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Ophthalmology 04/2013; 120(4):875-875.e1. · 5.45 Impact Factor
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ABSTRACT: PURPOSE: To evaluate the agreement of retinal nerve fiber layer (RNFL) color codes among Stratus, Cirrus, and Spectralis optical coherence tomography (OCT) in patients with relapsing-remitting multiple sclerosis. DESIGN: Prospective cohort study. METHODS: In 140 eyes from 70 patients having relapsing-remitting multiple sclerosis from January 2011 to September 2011, peripapillary RNFL thickness was measured using the fast RNFL program by Stratus, the optic disc cube protocol by Cirrus, and the N-site axonal analysis by Spectralis. RESULTS: Overall, a moderate to good RNFL color code agreement was found (0.435-0.884), except for the nasal quadrant. The temporal quadrant was the most abnormal color coding by both Cirrus (64.7%) and Spectralis (61.7%) in both the optic neuritis (ON) and non-ON group and by Stratus (58.8%) in the ON group. Abnormal temporal RNFL color-code rate was significantly higher in ON eyes than non-ON eyes by Cirrus (P < .001), Stratus (P < .001), and Spectralis (P = .030). Overall, Cirrus significantly displayed abnormal findings while both Stratus and Spectralis displayed normal results for the inferior quadrant (P < .05). On the other hand, Spectralis OCT showed a significantly higher rate of abnormal findings while Cirrus displayed normal results for the temporal quadrant in non-ON eyes (P < .001). CONCLUSIONS: We found a substantial color-code disagreement among devices in patients with relapsing-remitting multiple sclerosis regarding the ON antecedent. In non-ON eyes, Spectralis yielded a significantly higher thinning for temporal quadrant than Cirrus, suggesting that N-site axonal analysis could define axonal damage in relapsing-remitting multiple sclerosis patients earlier than conventional RNFL analysis.
American journal of ophthalmology 02/2013; · 3.83 Impact Factor
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Albrecht von Graæes Archiv für Ophthalmologie 05/2012; · 2.17 Impact Factor
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ABSTRACT: BACKGROUND: To evaluate the visual and anatomic outcomes after systemic steroid treatment in non-arteritic anterior ischemic optic neuropathy (NAION). METHODS: Ten eyes from ten patients diagnosed with NAION and treated during the acute phase with 80 mg daily, tapering-down dose of corticosteroids were compared with a non-contemporary cohort of 27 patients that received no treatment. The visual outcomes of treated and untreated group were compared. Patients underwent complete ophthalmic examination including determination of Snellen visual acuity (VA), visual fields (VFs) (standard automated perimetry, Swedish Interactive Testing Algorithm 24-2 strategy), and optical coherence tomography (OCT) scanning of the optic nerve head at diagnosis, 6-8 weeks and 6 months after presentation. RESULTS: No statistical differences were found between steroid-treated and untreated NAION for the median change in VA (Mann-Whitney P = 0.28), median change in VF mean deviation (MD) and median change in VF pattern standard deviation (PSD) (Mann-Whitney P = 0.213 and P = 0.07 respectively). Statistical analysis showed no differences when comparing average RNFL loss (P = 0.871) and RNFL loss for superior, nasal, inferior and temporal optic disc quadrants between both groups. Complications occurred in three of the ten treated patients (30%); in one of them, steroid therapy had to be discontinued. Another two patients developed a NAION in their fellow eye after 2 and 3 months while on low-dose prednisone. No complications developed in the control group. The study was interrupted early due to a significantly higher rate of complications observed in the treated group (P = 0.002) CONCLUSION: High-dose systemic steroid treatment did not show any beneficial effect in visual and anatomic outcomes when given during the acute phase of NAION. Furthermore, it caused serious complications in a third of the patients treated.
Albrecht von Graæes Archiv für Ophthalmologie 03/2012; · 2.17 Impact Factor
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ABSTRACT: To evaluate the accuracy of 3 spectral-domain (SD) optical coherence tomography (OCT) devices (Topcon 3D-1000 [Topcon]; Cirrus HD [Carl Zeiss Meditec, Inc], and Spectralis OCT [Heidelberg Engineering]) before and after mydriasis for the diagnosis of diabetic macular edema.
Cross-sectional study.
