Antonio Ferreras

University of Zaragoza, Caesaraugusta, Aragon, Spain

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Publications (133)214.63 Total impact

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    ABSTRACT: Purpose . To determine the agreement between Moorfields Regression Analysis (MRA), Glaucoma Probability Score (GPS) of Heidelberg retinal tomograph (HRT III), and peripapillary nerve fibers thickness by iVue Optical Coherence Tomography (OCT). Methods . 72 eyes with ocular hypertension or primary open angle glaucoma (POAG) were included in the study: 54 eyes had normal visual fields (VF) and 18 had VF damage. All subjects performed achromatic 30° VF by Octopus Program G1X dynamic strategy and were imaged with HRT III and iVue OCT. Sectorial and global MRA, GPS, and OCT parameters were used for the analysis. Kappa statistic was used to assess the agreement between methods. Results . A significant agreement between iVue OCT and GPS for the inferotemporal quadrant ( κ : 0.555) was found in patients with abnormal VF. A good overall agreement between GPS and MRA was found in all the eyes tested ( κ : 0.511). A good agreement between iVue OCT and MRA was shown in the superonasal ( κ : 0.656) and nasal ( κ : 0.627) quadrants followed by the superotemporal ( κ : 0.602) and inferotemporal ( κ : 0.586) sectors in all the studied eyes. Conclusion . The highest percentages of agreement were found per quadrant of the MRA and the iVue OCT confirming that in glaucoma damage starts from the temporal hemiretina.
    Preview · Article · Dec 2015 · Journal of Ophthalmology
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    ABSTRACT: Purpose . To analyse the visual outcome in wet age-related macular degeneration (AMD) patients depending on the number of ranibizumab injections. Methods . 51 naïve wet AMD patients were retrospectively recorded. Visual acuity (VA), central retinal thickness (CRT) measured with spectral domain (SD) optical coherence tomography (OCT), and number of intravitreal injections were compared at 6, 12, 18, 24, 30, and 36 months of follow-up. Kaplan-Meier survival rates (SRs) based on VA outcomes were calculated depending on the number of ranibizumab injections performed. Results . VA improved compared with baseline at 6 and 12 months ( P < 0.005 ). No differences were found at 18, 24, 30, and 36 months ( P > 0.05 ). CRT measured with Cirrus OCT decreased ( P < 0.001 ) at all time points analysed. The mean number of injections received was 6.98 ± 3.69 . At 36 months, Kaplan-Meier SR was 76.5% (the proportion of patients without a decrease in vision of more than 0.3 logMAR units). VA remained stable (≤0.01 logMAR units) or improved in 62.7%. Within this group, SR was 92.9% in those who received 7 or more injections versus 51.4% receiving
    Full-text · Article · Oct 2015 · Journal of Ophthalmology
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    ABSTRACT: Purpose: To evaluate frequency, conversion rate, and risk factors for blindness in glaucoma patients treated in European Universities. Methods: This multicenter retrospective study included 2402 consecutive patients with glaucoma in at least one eye. Medical charts were inspected and patients were divided into those blind and the remainder ('controls'). Blindness was defined as visual acuity≤0.05 and/or visual field loss to less than 10°. Results: Unilateral and bilateral blindness were respectively 11.0% and 1.6% at the beginning, and 15.5% and 3.6% at the end of the observation period (7.5±5.5 years, range:1-25 years); conversion to blindness (at least unilateral) was 1.1%/year. 134 eyes (97 patients) developed blindness by POAG during the study. At the first access to study centre, they had mean deviation (MD) of -17.1±8.3 dB and treated intraocular pressure (IOP) of 17.1±6.6 mmHg. During follow-up the IOP decreased by 14% in these eyes but MD deteriorated by 1.1±3.5 dB/year, which was 5-fold higher than controls (0.2±1.6 dB/year). In a multivariate model, the best predictors for blindness by glaucoma were initial MD (p<0.001), initial IOP (p<0.001), older age at the beginning of follow-up (p<0.001), whereas final IOP was found to be protective (p<0.05). Conclusions: In this series of patients, blindness occurred in about 20%. Blindness by glaucoma had 2 characteristics: late diagnosis and/or late referral, and progression of the disease despite in most cases IOP was within the range of normality and target IOP was achieved; it could be predicted by high initial MD, high initial IOP, and old age.
