Eija Vesti

University of Turku | UTU · Department of Ophthalmology

This article is an English translation of the 4th Finnish Current Care Guideline for diagnostics, treatment and follow‐up of primary open‐angle glaucoma, normal‐tension glaucoma and pseudoexfoliative glaucoma. This guideline is based on systematic literature reviews and expert opinions with Finland's geographical and operational healthcare environm...

Purpose: The purpose of the study was to study the association between retinal parameters and motor and cognitive outcomes in children born very preterm. Methods: This study is part of a prospective cohort study of very preterm infants (birth weight ≤ 1500 grams/gestational age < 32 weeks). At 11 years of age, the ophthalmological assessment inc...

Retinal microvasculature changes reflect systemic small vessel damage from obesity. The impact of bariatric surgery induced weight loss on the microvasculature is relatively unknown. We hypothesized that weight loss following bariatric surgery would be associated with improved structural changes in the retinal microvasculature, reflecting an overal...

Purpose Study purpose was to investigate the effects of bariatric surgery on intraocular pressure (IOP) and other ophthalmic parameters in a prospective observational follow‐up study. Methods Ophthalmic examination was performed on 22 obese women before and 6 months after bariatric surgery. A control group of 15 non‐obese age‐matched women were st...

Background Mooren ulcer has been considered as an idiopathic autoimmune keratitis. However, it has been in some cases suggested to be associated with hepatitis C, although the evidence is very vague. Case presentation We present a case of a man who was diagnosed with a primary Mooren ulcer in his right eye. The eye became blind despite of intensiv...

Purpose To evaluate the performance of various tests with automated and subjective evaluation for primary diagnostics of glaucoma in a normal clinical setting. Methods Subjects referred because of suspicion of glaucoma were recruited. All subjects had full ophthalmologic evaluation with stereophotography of the optic nerve head (ONH), red-free ret...

Purpose: To study the long-term outcome of deep sclerectomy with and without mitomycin-C (MMC) in patients with normal-tension glaucoma (NTG). Methods: We prospectively analysed consecutive patients randomized to surgery performed either with (MMC group) or without (non-MMC) MMC. Surgery was considered totally successful if, after surgery, the p...

Purpose: To determine the effect of intraocular pressure (IOP) lowering with deep sclerectomy (DS) on visual acuity, macular structures, and anterior ocular dimensions during the early postoperative period. Methods: We prospectively analyzed 35 eyes of 35 patients scheduled for DS. Our focus with the measurements was on early postoperative chang...

Exfoliation syndrome (XFS) is the most common known risk factor for secondary glaucoma and a major cause of blindness worldwide. Variants in two genes, LOXL1 and CACNA1A, have previously been associated with XFS. To further elucidate the genetic basis of XFS, we collected a global sample of XFS cases to refine the association at LOXL1, which previo...

Conclusions: The characteristics (the slope of the hill of vision, age effect, variation) of the visual field sensitivities measured with Ocusweep SAP perimetry were very similar to standard automated perimetry done at background luminance of 10 cd/m2 with Octopus. The difference between the threshold values measured with Ocusweep and Octopus devic...

Exfoliation syndrome (XFS) is the most common known risk factor for secondary glaucoma and a major cause of blindness worldwide. Variants in two genes, LOXL1 and CACNA1A, have previously been associated with XFS. To further elucidate the genetic basis of XFS, we collected a global sample of XFS cases to refine the association at LOXL1, which previo...

Purpose: The goal was to determine the effect of cataract surgery-induced change in ametropia and anterior chamber depth on the magnification of a fundus photograph. Methods: Fundus photographs were taken from 11 subjects undergoing cataract surgery and intraocular lens (IOL) implantation before and after surgery with a telecentric Zeiss and Top...

A 19-year-old man noticed blurred vision in his right eye. He had an intraocular pressure (IOP) of 60 mmHg, versus 12 mmHg in the fellow eye. He was initially diagnosed with an atypical, advanced pigmentary glaucoma. The IOP did not respond to maximal medication, deep sclerectomy, goniopuncture, and two cyclophotocoagulations. Sixteen months after...

Purpose: To study the effect of deep sclerectomy (DS) in primary open-angle glaucoma (POAG) and exfoliative glaucoma (EXG). Methods: We retrospectively analyzed the intraocular pressure (IOP)-lowering effect of DS in 235 consecutive eyes. Eyes were divided into 2 groups according to glaucoma subtype: POAG (127 eyes) and EXG (108 eyes). Postopera...