Sixty-two eyes of 62 consecutive patients with diabetes without recent loss of vision referred for retinal control were assessed. Two scans were performed for each SD OCT instrument. Central retinal thickness was measured before and after pupil dilation. Pupil dynamic was studied using pMetrics pupillometer (iVIS Technologies), and lens opacity was measured by Pentacam densitometry (Oculus). The diagnostic accuracy of SD OCT devices was assessed by sensitivity, specificity, and area under the receiver operating characteristic curve. Logistic regression analysis was used to assess the effect of pupil size and lens opacity on the reliability of SD OCT in the acquisition of adequate images.
The area under the receiver operating characteristic curve for the Topcon 3D OCT device was 0.84, that for the Cirrus HD OCT device was 0.93, and that for the Spectralis OCT device was 0.91. Significant differences in area under the receiver operating characteristic curve before and after pupillary dilatation were not found. Sensitivity and specificity associated with the cutoff value for the best performance were 82% and 74% for the Topcon 3D OCT device, 90% and 87% for the Cirrus HD OCT device, and 90% and 84% for the Spectralis OCT device, respectively. The Topcon 3D OCT device had an 11.3% segmentation algorithm failure rate for the central millimeter of the fovea, and the nuclear lens density was significantly greater in these eyes than in those without failure (17.1 ± 1.1 mm vs 10.4 ± 0.2 mm; P < .05).
SD OCT is a useful tool to detect and to measure diabetic macular edema without the need for pupil dilatation.
American journal of ophthalmology 03/2012; 153(3):536-543.e1. · 3.83 Impact Factor
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ABSTRACT: To evaluate if decompression surgery produces changes in retrobulbar blood flow parameters in Graves' ophthalmopathy (GO).
Retrobulbar blood vessels of 26 eyes (14 patients) that underwent orbital bone decompression between June 2009 and May 2010 were measured prospectively using color Doppler ultrasound before and after surgery. The disease was inactive in all patients enrolled according to the European Group on Graves' Orbitopathy. Patients were classified with mild, moderate-to-severe, or sight-threatening disease. All patients underwent a full ophthalmic examination including intraocular pressure and Hertel measurement. An age-matched control group included 20 eyes of 20 healthy volunteers.
The resistance indexes (RIs) in the central retinal artery (CRA) and ophthalmic artery (OA) were significantly higher in patients with GO preoperatively than in the control group (P < 0.001, P = 0.001 respectively). After decompression surgery, a significant decrease in RIs occurred in the CRA (5%) and OA (6%) (P = 0.002, P < 0.001 respectively). Proptosis was decreased a median of 6 mm (range, 4-7). Three-wall decompression surgery resulted in a significantly greater reduction in exophthalmos (median 7 mm) compared with two-wall surgery (median 5 mm) and one-wall surgery (2.5 mm). Although no significant correlation was found, the RIs decreased more with major reductions in exophthalmos.
In inactive moderate-to-severe GO, the RIs of the CRA and OA are higher than in normal subjects. The authors hypothesized that increased RIs of inactive GO may be due to orbital extrinsic compression of vascular structures because decompression surgery leads to decreases in the RIs of both the CRA and OA.
Investigative ophthalmology & visual science 04/2011; 52(8):5612-7. · 3.43 Impact Factor
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ABSTRACT: Optical coherence tomography (OCT) uses light interference patterns to produce a cross-sectional image of the retina. It is capable of measuring the unmyelinated axons of the retinal ganglionar cells as they converge on the optic disc. In a disease like multiple sclerosis (MS), in which axonal loss has been identified as an important cause of sustained disability, it may prove an invaluable tool. OCT has demonstrated that axonal loss occurs after each episode of optic neuritis and that the degree of axonal loss is correlated to visual outcomes. Furthermore, axonal loss occurs in MS even in the absence of inflammatory episodes, and the degree of this loss is correlated with the duration of the disease process, with more thinning as the disease advances and in progressive forms. Thus, OCT retinal nerve fiber layer measurements may represent an objective outcome measure with which to evaluate the effect of treatment.
Multiple sclerosis international. 01/2011; 2011:472790.
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ABSTRACT: To evaluate and compare toric intraocular lens (IOL) implantation and spherical IOL implantation with peripheral corneal relaxing incisions to manage astigmatism during phacoemulsification.
Ophthalmology Service, Hospital Ramón y Cajal, Madrid, Spain.
Prospective randomized comparative case series.