    Full-text · Article · Aug 2015 · PLoS ONE
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    ABSTRACT: Diabetes mellitus (DM) is a chronic disease that affects 387 million people worldwide. Diabetic retinopathy (DR), a common complication of DM, is the main cause of blindness in the active population. Diabetic macular edema (DME) may occur at any stage of DR, and is characterized by vascular hyperpermeability accompanied by hard exudates within the macula. Medical and surgical therapies have dramatically reduced the progression of DR, and timely intervention can reduce the risk of severe vision loss by more than 90 %. In 2012, intravitreal ranibizumab became the first antivascular endothelial growth factor (anti-VEGF) agent approved for DME and, since then, many reports of the use of ranibizumab for DME have been promising. Randomized, prospective, multicenter clinical trials-most notably, RESOLVE, READ-2, RISE/RIDE, RESTORE, DRCR.net protocol I, and RETAIN-reported improvements in best-corrected visual acuity and decreased central retinal thickness as measured with optical coherence tomography in patients with DME. Similar treatment benefits have also been noted in clinical trials evaluating intravitreal aflibercept and bevacizumab (DAVINCI, VISTA/VIVID, and BOLT) and more recently DRCR.net protocol T. Intravitreal steroids (dexamethasone intravitreal implant and fluocinolone acetonide), particularly in refractory cases, also play a significant role in the management of DME (MEAD/CHAMPLAIN and FAMOUS/FAME studies). In summary, over the last 5 years, blocking VEGF and inflammation has been shown to improve visual outcomes in patients with macular edema due to DM, revolutionizing the treatment of center-involved DME and establishing a new standard of care.
    No preview · Article · Aug 2015 · Drugs
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    Antonio Ferreras · Michele Figus · Paolo Frezzotti · Michele Iester

    Full-text · Article · Jul 2015
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    ABSTRACT: Objective. To assess the intrasession repeatability and intersession reproducibility of peripapillary retinal nerve fiber layer (RNFL) thickness parameters measured by scanning laser polarimetry (SLP) with enhanced corneal compensation (ECC) in healthy and glaucomatous eyes. Methods. One randomly selected eye of 82 healthy individuals and 60 glaucoma subjects was evaluated. Three scans were acquired during the first visit to evaluate intravisit repeatability. A different operator obtained two additional scans within 2 months after the first session to determine intervisit reproducibility. The intraclass correlation coefficient (ICC), coefficient of variation (COV), and test-retest variability (TRT) were calculated for all SLP parameters in both groups. Results. ICCs ranged from 0.920 to 0.982 for intravisit measurements and from 0.910 to 0.978 for intervisit measurements. The temporal-superior-nasal-inferior-temporal (TSNIT) average was the highest (0.967 and 0.946) in normal eyes, while nerve fiber indicator (NFI; 0.982) and inferior average (0.978) yielded the best ICC in glaucomatous eyes for intravisit and intervisit measurements, respectively. All COVs were under 10% in both groups, except NFI. TSNIT average had the lowest COV (2.43%) in either type of measurement. Intervisit TRT ranged from 6.48 to 12.84. Conclusions. The reproducibility of peripapillary RNFL measurements obtained with SLP-ECC was excellent, indicating that SLP-ECC is sufficiently accurate for monitoring glaucoma progression.
    Full-text · Article · Jul 2015
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    ABSTRACT: To determine the structure-function relationship between equivalent visual field areas obtained with the Octopus perimeter (OP), and the peripapillary retinal nerve fibre layer (RNFL) thickness measured with spectral-domain optical coherence tomography (OCT) in healthy individuals and patients with glaucomatous optic neuropathy. Eighty-eight normal subjects and 150 patients with open-angle glaucoma were prospectively recruited. Eligible participants for the glaucoma group were required to have elevated intraocular pressure and glaucomatous optic nerve head morphology. All participants underwent reliable automated perimetry with OP, and optic nerve head imaging with the Cirrus OCT. Principal component analysis of the mean threshold values for the visual field test points were performed independently for each hemifield. Pearson correlations were calculated between visual field regions and RNFL thickness sectors. Mild to moderate correlations were observed between the visual field regions and the peripapillary RNFL thicknesses. Each visual field region was significantly correlated with more than one RNFL sector, and vice versa. The strongest correlation was observed between the RNFL thickness at 5 and 7 clock-hour positions and the superonasal region of OP (r=0.63). Retinal sensitivity evaluated with OP correlated moderately well with the RNFL thickness measured by OCT. There was an overlap of the visual field regions within the optic disc. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    No preview · Article · Mar 2015 · The British journal of ophthalmology
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    ABSTRACT: Purpose: To assess the relationship between the retinal nerve fibre layer (RNFL) thickness and the frequency-doubling technology perimetry (FDT) outcome. Methods: Sixty-two healthy individuals and 72 glaucoma patients were prospectively selected. All participants underwent a reliable FDT and optical coherence tomography (OCT). Pearson correlations were calculated between the unlogged threshold values of FDT and RNFL thicknesses measured by OCT. Results: Mild to moderate correlations were found between a few points from FDT and RNFL thicknesses in the vertical axis. The nasal superior area of FDT and the RNFL thickness at the 7-o'clock position had the strongest correlation (0.434, p < 0.001). Conclusions: The poor agreement between FDT and OCT parameters suggests that both instruments assess different characteristics of glaucomatous optic neuropathy. The map obtained validates previously reported clinical findings and contributes to a better understanding of the structure-function relationship in glaucoma. © 2014 S. Karger AG, Basel.