To investigate and analyse one hundred-year-old endothelial cells of human transplanted corneal grafts and compare them with intact endothelium of unoperated eyes. Specular microscopy was performed on seven individuals (14 eyes) aged >100 years and on seven transplanted corneas with endothelial cells of at least 100 years old. All keratoplasties we...

Objective: To study the ability of a novel reaction time perimeter to detect a physiological blind spot. Methods: The location of the physiological blind spot of 11 healthy volunteers was determined with two independent methods, first by Octopus custom-made blind spot visual field program, and second by Fundus photography with a method previously d...

PurposeTo clinically verify the formula of Bennett et al. (Graefes Arch Clin Exp 1994; 232: 361) of determining the size of retinal features and to study the previously unknown conversion factor of Topcon fundus camera.Methods Fundus photographs were taken from 17 healthy volunteers with Topcon and telecentric Zeiss fundus cameras. The macula-disc...

PurposeThe purpose was to study the effect of prematurity on the macula–disc centre distance and whether it could be used as a reference tool for determining the size of retinal features in prematurely born children by fundus photography.Methods The macula–disc centre distance of the left eye was measured in pixels from digital fundus photographs t...

Eye is the official journal of the Royal College of Ophthalmologists. It aims to provide the practising ophthalmologist with information on the latest clinical and laboratory-based research.

To compare the outcome of deep sclerectomy (DS) with and without mitomycin-C (MMC) in patients with normal-tension glaucoma (NTG). We prospectively analysed the results of 37 eyes of 37 consecutive patients with NTG (age; mean ± SD; 64 ± 7 years) who underwent DS with a collagen implant. Patients were randomized to the MMC and non-MMC groups. Subco...

To study retinal blood flow and vessel diameter after intra-ocular pressure (IOP) reduction in high- and low-pressure glaucomas, that is, exfoliation glaucoma (ExG) and normal-tension glaucoma (NTG). The study included 17 eyes with ExG and 20 with NTG. A minimum of 25% IOP reduction was achieved by deep sclerectomy. Blood flow in the temporal perip...

Background: The aim of this study is to examine the relationship of selected systemic and oral health parameters and the salivary presence of six periodontal pathogens to age-related macular degeneration (AMD). Methods: The present cross-sectional study includes data on 1,751 individuals (≥30 years old). General health information was obtained b...

The intra-ocular pressure immediately before glaucoma surgery can be raised. We wished to investigate if ocular compression for 20 min before a combined peri- and retrobulbar injection would result in a lower pressure after the block. Sixty consecutive patients scheduled for filtration surgery were randomly assigned to receive ocular compression us...

To investigate whether any peripapillary retinal blood flow changes are related to disc hemorrhage (DH). The study included 21 eyes of 21 patients, of which 14 eyes had glaucoma. All eyes were examined at the time of detection of DH and again 6 months later. Blood flow in the peripapillary retina was measured by scanning laser Doppler flowmetry (He...

To study longitudinal changes in optic nerve head (ONH) topography in healthy volunteers. One eye each of 36 healthy volunteers was prospectively followed for 11 (7-13) years with the Heidelberg Retina Tomograph I (HRT I). All eyes had normal visual fields, non-glaucomatous ONHs, no defects on red-free nerve fibre layer photographs and intraocular...

Purpose To study retinal blood flow changes after filtration surgery in eyes with normal tension glaucoma (NTG) and exfoliation glaucoma (ExG). Methods Included were one eye of 18 patients with NTG (median age, range; 63 years, 53‐86 years) and 18 with ExG (72 years, 53‐84 years). Deep sclerectomy was performed on all eyes. Temporal peripapillary r...

Purpose To study the effect of deep sclerectomy (DS) with and without Mitomycin‐C(MMC) on intraocular pressure (IOP) in normal tension glaucoma (NTG) patients. Methods We prospectively analysed the results of 29 eyes of 29 consecutive NTG patients (mean ±SD age, 62,9 ±7,0 years ) to whom DS was performed. Patients were randomized to the Mitomycin‐C...

Ophthalmoscopy is sometimes very difficult, especially if special ophthalmologic equipments are not available. However, the examination of the optic disc is a skill a general practitioner needs. The use of mydriatics makes it much easier. Examination of the optic disc head is essential when increased intracranial pressure is suspected. Diabetes and...

