Cases reported "Vision Disorders"

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1/4. Optical coherence tomography measurement of nerve fiber layer thickness and the likelihood of a visual field defect.

    PURPOSE: To determine if optical coherence tomography (OCT) measurements of nerve fiber layer (NFL) thickness can be used to predict the presence of visual field defects (VFD) associated with glaucoma.DESIGN: Quota-sampled, cross-sectional study.methods: Retrospective study of OCT NFL thickness measurements in 276 eyes of 276 subjects. All persons received OCT NFL thickness analysis; 136 eyes underwent frequency-doubling technology (FDT) perimetry; and 140 eyes underwent Swedish interactive threshold algorithm (SITA) perimetry. We defined a parameter called NFL(50), which is the NFL thickness value at which there was a 50% likelihood of a VFD with either SITA or FDT perimetry. We evaluated the use of NFL(50).RESULTS: The mean NFL thickness with (n = 68) and without (n = 68) a VFD in the FDT group was 93.2 microm /- 22.6 and 108.4 microm /- 14.1, respectively. The mean NFL thickness with (n = 70) and without (n = 70) a VFD in the SITA group was 78.9 microm /- 24.8 and 103.0 microm /- 18.0, respectively. The FDT mean NFL(50) value was 98.5 microm. The SITA mean NFL(50) value was 87.0 microm. The area under the receiver operator characteristic (AROC) curve for mean NFL was 0.73, and the positive predictive value (PPV) for FDT mean NFL(50) was 72.2%. For SITA mean NFL, the AROC was 0.79 and the PPV for NFL(50) was 77.2%.CONCLUSION: Nerve fiber layer thickness analysis using OCT may be clinically useful in identifying subjects who have visual field loss. However, the PPV suggests that OCT may need higher resolution and better reproducibility to enhance its sensitivity and specificity for population screening.
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ranking = 1
keywords = specificity
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2/4. Rotary diamond Chart--a new visual field screening device.

    The Rotary diamond Chart (RDC) is presented as a new clinical method suitable for screening general optometry patients for visual field defects. A pilot study was conducted using both the rotary diamond chart and a central 76-point threshold-related screening test (Allergan-Humphrey) on 21 consecutive clinical patients. Full-threshold field testing was then completed on those subjects failing either screening test. The RDC detected five of six visual field defects including one very subtle defect which was not detected by the automated screening test. The sensitivity of the RDC visual field screening assessment was 83.33 percent with a specificity of 100 percent. These results suggest that the RDC is an effective clinical visual field screening test. It is easy for the clinician to use and for the patient to understand.
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ranking = 1
keywords = specificity
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3/4. Specificity of IHS criteria in childhood headache.

    We prospectively assessed the relative specificity of the International headache Society (IHS) criteria in 30 children referred to a pediatric neurologist. An important cause of headache, including raised intracranial pressure with slit ventricle syndrome, would have been missed in 4 children if one had relied on IHS criteria alone. Specific revisions have been proposed to minimize misclassification and further enhance the relevance of the IHS document for children.
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ranking = 1
keywords = specificity
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4/4. Muller cell-specific autoantibodies in a patient with progressive loss of vision.

    PURPOSE: To study the specificity of circulating retinal autoantibodies in a patient with progressive loss of vision resembling cancer-associated retinopathy in the absence of systemic malignancy. methods: Patient's serum was tested for the presence of antiretinal antibodies by Western blot analysis, and immunohistochemical analysis was performed on cryosections of rat retina and on cultured rat retinal Muller cells. RESULTS: Western blot analysis revealed that the serum contained a high titer of autoantibodies against a 35-kDa retinal antigen. A protein of similar molecular weight and antigenicity has been found to be present in protein extracts of bovine, rat, and fish retina. Immunohistochemical analysis suggested that the autoantibodies did not localize to retinal neural cells, as reported for several other putative autoimmune retinal disorders, but rather to the retinal Muller cells. This cell type-specificity could be confirmed using purified cultured retinal Muller cells. CONCLUSIONS: These results suggest that an autoimmune response directed against the retinal Muller cells, in the absence of overt systemic malignancy, may lead to a slow-developing visual deterioration.
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ranking = 2
keywords = specificity
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