Eyes with cataract and corneal astigmatism (1.00 to 3.00 diopters [D]) had toric IOL implantation or peripheral corneal relaxing incisions. Outcome measures were visual outcomes, slitlamp assessment, digital toric IOL axis determination, spectacle need, and patient satisfaction.
Three months postoperatively, the mean uncorrected distance visual acuity (UDVA) was 0.13 ± 0.10 (SD) in the toric IOL group and 0.19 ± 0.12 in the relaxing incisions group; the UDVA was better than 0.20 in 75% of eyes and 60% of eyes, respectively. Refractive cylinder decreased significantly in both groups, with a mean residual refractive astigmatism of 0.61 ± 0.41 D in the toric IOL group and 1.32 ± 0.60 D in the relaxing incisions group (P<.01). The mean toric IOL rotation was 3.65 ± 2.96 degrees, with no significant differences between slitlamp and digital photograph measurements. There was a trend toward better mesopic contrast sensitivity with glare in the toric IOL group. There were no differences in VF-14 or patient satisfaction results; 15% of patients in the toric IOL group and 45% in the relaxing-incision group required distance spectacles postoperatively.
Although refractive astigmatism decreased in both groups, toric IOL implantation was more effective and predictable, resulting in greater spectacle independence.
Journal of cataract and refractive surgery 10/2010; 36(10):1700-8. · 2.75 Impact Factor
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ABSTRACT: To identify the clinical and anatomic characteristics of filtering blebs after nonpenetrating deep sclerectomy (NPDS) using ultrasound biomicroscopy, and to evaluate its influence on intraocular pressure (IOP) control.
We conducted a prospective interventional case series in 18 eyes of 18 patients who had undergone nonpenetrating deep sclerectomy with Esnoper® implant. A complete ophthalmic examination and ultrasound biomicroscopy (UBM) exploration were performed at 1, 3, and 6 months postoperatively.
Intraocular pressure significantly decreased from a mean of 23.5 mmHg (SD 3.5) preoperatively to a mean of 13.1 mmHg (SD 7.6), 13.2 mmHg (SD 4.3), and 13.3 mmHg (SD 3) at 1, 3, and 6 months postoperatively, respectively. At 6 months, lower IOP levels significantly correlated with hyporeflective blebs (r=-0.82, p=0.000), with the presence of hyporeflective suprachoroidal space (r=-0.67, p=0.003) and with the presence of hyporeflective area around the scleral lake (r=-0.55, p=0.02). The presence of these 3 filtration signs together correlated with lower IOP levels compared with the presence of only 1 or 2 (p=0.000, p=0.004, p=0.0005) at 1, 3, and 6 months postoperatively, respectively. A thinner trabeculo-descemetic membrane (TDM) was significantly correlated with lower postoperative IOP value at the first postoperative month (r=0.45, p=0.05). Intraocular pressure mean values and UBM characteristics were not significantly different between eyes with single NPDS and eyes following combined NPDS-phacoemulsification. At 6 months, eyes without goniopuncture had lower IOP values (p=0.02), higher bleb (p=0.015), and thinner TDM (p=0.01) than those needing goniopuncture.
Ultrasound biomicroscopy is a useful method to evaluate outflow mechanisms after NPDS and their correlation with postoperative IOP control.
European journal of ophthalmology 10/2010; 21(4):391-9. · 0.96 Impact Factor
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ABSTRACT: To evaluate changes in anterior chamber morphology with the Pentacam anterior segment analyzer and gonioscopy after laser peripheral iridotomy (LPI) in patients with primary angle closure glaucoma and narrow angle and to compare central corneal thickness measurements performed with Pentacam and ultrasound pachymetry.
Twenty eyes of 20 patients were enrolled in this prospective interventional study. Before and after LPI, volume, angle, and central and peripheral depth of anterior chamber was quantified with Pentacam. Central corneal thickness was measured with Pentacam and ultrasound pachymetry.
Mean central corneal thickness as measured with Pentacam pachymetry was slightly lower than the measurements provided by ultrasonic pachymetry (551.9 microm, range 509-659, versus 556.8 microm, range 520-644) (p=0.93) with an intraclass correlation coefficient of 0.92. Anterior chamber angle increased from 20.32 (standard deviation [SD] 4.2) to 22.31 degrees (SD 3.9). Anterior chamber central depth increased significantly from 1.79 mm (SD 0.22) to 1.85 mm (SD 0.21) and volume changed from 72.18 mm (SD 16.82) to 89.12 mm (SD 12.3), p=0.001. Gonioscopy showed that Shaffer angle widened significantly in all quadrants. Mean intraocular pressure changed from 20.8 mmHg to 18.3 mmHg after LPI (p<0.05).