To study the intraocular pressure (IOP)-reducing effect of deep sclerectomy on normal-tension glaucoma (NTG) patients. We retrospectively analysed 21 eyes of 18 consecutive NTG patients who had undergone deep sclerectomy with mitomycin-C and a collagen implant. Median (range) preoperative IOP was 15.1 mmHg (9.3-20.8) and median follow-up time 13 mo...

Three generations of one family (ten males and five females) with two young boys (cousins) and grandfather showing signs of retinoschisis were examined clinically and electrophys-iologically. The inheritance of the retinoschisis was determined to be X-linked. The aim of this study was to detect the typical ERG findings in juvenile retinoschisis and...

The aim of this article is to study peripapillary retinal blood flow in patients with progressive and stable exfoliation glaucoma (ExG). Fifty-eight eyes with ExG were included; 25 of them had progressive and 33 stable glaucoma. Retinal blood flow in the peripapillary retina was measured with scanning laser Doppler flowmetry. Acquired flow maps wer...

To study whether reversal of optic disc cupping after intraocular pressure (IOP) reduction is related to risk of glaucoma progression. In this prospective follow-up study, where 51 patients with exfoliation glaucoma and five with ocular hypertension combined with exfoliation syndrome were followed for 6 years after IOP reduction, 24 showed progress...

Purpose: Reversal of optic disc cupping after reduction in intraocular pressure (IOP) is well documented. The effect of cup reversal on the risk of progression of glaucoma was investigated. Methods: All 80 consecutive patients referred to the Helsinki University Eye Hospital between May 1995 and May 1997 because of exfoliation glaucoma were include...

Purpose: Vascular pathogenesis in glaucoma has been recognized and optic disc haemorrhages (DH) may pre‐cede nerve fiber damage in glaucoma. The change in peripapillary retinal capillary flow after resorbtion of DH was investigated. Methods: Included were 25 eyes of 25 patients with DH. 17 eyes had glaucoma. Peripapillary retinal capillary flow was...

Purpose: To study the effect of deep sclerectomy (DS) on intraocular pressure (IOP) in normal tension glaucoma (NTG) patients. Methods: We retrospectively analysed 21 eyes of 18 consecutive NTG patients to whom DS was performed. A collagen implant was used (Aquaflow, Staar surgical, Nidau, Switzerland) in 20 of 21 operations. Mitomycin‐C (0.4 mg/ml...

To study how many of the patients with treated glaucoma or ocular hypertension go blind during their lifetime and which factors are associated with blindness. The data on 106 consecutive patients who had died between 1991 and 2002 was retrospectively evaluated. At diagnosis 39 patients had primary open-angle glaucoma, 27 had exfoliation glaucoma, a...

To measure the levels of matrix metalloproteinase (MMP)-2 and tissue inhibitors of metalloproteinases (TIMP)-2 and to study the expression pattern and molecular forms of MMP-2, 8, 9, 13, and 14 and TIMP-1 and 2 in aqueous humor samples in cases of uveitis-related secondary glaucoma (USG) with a history of up to 20 years by comparison with primary o...

To evaluate visual performance after unilateral photorefractive keratectomy (PRK) performed for >/=2.75-diopter (D) myopic anisometropia. Prospective observational case series. Eleven patients exhibiting >/=2.75-D myopic anisometropia appropriate for PRK. Photorefractive keratectomy was performed on 11 eyes of 11 patients for myopic anisometropia r...

To compare the performance characteristics of seven methods for analyzing glaucomatous visual field progression, using a combination of real patient data and computer simulation techniques. The initial and final visual field results, separated by 7 years and measured with the full-threshold 30-2 program of the Humphrey Field Analyzer (Carl Zeiss Me...

METHODS. The initial and final visual field results, separated by 7 years and measured with the full-threshold 30-2 program of the Humphrey Field Analyzer (Carl Zeiss Meditec, Dublin, CA) of 76 patients with open-angle glaucoma were used. A computer simulation program generated 14 interim semiannual visual fields under conditions of high, moderate,...

To compare posterior capsular opacification in eyes with IOL of two different materials--silicone or acrylic. Eighty consecutive eyes undergoing cataract surgery were prospectively randomized in two groups, 40 eyes receiving a silicone (Sl--30NB) and 40 eyes an acrylic (Acrysof MA60BM) intraocular lens (IOL). The same surgeon performed phacoemulsif...

The authors sought to verify computer simulation of visual fields by comparing thresholds of real and corresponding simulated visual fields. Four patients with stable glaucomatous visual fields and three patients with progressing glaucomatous visual fields were chosen for the study. Visual fields had been recorded at 6-month intervals for 5 to 7.5...

