks' gestation in Sweden during a 3-year period. Methods: A national population–based study was performed in Sweden from April 1, 2004, to March 31, 2007. According to the study protocol, initial eye examinations were to be performed at postnatal week 5, and examinations were repeated until the retina was completely vascularized or until criteria for treatment were met. The examinations were to be performed weekly, enabling study of the course and severity of ROP. In infants without ROP or with mild ROP without progression during the latest examinations, further examinations were performed weekly or every other week from postmenstrual age 35 weeks. Results: During the study, 368 infants (72.7%) developed ROP. Postmenstrual age at onset of ROP was significantly related to severity of ROP, even when controlling for gestational age (ie, the earlier the onset of ROP, the higher the risk of developing severe ROP). Site of onset of ROP was significantly related to gestational age at birth. The risk of nasal onset was almost doubled for every week of decrease in gestational age at birth. Nasal onset was associated with severe ROP, even after adjusting for gestational age at birth. Conclusion: This population-based study confirms results of the Cryotherapy for Retinopathy of Prematurity study and shows new correlations regarding time and site of onset of ROP, both of which are associated with disease severity.
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| 6. |
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| 7. |
- Bengtsson, Boel, et al.
(författare)
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Prediction of glaucomatous visual field loss by extrapolation of linear trends.
- 2009
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Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 127:12, s. 1610-1615
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate how well short-term progression rates can predict long-term visual field outcomes in patients with glaucoma. METHODS: We calculated visual field rates of progression using linear regression analysis of the Visual Field Index (VFI) for 100 consecutive patients with glaucoma having 10 or more Swedish Interactive Thresholding Algorithm standard field tests. Final VFI was predicted on the basis of linear extrapolation of the slope defined by the initial 5 field test results. Final VFI also was estimated using linear regression of all qualifying examination results for each patient. Primary outcome measures were the absolute difference and the correlation between predicted and estimated final VFI values. RESULTS: Patient follow-up averaged 8.2 years and 11 field examinations. Median VFI progression rate was -1.1% per year both for the initial 5 test results and also for the complete series. Seventy percent of patients had a predicted final VFI within +/-10% of the estimated final VFI, and the 2 VFI calculations had a correlation coefficient of 0.84. CONCLUSION: Linear extrapolation based on 5 initial visual field test results was a reliable predictor of future field loss in most patients. Patients in whom linear regression analysis suggests dangerously rapid rates of visual field progression may be candidates for significant alterations in therapy.
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| 8. |
- Burstedt, Marie, et al.
(författare)
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Central Retinal Findings in Bothnia Dystrophy Caused by RLBP1 Sequence Variation
- 2010
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Ingår i: Archives of ophthalmology (1960). - : American Medical Association. - 0003-9950. ; 128:8, s. 989-995
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the central retinal findings early in the course of Bothnia dystrophy caused by the homozygous missense R234W sequence variation in the RLBP1 gene. Methods: In 8 young patients with Bothnia dystrophy (aged 9-34 years), high- and low-contrast distance visual acuity and visual fields were measured with Humphrey central (24-2) threshold testing and Goldmann perimetry. Central retinal thickness was measured with optical coherence tomography. Cross-sectional images were analyzed and a linear scanning protocol was applied to examine retinitis punctata albescence in the posterior pole. Results: Affected visual acuity (4 of 8 cases) and poor low-contrast visual acuity (8 of 8 cases) were found. Significant foveal depression and visual field loss were evident with Humphrey threshold testing at all ages, and paracentral and central scotomata in the second decade of life advanced in adulthood as verified with Goldmann perimetry. Optical coherence tomography showed generalized retinal thinning in the central foveal, foveal (innermost ring diameter [empty set], 1 mm), and inner ring (empty set, 3 mm) areas in all ages, and early retinal thinning was found in the inferior areas of the outer macula (empty set, 6 mm). Foveal and extrafoveal thinning of the retinal layers and outer nuclear layer were found. Homogeneous retinitis punctata albescence changes were visualized in and/or adjacent to the retinal pigment epithelium choriocapillaris complex with high reflectance. Conclusions: In the RLBP1 Bothnia dystrophy phenotype, a loss of function and thinning of the central macula are found, indicating early damage of the cone photoreceptors in this disease of the visual cycle. Retinitis punctata albescence spots in the posterior pole are situated close to or in the retinal pigment epithelium-choriocapillaris complex.
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| 9. |
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| 10. |
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| 11. |
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| 12. |
- Frisén, Lars, 1939, et al.
(författare)
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Drusen in the optic nerve head. Verification by computerized tomography.
- 1978
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Ingår i: Archives of ophthalmology (Chicago, Ill. : 1960). - 0003-9950. ; 96:9, s. 1611-4
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Tidskriftsartikel (refereegranskat)abstract
- Five patients with a clinical diagnosis of buried or exposed drusen of the optic nerve head were examined by computerized tomography (CT). The relative x-ray absorption within their nerve heads was significantly larger than in controls, reflecting the high calcium content of drusen. Computerized tomography, and particularly high-definition CT, therefore merits consideration in the investigation of disc swelling.
