To evaluate point-wise variability of threshold sensitivity at different test locations on 24-2 and 10-2 visual field (VF).Electronic medical records of patients seen at a tertiary eye care center were screened to include those with at least 3 reliable VF with glaucomatous defects involving fixation on 24-2 and confirmed on 10-2 test strategy. Ninety eyes of 90 patients were categorized into 3 severity groups based on mean deviation (MD on 24-2) test strategy; MD<-6 dB and >-12 dB, <-12 dB and >-20 dB and <-20 dB and >-30 dB. Variability of threshold sensitivity at all topographical test locations in central (ring 1), mid-peripheral (ring 2), peripheral rings on 24-2 VF test strategy (ring 3), and central (ring 4) and paracentral (ring 5) on 10-2 VF test along with variability of visual field index and central field index were calculated by multilevel mixed effects model.Central ring1 on 24-2 and ring 4 on 10-2 showed higher variability (>10 dB) than peripheral ring 2, 3, and 5. Seventy-three eyes were adjudged as stable and 17 as progressing in this cohort. The average ring and point-wise variability was higher in stable eyes (2-6 dB) across all glaucoma severities. Across severity, variability was seen to decrease with increasing severity with minimal variability in point-wise threshold sensitivity beyond MD <-20 dB.Central test points/ring on 24-2 and 10-2 with greater threshold variability suggests that status of the eye, severity and topographical location of test points should be incorporated into conventional progression algorithms to predict true glaucoma progression.
The 5th edition WHO classification of B-cell tumors is a systematic update to the fourth revised version of the classification. The changes include updated names of entities, sharpened diagnostic criteria, and upgrades from provisional to definite entities. This review focuses on the changes in the content of each chapter of B-cell tumors, facilitating domestic colleagues engaged in the diagnosis and treatment of lymphohematopoietic tumors to understand the latest progress and guide daily work.
Intraocular pressure (IOP) monitoring in glaucoma management is evolving with novel devices. We investigated the reproducibility of 24 hour profiles on two consecutive days and after 30 days of self-measurements via telemetric IOP monitoring.
Analysis of the retinal nerve fiber layer (RNFL) thickness deviation map, a topographic image providing spatial information of categorical classification of RNFL measurements
To report a case of spontaneous Descemet-membrane detachment in a patient with anterior megalophthalmos managed by intracameral perflouropropane (C3F8) gas instillation.Retrospective case review.A 12-year-old boy presented with spontaneous corneal edema in the left eye. The anterior segment findings were suggestive of anterior megalophthalmos. Slit-lamp examination of the left eye revealed a detached Descemet membrane superiorly. Anterior segment optical coherence tomography delineated the detached Descemet membrane. Descemetopexy with nonexpansile 14% perflouropropane (C3F8) gas resulted in rapid and complete resolution of corneal edema.Patients with anterior megalophthalmos can develop spontaneous detachment of Descemet membrane, which can be effectively managed by intracameral gas instillation.
To evaluate the safety and efficacy of XEN gel implant (Allergan Inc., Irvine) as a standalone versus combined XEN-Phacoemulsification surgery (XEN+cataract) in glaucoma patients.Prospective, interventional study. One-hundred forty-nine eyes (113 patients) with open-angle glaucoma and uncontrolled intraocular pressure (IOP) despite medical treatment were enrolled at a tertiary glaucoma center and followed up for a minimum of 1 year. Approximately two-thirds of patients underwent combined XEN+cataract surgery, while the remainder had XEN alone surgery. Primary outcome was a 20% or more decrease in IOP from medicated baseline at 1 year. Mean IOP, mean number of medications at last follow-up, and incidence of adverse effects were analyzed.Of 149 enrolled eyes, data of 87 (58%) were available at 1 year. A total of 109 (73.2%) eyes underwent XEN+cataract surgery and 40 (26.8%) XEN alone surgery. Mean medicated IOP was 20.0±7.1 at baseline and 13.9±4.3 mm Hg at 1 year (P<0.01), a 31% IOP reduction. Mean medications dropped from 1.9±1.3 preoperatively to 0.5±0.8 at 1 year (P<0.001). In total, 62.1% of patients achieved a ≥20% IOP reduction; this proportion was higher in the XEN alone group. 57.7% of eyes achieved complete success (without any antiglaucoma medications) and 71.1% qualified success (with or without medications) when IOP<16 mm Hg was considered as the definition of success. In all, 37% of patients required needling intervention. Adverse effects included bleb revision in 5 eyes, choroidal detachment in 2 eyes, and second glaucoma surgery in 9 eyes.The XEN gel implant as a standalone procedure or combined with cataract surgery demonstrated safe and sustained IOP reduction after 1 year.
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