This study investigated whether retinal capillary circulation in the macula is affected in exfoliation glaucoma and whether such changes can be detected in exfoliation syndrome without glaucoma. Blue-field entoptic simulation (measurement of macular capillary leukocyte velocity and density) was performed in 2 groups: 10 subjects with unilateral exf...

To study the effect of phacoemulsification and intraocular lens implantation (PHACO IOL) on intraocular pressure (IOP) and glaucoma medication in open-angle glaucoma (OAG) eyes. 38 open-angle glaucoma (OAG) eyes with cataract underwent phacoemulsification and intraocular lens implantation (PHACO IOL) performed by one surgeon (RJU). None of the pati...

The purpose was to study whether any differences exist in the optic nerve head (ONH) and peripapillary retinal blood flow between the two eyes of patients with unilateral exfoliation glaucoma or ocular hypertension (OHT) with exfoliation syndrome. This cross-sectional study included 50 patients. All had exfoliation syndrome with glaucoma or OHT in...

To evaluate intraocular pressure (IOP) after phacoemulsification and intraocular lens (IOL) implantation in nonglaucomatous eyes with and without exfoliation. Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland. One hundred ninety-six eyes that had phacoemulsification with IOL implantation were examined. Eyes with a...

To study the relation between optic nerve head topography (Heidelberg retina tomograph, HRT) and disc area, visual field index mean defect (MD), and intraocular pressure (IOP), and to see whether change in HRT parameters is associated with change in MD in a prospective follow up. 80 consecutive patients (69 patients with exfoliation glaucoma and 11...

To find out how ophthalmologists themselves experience the correction of myopia after photorefractive keratectomy. Visuomotor functions were of special interest. Four ophthalmology residents and one medical engineer underwent photorefractive keratectomy for myopia. Objective measurements including refraction, corneal topography, perimetry, contrast...

Exfoliation syndrome abnormal deposition in the anterior segment of the eye of an unknown substance thought to be related to elastic fibres and basement membrane components is associated with accelerated cataract progression. increased frequency of intraoperative and postoperative complications and increased risk for glaucoma and. therefore, is a c...

If, at the time of glaucoma diagnosis, the intraocular pressure (IOP) is higher and the initial field loss more advanced in glaucomatous eyes with than without exfoliation, the cause of the optic disc damage has been suggested to be the high IOP associated with the exfoliation syndrome (EXS). We decided to investigate whether EXS alone, without the...

To evaluate the feasibility of using confocal scanning laser tomography in the analysis of macular topography in patients with subfoveal choroidal neovascularization associated with age-related macular degeneration (AMD) and to analyze quantitatively the changes in topography after local strontium-plaque radiation therapy. Prospective case series....

To determine the feasibility of adapting confocal scanning laser (CSL) tomography of the optic disc for quantitative evaluation of papilledema in pseudotumor cerebri (PTC). Confocal scanning laser tomography of the optic disc was performed in 11 patients with diagnosed PTC and 12 visually normal control subjects of similar age. In five patients wit...

To evaluate the correlation between the central visual field and changes in fluorescein angiography and fundus photography in patients treated with strontium plaque radiotherapy for subfoveal exudative age related macular degeneration (AMD). Octopus program 34 automated static perimetry, fluorescein angiography, and colour fundus photography were p...

To analyze the long-term effects of soft and hard (PMMA) contact lenses (CL) on the human corneal endothelium. One hundred and one contact lens wearers with > or =10 years' wearing time and 50 healthy control subjects were examined with specular microscope. The mean corneal endothelial cell densities of the CL wearers (2846 cells/mm2) and of the co...

Pigment dispersion syndrome and pigmentary glaucoma affect typically young, myopic persons. Iridozonular contact causes pigment dispersion and obstruction of the trabecular meshwork. Accumulation of pigment may result in transient elevation of intraocular pressure or irreparable damage to the meshwork accompanied by uncontrolled glaucoma. In the re...

The outcome of trabeculectomy in the treatment of primary open-angle glaucoma and exfoliative glaucoma was reviewed. The study included 87 consecutive eyes of 87 patients with open-angle glaucoma. The outcome of trabeculectomy was correlated with a biomicroscopic appearance of the filtering bleb. Visual acuity, myopic shift in refraction, and lens...