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| 13. |
- Frisén, Lars, 1939
(författare)
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Fundus changes in acute malnutritional optic neuropathy.
- 1983
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Ingår i: Archives of ophthalmology (Chicago, Ill. : 1960). - 0003-9950. ; 101:4, s. 577-9
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Tidskriftsartikel (refereegranskat)abstract
- A peculiar dilation and tortuosity of small retinal vessels within the arcuate areas of the retinal nerve fiber layer occurred in a series of patients with acute malnutritional optic neuropathy ("tobacco-alcohol amblyopia"). These evanescent vascular abnormalities may be caused by arteriovenous shunting. They seem to be specific indicators of the early phase of this disease.
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| 14. |
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| 15. |
- Frisén, Lars, 1939
(författare)
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Vanishing optotypes. New type of acuity test letters.
- 1986
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Ingår i: Archives of ophthalmology (Chicago, Ill. : 1960). - 0003-9950. ; 104:8, s. 1194-8
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Tidskriftsartikel (refereegranskat)abstract
- Acuity test letters generated on a television monitor were studied with regard to detection and resolution thresholds, both for the native configurations and after high-pass spatial frequency filtering. Comparisons were made with printed acuity charts of different contrast. Filtering diminished the interval between detection and resolution thresholds. Under some circumstances, a small (1 dB, about 26%) increment in size could make a previously invisible optotype clearly visible, or vice versa. The term vanishing optotype is suggested for acuity targets with this peculiar property. Vanishing optotypes do not seem useful for routine clinical acuity testing, but they may be advantageous, for example, in preferential looking-acuity tests for infants and visual field examinations. Like the present tests, such novel applications can be generated relatively easily on personal computers.
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| 16. |
- Friström, Björn, et al.
(författare)
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Interaction of PhXA41, a New Prostaglandin Analogue, With Pilocarpine : A Study on Patients With Elevated Intraocular Pressure
- 1993
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Ingår i: Archives of ophthalmology (1960). - 0003-9950. ; 111:5, s. 662-665
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Tidskriftsartikel (refereegranskat)abstract
- Objective. —To evaluate the effects of PhXA41, a new prostaglandin analogue, on the intraocular pressure (IOP) in patients receiving pilocarpine treatment and the effects of pilocarpine in patients receiving PhXA41 treatment.Design. —Twenty patients with ocular hypertension were randomized into two parallel groups. The treatment period was 2 weeks. Ten patients in group 1 were given PhXA41 twice daily during week 1 and, in addition, pilocarpine three times daily during week 2. Ten patients in group 2 received pilocarpine three times daily during week 1 and PhXA41 twice daily in addition during week 2. PhXA41 was used in a concentration of 0.006%, and pilocarpine was given in a concentration of 2%.Main Outcome Measures. —In group 1, the mean IOP on day 0 was 25.1 mm Hg; on day 7,19.1 mm Hg; and on day 14,17.6 mm Hg. In group 2, the mean IOP on day 0 was 23.8 mm Hg; on day 7,20.4 mm Hg; and on day 14,17.7 mm Hg.Results. —PhXA41 had a clinically significant IOP-lowering effect (23.4% reduction on day 7 as compared with baseline day (P<.001). The corresponding value with pilocarpine was 14.3% (P<.001). When pilocarpine was added to PhXA41, the additional IOP reduction was 7.4% (P<.01) compared with 14.2% (P<.01) when PhXA41 was added to pilocarpine. The two groups were found to have an almost equal reduction in IOP on day 14 (group 1,29.4%; group 2, 26.6%). No serious adverse reactions were seen. Some conjunctival hyperemia in the PhXA41-treated eyes was noted on day 7, as compared with the pilocarpine-treated eyes, but there were few complaints of discomfort.Conclusions. —This study indicated that PhXA41 could be useful in the treatment of glaucoma, as monotherapy, or in certain cases in combination with pilocarpine.
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| 17. |
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| 18. |
- Heijl, A, et al.
(författare)
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A clinical study of perimetric probability maps
- 1989
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Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 107:2, s. 199-203
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Tidskriftsartikel (refereegranskat)abstract
- Perimetric probability maps depict visual field results in terms of the frequency with which the measured findings are seen in a normal population. We tested clinically the importance of the model of the normal visual field used to calculate such maps. Forty-one eyes of 41 normal subjects and 58 eyes of 46 glaucomatous patients were studied. Probability maps were calculated by means of two different models of the normal visual field. The first model assumed gaussian threshold distributions with constant variability across the field. The second used empirically determined nongaussian location-dependent threshold distributions. Probability maps using the empiric model allowed better separation between glaucomatous and normal eyes, and the number of significant points in normal subjects was in better agreement with the theoretically expected number. The gaussian model yielded an unacceptably high frequency of significant points in normal fields, particularly in the midperiphery. The clinical usefulness of perimetric probability maps depends critically on the choice of normal visual field model.
