Browsing by Subject "Ocular Hypertension"

Now showing 1 - 3 of 3
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    Comparison of matrix frequency-doubling technology perimetry and standard automated perimetry in monitoring the development of visual field defects for glaucoma suspect eyes
    (PLOS, 2017-05-18) Hu, Rongrong; Wang, Chenkun; Racette, Lyne; Ophthalmology, School of Medicine
    BACKGROUND: Perimetry is indispensable for the clinical management of glaucoma suspects. Our goal is to compare the performance of standard automated perimetry (SAP) and Matrix frequency-doubling technology (FDT) perimetry in monitoring the development of visual field (VF) defects in glaucoma suspect eyes. METHODS: Longitudinal data of paired SAP and FDT from 221 eyes of 155 glaucoma suspects enrolled in the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study were included. All eyes had glaucomatous optic neuropathy or ocular hypertension, but normal SAP and FDT results at baseline. The development of glaucomatous VF defects was defined as the presence of a cluster of ≥ 3 (less conservative) or ≥ 4 (more conservative) locations confirmed on ≥ 2 additional consecutive tests. Risk factors for the development of VF defects were analyzed by COX proportional hazard models. After conversion into common logarithmic units, the rates of change of global VF indices were fitted with linear mixed models. RESULTS: FDT detected more eyes that developed VF defects than SAP using the less conservative criterion, and no significant difference was observed using the more conservative criterion. For those eyes detected by both SAP and FDT, FDT detected the development of VF defects either earlier than SAP or simultaneously in most cases. Baseline structural measurements were not significantly associated with an increased risk for the development of glaucomatous VF defects on either SAP or FDT. Older age was significantly associated with the development of VF defects on FDT but not on SAP. Both SAP and FDT detected a progressing worsening trend of pattern standard deviation over time with a similar rate of change between these test types. CONCLUSIONS: Matrix FDT would be useful to monitor the onset of VF defects in glaucoma suspects and may outperform SAP in the early stage of glaucomatous VF damage.
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    Intraocular pressure, blood pressure, and retinal blood flow autoregulation: a mathematical model to clarify their relationship and clinical relevance
    (Association for Research in Vision and Opthalmology, 2014-07) Guidoboni, Giovanna; Harris, Alon; Cassani, Simone; Arciero, Julia; Siesky, Brent; Amireskandari, Annahita; Tobe, Leslie; Egan, Patrick; Januleviciene, Ingrida; Park, Joshua; Department of Mathematical Sciences, School of Science
    PURPOSE: This study investigates the relationship between intraocular pressure (IOP) and retinal hemodynamics and predicts how arterial blood pressure (BP) and blood flow autoregulation (AR) influence this relationship. METHODS: A mathematical model is developed to simulate blood flow in the central retinal vessels and retinal microvasculature as current flowing through a network of resistances and capacitances. Variable resistances describe active and passive diameter changes due to AR and IOP. The model is validated by using clinically measured values of retinal blood flow and velocity. The model simulations for six theoretical patients with high, normal, and low BP (HBP-, NBP-, LBP-) and functional or absent AR (-wAR, -woAR) are compared with clinical data. RESULTS: The model predicts that NBPwAR and HBPwAR patients can regulate retinal blood flow (RBF) as IOP varies between 15 and 23 mm Hg and between 23 and 29 mm Hg, respectively, whereas LBPwAR patients do not adequately regulate blood flow if IOP is 15 mm Hg or higher. Hemodynamic alterations would be noticeable only if IOP changes occur outside of the regulating range, which, most importantly, depend on BP. The model predictions are consistent with clinical data for IOP reduction via surgery and medications and for cases of induced IOP elevation. CONCLUSIONS: The theoretical model results suggest that the ability of IOP to induce noticeable changes in retinal hemodynamics depends on the levels of BP and AR of the individual. These predictions might help to explain the inconsistencies found in the clinical literature concerning the relationship between IOP and retinal hemodynamics.
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    Prediction accuracy of a novel dynamic structure-function model for glaucoma progression
    (Association for Research in Vision and Opthalmology, 2014-12) Hu, Rongrong; Marín-Franch, Iván; Racette, Lyne; Department of Ophthalmology, IU School of Medicine
    PURPOSE: To assess the prediction accuracy of a novel dynamic structure-function (DSF) model to monitor glaucoma progression. METHODS: Longitudinal data of paired rim area (RA) and mean sensitivity (MS) from 220 eyes with ocular hypertension or primary open-angle glaucoma enrolled in the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study were included. Rim area and MS were expressed as percent of mean normal based on an independent dataset of 91 healthy eyes. The DSF model uses centroids as estimates of the current state of the disease and velocity vectors as estimates of direction and rate of change over time. The first three visits were used to predict the fourth visit; the first four visits were used to predict the fifth visit, and so on up to the 11th visit. The prediction error (PE) was compared to that of ordinary least squares linear regression (OLSLR) using Wilcoxon signed-rank test. RESULTS: For predictions at visit 4 to visit 7, the average PE for the DSF model was significantly lower than OLSLR by 1.19% to 3.42% of mean normal. No significant difference was observed for the predictions at visit 8 to visit 11. The DSF model had lower PE than OLSLR for 70% of eyes in predicting visit 4 and approximately 60% in predicting visits 5, 6, and 7. CONCLUSIONS: The two models had similar prediction capabilities, and the DSF model performed better in shorter time series. The DSF model could be clinically useful when only limited follow-ups are available. (ClinicalTrials.gov numbers, NCT00221923, NCT00221897.).