    No preview · Article · Nov 2014 · Ophthalmologica
  • Pilar Calvo · Antonio Ferreras · Fadwa Al Adel · Yao Wang · Michael H Brent
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    ABSTRACT: To evaluate the visual and anatomical outcomes of dexamethasone intravitreal implant (DXI; 700 μg, Ozurdex; Allergan, Irvine, California, USA) as adjunctive therapy for patients with refractory wet age-related macular degeneration (AMD). Retrospective review of the medical records of seven patients (seven eyes) who initially responded well to intravitreal ranibizumab but subsequently developed persistent intra/sub-retinal fluid (IRF/SRF) and underwent a single injection of DXI, between May 2012 and May 2013. Two weeks after DXI, the patients continued with their monthly ranibizumab injections. Best corrected visual acuity (BCVA) logarithm of the minimum angle of resolution (logMAR) and central retinal thickness (CRT) were recorded at baseline, 2 weeks, 6 weeks, 3 months and 6 months after DXI injection. Complications were recorded too. All patients had at least 24 months of ranibizumab treatment. Mean age was 81.5±5.8 years. At baseline, mean BCVA was 0.53±0.13 logMAR (20/70 Snellen) and mean CRT was 273.14±50.94 μm. BCVA did not change significantly after DXI over the follow-up period. However, all eyes had lost fewer than 0.3 logMAR units. Complete resolution of the persistent IRF/SRF was achieved in five eyes (71.4%) at 6 weeks, and remained stable at 3 months. Two weeks after DXI injection, the mean CRT diminished compared with baseline (248.28±31.8 µm; p=0.03) and the greatest reduction was observed at 3 months after DXI injection (241.5±36.6 µm; p=0.04). Progression of lens opacity was detected in one case (50% of phakic eyes). Retreatment with DXI was performed in two eyes. DXI appears to be effective in vision stabilisation, decreasing IRF/SRF and improvement of CRT in eyes with refractory wet AMD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    No preview · Article · Nov 2014 · British Journal of Ophthalmology
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    ABSTRACT: Purpose: To evaluate the outcomes of standard automated perimetry (SAP) in patients with obstructive sleep apnea (OSA). Methods: Eighty OSA patients and 111 age-matched controls were consecutively and prospectively enrolled. One eye per subject was randomly selected. All participants underwent at least one reliable SAP (24-2 SITA Standard algorithm). The peripapillary retinal nerve fiber layer thickness (RNFL) was measured with spectral-domain optical coherence tomography (OCT). Patients with OSA were classified into three groups according to the apnea/hypopnea index: mild, moderate, or severe OSA. Parameters of SAP and OCT were compared between healthy controls and OSA patients. Correlation of apnea/hypopnea index with OCT and SAP measurements were calculated. Results: Mean age, best-corrected visual acuity, and central corneal thickness were similar between groups. Intraocular pressure, however, was lower in the OSA group. Mean deviation of SAP was -0.23 ± 0.8 dB in the control group and -1.74 ± 2.8 dB in the OSA group (P < 0.001). Thickness of RNFL measured with OCT did not differ significantly between groups. Patients with OSA showed reduced sensitivity at most points tested by white-on-white perimetry compared with healthy individuals. The threshold values were more depressed in the peripheral visual field. The apnea/hypopnea index was related to the SAP indices: Pearson correlations were -0.432 with mean deviation, 0.467 with pattern standard deviation, and -0.416 with the visual field index (P < 0.001). Conclusions: Patients with OSA exhibited reduced retinal sensitivity measured with SAP compared with healthy controls.