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| 19. |
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| 20. |
- Heijl, A, et al.
(författare)
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Computerized profile perimetry in glaucoma
- 1980
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Ingår i: Archives of Ophthalmology. - 0003-9950. ; 98:12, s. 201-2199
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Tidskriftsartikel (refereegranskat)abstract
- The new profile testing mode of the COMPETER automatic perimeter was clinically tested and compared with careful manual profile perimetry on the Tübinger perimeter. Each of 110 patients with glaucomatous field defects, patients with suspected glaucoma, and normal subjects had one meridian tested. All of the 55 patients who showed an abnormal result on the manual profile also had abnormal findings on the automatic test. Two (4%) of the profiles labeled as normal on initial manual perimetry were identified by the automatic perimeter to be abnormal, and these defects were confirmed on repeated manual profile perimetry. The automatic perimetry gave five (9%) false-positive results in the 53 normal manual profiles, thus giving a specificity of 91%. In two of these cases, the automatic profile indicated defects in areas where the manual profile appeared normal, but there was abnormality in the manual kinetic perimetry in the affected area. The automatic profiles of the COMPETER automatic perimeter are accurate, sensitive, time-saving, and clinically useful.
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| 21. |
- Heijl, A, et al.
(författare)
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Glaucoma follow-up when converting from long to short perimetric threshold tests
- 2000
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Ingår i: Archives of Ophthalmology. - 0003-9950. ; 118:4, s. 93-489
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study the influence of test length in automated perimetry follow-up of glaucomatous eyes and, particularly, to determine if it is possible to usefully interpret test results obtained using a testing algorithm shorter than that used for baseline testing.METHODS: Automated perimetry findings were retrospectively evaluated in 31 patients with glaucoma for whom multiple Humphrey 30-2 tests were available on the Full Threshold strategy and the SITA Standard strategy.RESULTS: Variability around the mean deviation regression lines was smaller with SITA than with the Full Threshold strategy. Mean deviation values with SITA averaged about 1 dB less severe. Although localized scotomas measured in decibels were deeper on the Full Threshold strategy, number of significantly depressed points on total deviation and pattern deviation probability plot analyses did not differ significantly between the 2 strategies.CONCLUSIONS: The SITA strategy showed test-retest consistency that was at least as good as that of the Full Threshold strategy. The 2 strategies produced similar results when analyzed relative to their respective normal significance limits. Generally, it is appropriate to establish a new baseline when converting from one perimetric algorithm to another. When necessary, however, results may be usefully compared if such comparisons are based on total and pattern deviation probability maps rather than on decibel values.
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| 22. |
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| 23. |
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| 24. |
- Heijl, Anders, et al.
(författare)
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The effect of perimetric experience in normal subjets
- 1989
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Ingår i: Archives of Ophthalmology. - 0003-9950. ; 107:1, s. 81-86
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Tidskriftsartikel (refereegranskat)abstract
- Two groups of normal subjects were submitted to repeated automated static threshold perimetry. Perimetric results were strongly affected by the level of experience in some subjects; in the majority, however, the effect of experience was small. Initial field tests often showed high numbers of depressed points. Sensitivity increased with perimetric training, particularly between the first sessions. Those subjects who improved most started low, gradually approaching normal levels with experience. Learning effects were more pronounced peripherally than paracentrally and "untrained" fields characteristically showed concentric contraction with numerous points with low sensitivity peripherally. An important practical conclusion is to allow repeated testing of all inexperienced patients in whom initial fields do not agree with clinical findings. A chart showing a concentrically narrowed field should be viewed with particular suspicion. Furthermore, a single initial field may constitute an inadequate baseline for clinical follow-up.
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| 25. |
- Heijl, A, et al.
(författare)
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The effect of perimetric experience in patients with glaucoma
- 1996
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Ingår i: Archives of Ophthalmology. - 0003-9950. ; 114:1, s. 19-22
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study prospectively the effects of perimetric learning in glaucoma patients.PATIENTS AND METHODS: Twenty-five patients with newly detected glaucoma underwent repeated perimetric testing using the 30-2 full threshold program with the Humphrey perimeter. Each patient was tested five times at about 1-week intervals. No patient had undergone perimetry before entering the study.RESULTS: In most patients, visual field results improved with repeated testing. Improvements were obvious in 21 of the 37 glaucomatous eyes. Means of mean deviation values improved significantly, by 2.81 dB (P < .001, analysis of variance), between the first and the second test session, and no significant differences were shown between tests 2 and 5. Fields with moderate field loss improved more than fields with milder or more severe loss. Learning effects were more pronounced peripherally than centrally, and better points improved more than more disturbed ones.CONCLUSIONS: The effects of perimetric learning were large and common, and are clinically important. Baselines for perimetric follow-up of patients with glaucoma should consist of more than one test. To avoid misleading conclusions, studies using perimetry to assess the effects of glaucoma treatment should take learning effects into consideration.
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