RESUMEN
In contrast to developing countries, xerophthalmia is rather rare in developed countries. Malnutrition (e.g. in mentally deficient or psychiatric patients), chronic liver diseases (e.g. due to alcoholism), or bowel surgery can be reasons for vitamin A deficiency in developed countries. The prodromal stage of hypovitaminosis A is characterized by nyctalopia, which often manifests subclinically. Longer lasting and severe cases of vitamin A deficiency may be complicated by the occurrence of keratinizing metaplasia in the cornea and conjunctiva, xerosis, keratomalacia or blindness.
Asunto(s)
Trastornos Inducidos por Alcohol/diagnóstico , Trastornos Inducidos por Alcohol/tratamiento farmacológico , Trastornos de la Visión/prevención & control , Deficiencia de Vitamina A/diagnóstico , Deficiencia de Vitamina A/tratamiento farmacológico , Xeroftalmia/diagnóstico , Xeroftalmia/tratamiento farmacológico , Corticoesteroides/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Resultado del Tratamiento , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiología , Vitamina A/uso terapéutico , Xeroftalmia/etiologíaRESUMEN
The visual functional diagnostics for patients with advanced glaucomatous optic neuropathy are subject to challenge. Reduced visual acuity, instable fixation and extensive scotomata frequently lead to incorrect results within the central 30° or 24° field. Static automatic perimetry (SAP) in particular is often hampered by extended examination time and fatigue especially in older patients. Focusing of the examination towards the central 10° field using a dense test grid (2° distance between stimulus locations) allows a more exact assessment of the small remaining central island. Tailoring the examination area towards the central 10° field may be useful even in cases with a mean deviation (MD) of 15 dB. In cases of advanced visual field loss kinetic perimetry is superior to static perimetry for various reasons: sharply demarcated visual field defects can be comparatively easily delineated (edge detection); the results are more reliable because fixation can be easily controlled and fatigue is much less pronounced in this interactive examination procedure. However, manual kinetic visual field testing within the central 5° using the conventional Goldmann perimeter is almost impossible due to technical reasons. Semi-automated kinetic perimetry, presenting moving stimuli along interactively defined vectors is a useful tool under these circumstances. The standardized presentation of kinetic stimuli is also feasible within the pericentral region and has particular advantages also with regard to follow-up examinations. On the other hand, detection and delineation of small visual field remnants are comparatively difficult to handle with this kind of vector-based kinetic perimetry.
Asunto(s)
Glaucoma/complicaciones , Glaucoma/diagnóstico , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiología , Pruebas de Visión/métodos , HumanosRESUMEN
Examination of the visual field using static automated perimetry (SAP) is the method of choice for the detection of functional damage secondary to glaucoma. However, with SAP early visual field defects might be missed even if there is already visible damage of the retinal nerve fibre. The microperimetry or beter fundus perimetry provides a detailed examination of the differential luminance threshold within defined retinal areas. However, in contrast to lesions of the retinal receptors, in cases of glaucomatous damage the retinal fibre course has to be considered resulting in a displacement between the structural lesion and the location of the related functional defect. The functional damage may be detected at earlier stages and with enhanced spatial resolution compared to conventional SAP. The extra costs and time associated with the application of fundus perimetry have prevented its widespread use. Current developments are leading to new options.
Asunto(s)
Glaucoma/complicaciones , Glaucoma/diagnóstico , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiología , Pruebas del Campo Visual/métodos , HumanosRESUMEN
Headaches are a common and widespread complaint. Differential diagnostics are crucial for successful therapy and often require an interdisciplinary approach. General practitioners tend to refer patients with extraordinary types of headaches to physicians specialized in neurology, ophthalmology and otolaryngology. This article offers an overview about the range of headache disorders particularly associated with the ophthalmologic anatomy and function.
Asunto(s)
Oftalmopatías/complicaciones , Oftalmopatías/diagnóstico , Cefalea/diagnóstico , Cefalea/etiología , Oftalmopatías/terapia , Cefalea/terapia , HumanosRESUMEN
AIM: The aim of this study was to evaluate measurements of the central corneal thickness using OLCR and ultrasound pachymetry (IOPac). MATERIALS AND METHODS: In a retrospective observational study, fifty patients were assessed. Central corneal thickness was measured using OLCR and ultrasound. RESULTS: The IOPac system shows results for the central corneal thickness between 419 µm and 613 µm. The OLCR values ranged between 421 and 598 µm. The coefficient of variation was 1.12 % in the case of the IOPac and 0.97 % in the case of the OLCR. The paired Student's t-test showed no significant differences between the two methods. The agreement between the two methods was high with r = 0.929. CONCLUSIONS: The agreement between the results for the central corneal thickness using OLCR and ultrasound is high. The OLCR is a non-touch technology that does not require local anaesthesia, thus further reducing the risk of infection or mechanical trauma. Especially in surgical applications or glaucoma assessments, movement artefacts need to be ruled out, which potentially could cause wrong values and thus lead to wrong decisions.
Asunto(s)
Córnea/fisiopatología , Técnicas de Diagnóstico Oftalmológico/instrumentación , Glaucoma/diagnóstico , Glaucoma/fisiopatología , Refracción Ocular , Procesamiento de Señales Asistido por Computador/instrumentación , Tomografía de Coherencia Óptica/instrumentación , Ultrasonografía/instrumentación , Femenino , Humanos , Presión Intraocular/fisiología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Estadística como AsuntoRESUMEN
The Ocular Hypertension Treatment Study (OHTS) has shown that analyzing changes of the optic disc configuration is superior to evaluating visual field findings for the early detection of primary open angle glaucoma. The Confocal Scanning Laser Ophthalmoscopy Ancillary Study (CSLO) is the first study to reveal that certain topographic baseline measurements of the optic disc are significantly associated with the development of primary open angle glaucoma in patients with ocular hypertension. An abnormally increased "mean height contour" value proved to be the individual parameter connected with the highest risk. The reliability of the Moorfields Regression Analysis of certain individual sectors during early detection of a primary angle glaucoma is higher than that of the global measurement. The temporal superior and inferior as well as the nasal inferior sectors have the highest positive predictive values and the largest risks in both univariate and multivariate analysis.
Asunto(s)
Glaucoma de Ángulo Abierto/diagnóstico , Microscopía Confocal/métodos , Hipertensión Ocular/diagnóstico , Oftalmoscopía/métodos , Glaucoma de Ángulo Abierto/etiología , Humanos , Hipertensión Ocular/complicaciones , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
The development of laser scanning tomography in the late 1980s enabled the possibility of an exact three-dimensional biomorphorphometry of the optic nerve head. This technique is designed for 3D measurement of the topography of the optic disc with high accuracy and reproducibility. With the development of the Heidelberg retina tomograph with highly advanced and user-friendly software, a quick examination is possible. Currently the instrument is already used on a routine basis in the ophthalmological practice. It has been shown that glaucomatous changes of the optic disc can be detected using laser scanning tomography before perimetric deterioration occurs. Therefore this technique is crucial in the follow-up of glaucoma patients.