    No preview · Article · Oct 2014 · Investigative Ophthalmology & Visual Science
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    ABSTRACT: Purpose:: To compare the diagnostic performance of different segmentations of the nerve fiber layer (NFL) thickness measurements using an artificial neural network and to define the optimal number of sectors with best diagnostic ability for glaucoma diagnosis. Methods:: A total of 117 glaucoma patients and 123 normal subjects were included in the study. NFL thickness measurements were performed using the Spectralis-OCT (Heidelberg Engineering) to obtain the NFL thickness average; measurements from 2 semicircles, 4 quadrants, and 6, 8, 12, 16, 24, 32, and 64 sectors; and 768 uniformly divided locations around the peripapillary NFL. An artificial neural network evaluation was performed to compare the influence of sector analysis on the diagnostic performance of optical coherence tomography. Receiver operating characteristic curves were used to compare the diagnostic ability of the different segmentation analyses. Results:: The 6 sectors divided by the horizontal division of the nasal and temporal quadrants were better than the 6 sectors divided by the vertical line through the superior and inferior quadrants [areas under curve, 0.778; 95% confidence interval (CI), 0.720-0.829 and 0.814; 95% CI, 0.759-0.861, respectively]. In the case of quadrants, clock quadrants (area under curve 0.770; 95% CI, 0.712-0.822) were better than the ISNT (inferior-superior-nasal-temporal) quadrants (area under curve, 0.770; 95% CI, 0.712-0.822; P=0.003). The first segmentation strategy that improved the diagnostic value of 4 ISNT quadrants was the 12-sector analysis (area under curve, 0.845; 95% CI, 0.793-0.889; P=0.001). Conclusions:: The 2 best candidate strategies for the OCT report were the 12-sector analysis and the 4 planimetric quadrant (alternatively, the 4 clock quadrants) analysis.
    No preview · Article · Jul 2014 · Journal of Glaucoma
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    ABSTRACT: Objective: To compare the equivalent optic nerve head (OHN) parameters obtained with confocal scanning laser ophthalmoscopy (HRT3) and spectral-domain optical coherence tomography (OCT) in healthy and glaucoma patients. Methods: One hundred and eighty-two consecutive healthy subjects and 156 patients with open-angle glaucoma were divided into 2 groups according to intraocular pressure and visual field outcomes. All participants underwent imaging of the ONH with the HRT3 and the Cirrus OCT. The ONH parameters and the receiver operating characteristic (ROC) curves were compared between both groups. Results: Mean age did not differ between the normal and glaucoma groups (59.55 ± 9.7 years and 61.05 ± 9.4 years, resp.; P = 0.15). Rim area, average cup-to-disc (C/D) ratio, vertical C/D ratio, and cup volume were different between both instruments (P < 0.001). All equivalent ONH parameters, except disc area, were different between both groups (P < 0.001). The best areas under the ROC curve were observed for vertical C/D ratio (0.980 for OCT and 0.942 for HRT3; P = 0.11). Sensitivities at 95% fixed-specificities of OCT parameters were higher than those of HRT3. Conclusions: Equivalent ONH parameters of Cirrus OCT and HRT3 are different and cannot be used interchangeably. ONH parameters measured with OCT yielded a slightly better diagnostic performance.
    Full-text · Article · Jul 2014 · BioMed Research International
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    ABSTRACT: Objective: To evaluate the relationship between spectral-domain optical coherence tomography (OCT) and standard automated perimetry (SAP) in healthy and glaucoma individuals. Methods: The sample comprised 338 individuals divided into 2 groups according to intraocular pressure and visual field outcomes. All participants underwent a reliable SAP and imaging of the optic nerve head with the Cirrus OCT. Pearson correlations were calculated between threshold sensitivity values of SAP (converted to linear scale) and OCT parameters. Results: Mean age did not differ between the control and glaucoma groups (59.55 ± 9.7 years and 61.05 ± 9.4 years, resp.; P = 0.15). Significant differences were found for the threshold sensitivities at each of the 52 points evaluated with SAP (P < 0.001) and the peripapillary retinal nerve fiber layer (RNFL) thicknesses, except at 3 and 9 clock-hour positions between both groups. Mild to moderate correlations (ranging between 0.286 and 0.593; P < 0.001) were observed between SAP and most OCT parameters in the glaucoma group. The strongest correlations were found between the inferior RNFL thickness and the superior hemifield points. The healthy group showed lower and weaker correlations than the glaucoma group. Conclusions: Peripapillary RNFL thickness measured with Cirrus OCT showed mild to moderate correlations with SAP in glaucoma patients.
