BACKGROUND AND OBJECTIVE: To evaluate the prevalence of hemodynamically signif icant carotid artery stenosis, peripapillary blood flow, and serologic abnormali ties in a pilot study among patients with glaucoma. PATIE...BACKGROUND AND OBJECTIVE: To evaluate the prevalence of hemodynamically signif icant carotid artery stenosis, peripapillary blood flow, and serologic abnormali ties in a pilot study among patients with glaucoma. PATIENTS AND METHODS:All sub jects underwent complete eye examination, standard automated perimetry, carotid Doppler ultrasonography, serum laboratory testing, and scanning laser Doppler fl owmetry (SLDF). Subjects were subdivided into two groups based on glaucoma subty pe (normal-tension vs primary openangle glaucoma) and severity (mild vs moderat e-advanced). RESULTS: Twenty eyes of 20 patients with associated glaucomatous v isual field loss were enrolled. No significant differences in age, gender, intra ocular pressure, systemic comorbidity, number of antiglaucoma medications, and p rior filtration surgery were observed between the groups based on the type and s everity of glaucoma. The prevalence of clinically significant (>70%) carotid st enosis, mean peripapillary blood flow assessed by SLDF, mean erythrocyte sedimen tation rate, mean hematocrit, mean hemoglobin, and positive FTA-ABS was similar in both groups. Severity of glaucomatous damage as determined by visual field m ean defect did not correlate with the degree of carotid artery stenosis (R2< 0.0 001, P = 0.99) or peripapillary blood flow derived from mean SLDF (R2=0.000 5, P =0.92). CONCLUSION: Data from this pilot study demonstrate that the prevalence o f hemodynamically significant carotid stenosis, peripapillary blood flow, and se rologic abnormalities are similar in patients with normal-tension and primary o pen-angle glaucoma, and do not correlate with glaucoma severity.展开更多
Background: In patients with postgenicular lesions of the visual system, areas of residual vision (ARVs) are the main predictor of recovery induced by vision restoration therapy (VRT). In these partially defective reg...Background: In patients with postgenicular lesions of the visual system, areas of residual vision (ARVs) are the main predictor of recovery induced by vision restoration therapy (VRT). In these partially defective regions, the elevated pe rceptual thresholds can be acutely reduced by attentional cueing. Objective: To examine whether directing attention to ARVs using a visuospatial cue also increa ses longterm neural plasticity and thus enhances permanent training outcome. M ethods: In a prospective, randomized clinical trial, treatment outcome was compa red in patients with postgenicular visual system lesions who received either sta ndard VRT (control group [CG]; n=10) or VRT with attentional cueing (experim en tal group [EG]; n=9). Visual field size was determined before and after a 6-m on th treatment period using Tübingen Automated Perimetry and computerbased high resolution perimetry (HRP) and in regular intervals throughout this period b y HRP and detection performance in VRT. Results: In the area of the cue, restora tion of vision was significantly greater than during VRT without cueing: cued pa tients showed a much more pronounced shift of the visual field border toward the blind area than that observed in the CG or in uncued regions of the EG. Focusin g attention at ARVs during treatment changed topographic and temporal patterns o f recovery as compared with uncued regions of the visual field. Conclusions: Use of a visuospatial cue to focus attention at areas of residual vision amplifies longterm neuronal plasticity. The authors propose that topdown signals preac tivate partially damaged areas of V1, thus linking visual and attentional neuron al networks, with the effect of permanently increasing conscious visual percepti on.展开更多
文摘BACKGROUND AND OBJECTIVE: To evaluate the prevalence of hemodynamically signif icant carotid artery stenosis, peripapillary blood flow, and serologic abnormali ties in a pilot study among patients with glaucoma. PATIENTS AND METHODS:All sub jects underwent complete eye examination, standard automated perimetry, carotid Doppler ultrasonography, serum laboratory testing, and scanning laser Doppler fl owmetry (SLDF). Subjects were subdivided into two groups based on glaucoma subty pe (normal-tension vs primary openangle glaucoma) and severity (mild vs moderat e-advanced). RESULTS: Twenty eyes of 20 patients with associated glaucomatous v isual field loss were enrolled. No significant differences in age, gender, intra ocular pressure, systemic comorbidity, number of antiglaucoma medications, and p rior filtration surgery were observed between the groups based on the type and s everity of glaucoma. The prevalence of clinically significant (>70%) carotid st enosis, mean peripapillary blood flow assessed by SLDF, mean erythrocyte sedimen tation rate, mean hematocrit, mean hemoglobin, and positive FTA-ABS was similar in both groups. Severity of glaucomatous damage as determined by visual field m ean defect did not correlate with the degree of carotid artery stenosis (R2< 0.0 001, P = 0.99) or peripapillary blood flow derived from mean SLDF (R2=0.000 5, P =0.92). CONCLUSION: Data from this pilot study demonstrate that the prevalence o f hemodynamically significant carotid stenosis, peripapillary blood flow, and se rologic abnormalities are similar in patients with normal-tension and primary o pen-angle glaucoma, and do not correlate with glaucoma severity.
文摘Background: In patients with postgenicular lesions of the visual system, areas of residual vision (ARVs) are the main predictor of recovery induced by vision restoration therapy (VRT). In these partially defective regions, the elevated pe rceptual thresholds can be acutely reduced by attentional cueing. Objective: To examine whether directing attention to ARVs using a visuospatial cue also increa ses longterm neural plasticity and thus enhances permanent training outcome. M ethods: In a prospective, randomized clinical trial, treatment outcome was compa red in patients with postgenicular visual system lesions who received either sta ndard VRT (control group [CG]; n=10) or VRT with attentional cueing (experim en tal group [EG]; n=9). Visual field size was determined before and after a 6-m on th treatment period using Tübingen Automated Perimetry and computerbased high resolution perimetry (HRP) and in regular intervals throughout this period b y HRP and detection performance in VRT. Results: In the area of the cue, restora tion of vision was significantly greater than during VRT without cueing: cued pa tients showed a much more pronounced shift of the visual field border toward the blind area than that observed in the CG or in uncued regions of the EG. Focusin g attention at ARVs during treatment changed topographic and temporal patterns o f recovery as compared with uncued regions of the visual field. Conclusions: Use of a visuospatial cue to focus attention at areas of residual vision amplifies longterm neuronal plasticity. The authors propose that topdown signals preac tivate partially damaged areas of V1, thus linking visual and attentional neuron al networks, with the effect of permanently increasing conscious visual percepti on.