The authors examined the influences of diabetes on the results of visual function testing in patients with ocular hypertension (OHT). Color vision (desaturated D-15), contrast sensitivity together with both transient and steady-state pattern electroretinogram (PERG) findings from patients with documented OHT were examined in a historic cohort study...

To evaluate how often a microaneurysm (MA) seen in a fluorescein angiogram (FAG) is visualized in colour or red-free photographs, and conversely how often a red dot seen in a colour photograph or a red-free photograph is found in an FAG as an MA. Sixty-degree FAGs, colour photographs and red free fundus photographs of 24 patients with mild backgrou...

To analyze changes in the optic disc topography after filtration surgery. Laser scanning tomography was performed in 10 eyes of 9 patients (mean age 65.6 +/- 8.1 years; age range 55 to 75 years) after a mean follow-up of 3.7 months, and in 8 eyes of 7 patients (mean age 63.1 +/- 7.6 years; age range 55 to 75 years) after a mean follow-up of 13.1 mo...

Purpose. Low spatial frequency simusoidal gratings which are counterphased at a high temporal frequency are percieved at twice the spatial frequency (i.e. the frequency doubling illusion or FDI). This phenomenon has been associated with the non-linear response of retinal neurons. This study examined the contrast sensitivity of the pattern ERG elici...

Purpose. This study examined the influence of frame size and focal plane on the measurement of retinal arterial blood velocity with the HRF. Methods. Arterial blood velocity was determined in 5 healthy, visually normal volunteers (mean age = 35.2 years) using laser Doppler flowmetry (HRF version 1.02). Velocity was measured in the superior nasal, s...

The effect of injecting sodium hyaluronate (Healon) before fistulization in trabeculectomy was investigated in a prospective, randomized study of 107 consecutive eyes. Fifty-two eyes were operated on with the viscoelastic and 55 without. An early postoperative intraocular pressure (IOP) peak of 21 mm Hg or more occurred in 27% of the study eyes ver...

In cerebral achromatopsia, the patient loses the ability to see colours after cortical damage. As an only sequel to a stroke, cerebral achromatopsia is rare. Although the existence of a separate colour centre in the brain was postulated in the late 19th century, confirmatory data are quite recent. The authors describe a photographer who has lost th...

Cataract progression after trabeculectomy was investigated in a study of 47 eyes with exfoliative glaucoma (ExG) and in 20 eyes with primary open-angle glaucoma (POAG). Cataract progression was assessed from the need for cataract extraction, deterioration of visual acuity by > or = 2 Snellen lines, myopic change in the refraction and increase in th...

We retrospectively reviewed the results of 88 primary trabeculectomies with 1- to 5-year (mean, 3-year) follow up in an attempt to correlate the biomicroscopic appearance and function of the filtering bleb with intraocular pressure (IOP), and to detect possible risk factors for bleb failure. IOP in 74% of the eyes was < or = 21 mm Hg without medica...

A series of 305 consecutive patients 30 years of age or older scheduled for cataract surgery was examined to find out the frequency of exfoliation syndrome, the predominant type of cataract, and the intraocular pressure status. The mean age of 222 (72.8%) females and 83 (27.2%) males was 71.7 (+/- 11.1) years (range 32 to 91 years). Exfoliation was...

Fourteen eyes (12 with open-angle glaucoma and 2 with secondary glaucoma) of 14 patients were operated by trabeculectomy at the inferior limbus. The surgical technique is described and results of 6-12 months follow-up are reported. Complication rate was reasonably low. Early postoperative IOP higher than 30 mmHg occurred in one eye where a blood cl...

Two subjects representing AIED (Aland Island Eye Disease) and a family with 5 males affected with an AIED related X-linked hereditary eye disease were studied clinically and electrophysiologically. The clinical picture of AIED includes myopia and astigmatism, reduced visual acuity, nystagmus, ocular albinism, hemeralopia and dyschromatopsia (No. 30...

Since the suggestion to use sodium hyaluronate as a replacement for vitreous and aqueous humor by Balasz in 1972 [1], visco-surgery has gained far-reaching importance. The most widely used substance is 1% sodium hyaluronate (Healon, Pharmacia) which is biologically inactive, highly purified and has a molecular weight of approximately 4000000. It is...

The outcome of trabeculectomy with the use of sodium hyaluronate was investigated in 99 trabeculectomies and compared with the results achieved in an earlier series of trabeculectomies without the use of sodium hyaluronate. The use of sodium hyaluronate facilitated performance of the surgery and tended to reduce the severity of postoperative shallo...