    Full-text · Article · Jun 2014 · BioMed Research International
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    Calvo P. · Wang Y. · Ferreras A. · Lam WC · Devenyi R. · Brent MH
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    ABSTRACT: Objective: To compare the 3-year outcomes of two different dosing regimens used for wet age-related macular degeneration patients treated exclusively with ranibizumab. Methods: A Treat and extend (TAE) dosing group (n=30) and a treat and observe (TAO) dosing group (n=30) were retrospectively recorded. Survival rates (SR) based on visual acuity (VA) outcomes were calculated and analyzed. The central retinal thickness measured with spectral domain (SD) optical coherence tomography (OCT) and number of intravitreal injections performed in both groups were also compared. Results: At 36 months, Kaplan-Meier SRs were 90.9% for TAE and 89.7% for TAO (loss<0.3 units logMAR). VA improved in 42.4% and 24.1%, while 33.4% and 62.1% remained stable for TAE and TAO groups, respectively. No final VA differences were found between both therapeutic strategies (p>0.05, log-rank test). No differences were found in the final number of injections received: 20.31±6.6 in TAE group vs. 18.41 ± 7.1 in TAO group (p=0.19). Conclusions: Both approaches showed similar number of injections and visual outcomes.
    Full-text · Article · Feb 2014 · Clinical and Experimental Ophthalmology
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    ABSTRACT: Purpose/methods To present the neuro-ophthalmology examination in 5 spastic ataxia of Charlevoix-Saguenay (ARSACS) patients showing significant increases in retinal nerve fiber layer (RNFL) thickness. Results/conclusions All patients showed abnormal visual fields, normal optic discs with increased visibility of RNFL in color stereo-photographs, normal examination with Heidelberg Retina Tomography instrument, and moderate to markedly increased RNFL thickness in Cirrus Optical Coherence Tomography evaluation (average thickness: 119 to 220 microns). We found evidence that RNFL hypertrophy may be an alternative funduscopic finding to the hypermyelinated retinal fibers in previous reports. A revision of ARSACS diagnostic criteria, particularly with regard to retinal alterations, is necessary.
    No preview · Article · Jan 2014 · Archivos de la Sociedad Espanola de Oftalmologia
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    ABSTRACT: Background/aims: To evaluate optic nerve head with spectral domain optical coherence tomography (OCT) in patients with Chiari I malformation (CMI) compared to healthy controls. Methods: Cross-sectional study. OCT of the optic nerve head of 22 patients with CMI and 22 healthy controls was quantitatively analyzed. The healthy controls were matched for age and sex with the study population. Mean retinal nerve fiber layer (RNFL) thickness was calculated for both eyes; the mean thickness value was also registered for each quadrant and for each subfield of the four quadrants. Results: CMI patients showed a reduction of the RNFL thickness in both eyes. This reduction was more statistically significant (P < 0.05) for the inferior quadrant in the right eye and in each quadrant than nasal one in the left eye. Conclusion: A distress of the retinal nerve fibers could explain the observed reduction of the RNFL thickness in patients with CMI; in our series the reduction of the RNFL thickness seems lower when CMI is associated with syringomyelia.
    Full-text · Article · Jan 2014 · BioMed Research International
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    ABSTRACT: Purpose: To evaluate the ability of frequency-doubling technology (FDT) perimetry in detecting visual field defects in young adults with type I diabetes prior to retinopathy or with minor retinovascular changes. Methods: This comparative cross-sectional study included 30 healthy subjects and 73 age-matched patients with type I diabetes mellitus. All subjects underwent a full ocular examination including an FDT with the threshold C-20-5 strategy. Only one eye per subject was randomly included in the statistical analysis. FDT results and time to perform the test were compared between the groups. Results: The mean age was 27.1 years in the control group and 26.6 years in the diabetic group (P = 0.875). The mean period from the onset of diabetes was 12.6 ± 6.7 years, while minimal retinovascular changes were observed in 18 eyes. Mean deviation of FDT did not differ between the groups. Although global indices of FDT were within normal limits, pattern standard deviation of FDT was higher in the diabetic group (P = 0.035). The area under the receiver operating characteristic curve was 0.647 for pattern standard deviation of FDT (standard error = 0.052; P = 0.017). Conclusion: FDT can detect retinal dysfunctions in diabetic patients prior to the onset of significant vascular complications.