In patients with primary angle closure glaucoma and narrow angles, anterior chamber volume, angle, and central and peripheral depth, measured with Pentacam, increase significantly after LPI.
European journal of ophthalmology 12/2009; 20(2):327-32. · 0.96 Impact Factor
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Ophthalmology 09/2009; 116(8):1587, 1587.e1-3. · 5.45 Impact Factor
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ABSTRACT: The aim of the study was to compare event-based glaucoma progression analysis (GPA) I with new GPA II software and pattern deviation-based trend analyses (visual field index [VFI]) to detect progression in a glaucoma population.
This was a retrospective study that included 90 eyes of 90 patients with a minimum of five reliable visual field tests and a follow-up period of at least 2 years.
Event-based GPA II detected progression in 16.7% of eyes in which trend analysis VFI failed. GPA detected progression 6.8 months earlier than VFI. GPA I and II showed excellent agreement (k = 0.94). Agreement between VFI and mean deviation (MD) linear analysis and with GPA criteria was k = 0.52 and k = 0.48, respectively. Mean rates of progression of MD and VFI were -0.41 dB and -1.30% annually, respectively (rho = 0.824; p<0.0001). Using VFI, mean follow-up time was 6.12 and 4.89 years (p = 0.004) and the mean number of visual field tests was 7.33 and 6.01 (p = 0.023) in eyes with and without progression, respectively.
Event-based software GPA I and II had excellent agreement. Event analysis showed earlier and greater sensitivity for detecting progression than VFI analysis and both had only moderate agreement. Trend analysis VFI is likely to detect progression in patients with a greater number of visual field tests and a longer follow-up time. The VFI analysis seems to be more accurate than MD analysis for determining rate of progression.
The British journal of ophthalmology 06/2009; 93(12):1576-9. · 2.92 Impact Factor
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Ophthalmology 05/2009; 116(4):814; author reply 814-5. · 5.45 Impact Factor
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ABSTRACT: To evaluate optical coherence tomography (OCT) measurement of peripapillary retinal nerve fiber layer (RNFL) thickness in patients with mild papilledema associated with idiopathic intracranial hypertension.
Patients with papilledema underwent a complete ophthalmic examination, including peripapillary RNFL analysis with OCT (Fast RNFL thickness 3.46; Carl Zeiss Meditec, Inc., Dublin, CA) at diagnosis and 3, 6, and 12 months after presentation. Age- and sex-matched control subjects underwent a similar evaluation. Changes in RNFL overall thickness and by quadrant and interocular differences were evaluated and studied regarding changes in visual field global indices (mean deviation [MD] and pattern SD [PSD]).
Both eyes of 22 patients with mild papilledema and 22 control subjects were included. At diagnosis, the RNFL thickness was 183.3 +/- 74.7 microm and 74.9% (78.5 microm) greater than in control eyes. Mean RNFL thicknesses in all quadrants were significantly greater in eyes with papilledema (P = 0.000). The mean average RNFL was significantly correlated with the MD (sigma = -0.451, P = 0.002) and PSD (sigma = 0.370, P = 0.013) at diagnosis. The RNFL thickness decreased significantly (P = 0.000), whereas the mean MD and the mean PSD improved (P = 0.000 and P = 0.005, respectively) at each follow-up visit. Regression analysis showed that for every 10 microm of mean RNFL thickness increase at baseline, there was a 0.6-dB decrease in MD at the last follow-up.
Peripapillary RNFL thickness abnormalities assessed by OCT in patients with mild papilledema were quantitatively correlated with visual field sensitivity losses. The data support the possible use of OCT as a noninvasive quantitative method of monitoring the amount and evolution of papilledema.
Investigative ophthalmology & visual science 12/2008; 50(11):5197-200. · 3.43 Impact Factor
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ABSTRACT: To compare visual field progression in glaucoma patients assessed by the glaucoma progression analysis (GPA) used in the Humphrey Field Analyzer perimeter and by objective clinical criteria.
Retrospective cross-sectional study of 93 eyes of 93 consecutive glaucoma patients with at least five reliable visual fields. Progression of the visual field damage was analyzed by a masked observer using both GPA and defined clinical criteria. Prevalence of progressive visual field damage was determined by clinical criteria and GPA analysis. Agreement between both methods was quantified by kappa analysis. GPA performance was also calculated using clinical criteria analysis as the reference standard.
The prevalence of progressive visual field damage was 30% and 29% with GPA evaluation and clinical criteria analysis respectively. Where two consecutive visual fields showing progressive damage were needed to confirm progression, the kappa index of agreement between these two approaches was 0.87 +/- 0.06 (mean +/- standard error of the mean). Where three consecutive fields showing progressive damage were required, the kappa index of agreement was 0.64 +/- 0.1. The GPA performance showed a sensitivity and specificity of 93% (95% CI, 83-100%) and 95% (95% CI, 90-100%) respectively, and a positive likelihood ratio of 20 if the two consecutive visual fields criterion was used. The performance was worse if three consecutive progressing visual fields were required to confirm progression.
There is a strong correlation between GPA identification of glaucomatous progression and a thorough objective clinical assessment of the visual fields. GPA could be a useful test to aid clinicians in the detection of glaucomatous progression, with high specificity, strong positive likelihood ratio, and good sensitivity and negative likelihood ratio.
Albrecht von Graæes Archiv für Ophthalmologie 12/2008; 247(3):391-7. · 2.17 Impact Factor
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ABSTRACT: To study the intraocular pressure (IOP) as a prognostic indicator on the first day after combined phacoemulsification and nonpenetrating deep sclerectomy.
Ramón y Cajal Hospital, Madrid, Spain.
This retrospective study included 70 eyes of 70 patients who had combined phacoemulsification-nonpenetrating deep sclerectomy with a reticulated hyaluronic acid implant. Visual acuity, IOP, and slitlamp examinations were performed preoperatively and 1 and 7 days and 1, 3, 6, 12, and 24 months postoperatively. A split point of 9.0 mm Hg on the first postoperative day was used. Success probability analysis was performed using a Kaplan-Meier survival curve. The need for medication and postoperative neodymium:YAG goniopuncture was also recorded.
The mean preoperative IOP was 22.5 mm Hg +/- 5.2 (SD). The mean postoperative IOP was 11.6 +/-8.1 mm Hg, 16.4 +/- 4.7 mm Hg, and 17.0 +/- 5.3 SD mm Hg at 1 day, 12 months, and 24 months, respectively. A greater success rate was observed in terms of survival (P = .006, log rank test) in patients with an IOP of 9 mm Hg or less on the first postoperative day; these patients also had a significantly reduced need for glaucoma treatment (P = .015) and goniopuncture (P = .009).
An IOP of 9 mm Hg or less on the first postoperative day might serve as a positive prognostic indicator in combined phacoemulsification with deep sclerectomy.
Journal of Cataract [?] Refractive Surgery 08/2008; 34(8):1374-8. · 2.26 Impact Factor
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ABSTRACT: To study the characteristics of nonarteritic anterior ischemic optic neuropathy (NAION) as measured with optical coherence tomography (OCT) at diagnosis and during the first year after the episode.
Cohort study.
Twenty-seven patients diagnosed with NAION in our center between April 1, 2004 and March 31, 2006.
Patients diagnosed with NAION underwent at the time of diagnosis and 6 weeks and 3, 6, and 12 months after presentation a complete ophthalmologic evaluation, including determination of Snellen visual acuity (VA), visual fields (VFs) (standard automated perimetry, Swedish Interactive Threshold Algorithm strategy 24-2), and optic nerve head (ONH) scanning with StratusOCT.
Characteristics of the ONH and their relationship with VA and VFs.
Initial mean retinal nerve fiber layer (RNFL) thickness in the affected eye was 200.9 microm (standard deviation [SD], 52.3 microm); this represented a 96.4% increase relative to the fellow eye. Percentages of RNFL loss 3, 6, and 12 months after onset were 38.9%, 42.3%, and 43.9%, respectively. At the 6-month visit, RNFL percentage decreases for the superior, nasal, inferior, and temporal quadrants were 51.5%, 28.5%, 41.2%, and 38.2%, respectively. Reduction in the superior quadrant RNFL thickness was statistically higher. Using regression analysis, it was found that for every micrometer of mean RNFL thickness lost there was a 2-decibel decrease in VF mean deviation (MD) and that there was a 1-line drop in Snellen VA for every 1.6 microm lost. The mean ONH area was 2.6 mm2 (SD, 0.4) in the unaffected eye; there was no correlation with VA, VF MD, or RNFL thickness of the affected eye at the last follow-up visit.