    Full-text · Article · Nov 2013
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    ABSTRACT: Background: To represent and interpret the three-dimensional (3D) geometry and the distribution of the axonal damage to the retinal nerve fiber layer (RNFL) in patients with multiple sclerosis (MS) compared with healthy subjects. To analyze alterations in RNFL morphology in eyes of MS patients with or without previous episodes of optic neuritis (ON). Methods: MS patients (n = 122) and age-matched healthy subjects (n = 108) were enrolled. The Spectralis optical coherence tomography system was used to determine the circumpapillary RNFL thickness. The 768 RNFL thickness measurements were used to evaluate thickness measurements in patients with or without antecedent ON and to design a 3D reconstruction of the RNFL thickness representing the mechanobiologic tissue response to neurodegeneration caused by MS and ON episodes. Results: RNFL thickness was decreased in MS patients, and was higher in the MS group with previous ON. Statistical analysis and 3D RNFL reconstruction revealed greater damage to the ganglionar cells in the superonasal RNFL area (101.77 µm in MS vs. 125.47 µm in healthy subjects) and in the inferotemporal RNFL (119.05 µm in MS eyes and 149.26 µm in healthy eyes). Conclusions: The 3D representation of RNFL thickness based on measurements allows physicians to better observe damage in the temporal areas, especially in patients with previous ON.
    Full-text · Article · Jun 2013 · Ophthalmic Research
  • N Güerri · V Polo · J.M. Larrosa · C Egea · A Ferreras · L.E. Pablo
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    ABSTRACT: Objective: To study the correlation between the sensitivity threshold values of the different points assessed by the Humphrey visual field analyzer (24-2 Swedish interactive threshold algorithm [SITA] standard strategy) in glaucoma patients. Subjects, material and methods: Prospective cross-sectorial study. One-hundred and four eyes of 104 glaucoma patients, defined by the appearance of the optic nerve head, were evaluated. Retinal threshold sensitivity points of standard automated perimetry (SA) with SITA standard 24-2 program were obtained. The upper and the lower hemifields were studied separately. Pearson correlation coefficients were calculated between the mean threshold sensitivity value at each point of the visual hemifield and the rest of the threshold points in the same hemifield. Results: Perimetric correlation maps between retinal threshold sensitivity values in the same hemifield were obtained. Most of the points showed moderate to high correlations (r≥0.65. P<0.001) with neighboring points and distant points in the same hemifield. Conclusions: There is a functional relationship between neighboring and distant points in Humphrey Visual Field Analyzer (SITA Standard 24-2) in glaucoma patients. This correlation is related to the anatomical arrangement of ganglion cell axons. This fact enables perimetric patterns of glaucoma defects to be obtained.
    No preview · Article · Jun 2013 · Archivos de la Sociedad Espanola de Oftalmologia
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    ABSTRACT: To present the neuro-ophthalmology examination in 5 spastic ataxia of Charlevoix-Saguenay (ARSACS) patients showing significant increases in retinal nerve fiber layer (RNFL) thickness. All patients showed abnormal visual fields, normal optic discs with increased visibility of RNFL in color stereo-photographs, normal examination with Heidelberg Retina Tomography instrument, and moderate to markedly increased RNFL thickness in Cirrus Optical Coherence Tomography evaluation (average thickness: 119 to 220 microns). We found evidence that RNFL hypertrophy may be an alternative funduscopic finding to the hypermyelinated retinal fibers in previous reports. A revision of ARSACS diagnostic criteria, particularly with regard to retinal alterations, is necessary.
    No preview · Article · Apr 2013 · Archivos de la Sociedad Espanola de Oftalmologia

Publication Stats

692 Citations
214.63 Total Impact Points

Institutions

  • 2008-2015
    • University of Zaragoza
      • Department of Surgery, Gynecology and Obstetrics
      Caesaraugusta, Aragon, Spain
  • 2005-2015
    • Hospital Universitario Miguel Servet
      • Servicio de Neurología
      Caesaraugusta, Aragon, Spain
  • 2009-2013
    • Aragon Health Sciences Institute
      Caesaraugusta, Aragon, Spain