Optical coherence tomography can diagnose optic disc edema and monitor RNFL loss over time. It is most useful at onset and 6 months after NAION, when RNFL loss has reached a plateau and is correlated with visual function. Future studies that aim to determine if a drug or intervention is useful for treating NAION may include OCT assessment of the RNFL thickness, because it provides an objective outcome measure correlated with visual performance.
Ophthalmology 01/2008; 114(12):2338-44. · 5.45 Impact Factor
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ABSTRACT: To describe the characteristics of the optic nerve head (ONH) in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and compare them with control subjects by using optical coherence tomography (OCT).
Patients with NAION underwent a complete ophthalmic examination, including OCT scanning of the ONH at diagnosis. The examination was repeated 1.5, 3, and 6 months later. Age- and sex-matched control subjects with no ocular disease underwent a similar evaluation. Data were obtained by using the ONH analysis protocol of the StratusOCT (Carl Zeiss Meditec, Dublin, CA).
Twenty-three patients and 23 control subjects were included. In eyes with NAION, the vertical integrated rim area decreased significantly (P < 0.01) from the acute phase to the 6-month visit. The cup-to-disc (C/D) area ratio increased significantly (P = 0.002) from the acute examination to the 3-month visit. There was a significant difference between the NAION fellow eyes and the control eyes in C/D ratio, evaluated by slit lamp funduscopy (P < 0.001), and in the C/D area ratio (P = 0.001). The vertical integrated rim area was significantly (P = 0.001) greater in NAION fellow eyes than in control eyes. There was no significant difference in optic disc area or vertical disc diameter among the control eyes, NAION-affected eyes, and NAION fellow eyes.
Although patients with NAION have lower C/D ratios than does the normal population, with a higher level of nerve fiber crowding, there was no difference in optic disc size between patients with NAION and control subjects. After the development of NAION, 47.8% of eyes had a C/D ratio that differed from that in the fellow eye by more than 0.1.
Investigative Ophthalmology & Visual Science 09/2007; 48(9):4087-92. · 3.60 Impact Factor
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ABSTRACT: To detect and quantify changes, using optical coherence tomography (OCT), in the peripapillary retinal nerve fiber layer (RNFL) thickness in patients with glaucoma who underwent deep sclerectomy.
Prospective, controlled, interventional case series.
Thirty-four consecutive patients who underwent monocular deep sclerectomy (surgery group) and medically treated fellow eyes (control group).
Quantitative analysis of the peripapillary RNFL by OCT and automated perimetry were performed before surgery and 6 months after surgery in both eyes.
The changes in RNFL thickness overall and by quadrant were evaluated and studied with respect to age, preoperative visual field test global indices, postoperative changes in intraocular pressure (IOP), and postoperative changes in visual field global indices. Changes observed in RNFL thickness were compared between eyes after surgery and in fellow eyes.
The IOP decreased from a baseline mean of 23.6+/-5.1 mmHg to 11.7+/-2.9 mmHg (P<0.001) 6 months after surgery at the time of OCT testing. The mean percent IOP change was 48.4+/-15.7%. No significant changes in the mean RNFL thickness overall or by quadrant were observed after surgery or in the mean deviation (MD) and pattern standard deviation after surgery. There was no significant difference in the RNFL thickness between eyes in the surgery group and those in the control group. The mean preoperative visual field MD was significantly (P = 0.006) worse in eyes with a postoperative decrease in the overall RNFL thickness compared with those with an increase in the RNFL thickness. No correlation was found between RNFL thickness changes and age or changes in the visual field global indices. There was no significant difference between eyes with an IOP reduction of more than 50% and those with a reduction in IOP less than 30% (P = 0.514).
The authors found no significant changes in the peripapillary RNFL thickness measured 6 months after deep sclerectomy. The only significant factor related to RNFL thickness changes after surgery was the preoperative visual field MD (P = 0.038).
Ophthalmology 04/2007; 114(3):488-93. · 5.45 Impact Factor
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Ophthalmology 02/2007; 114(1):200. · 5.45 Impact Factor
