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Aspects of structural and functional assessment in open angle glaucoma

Bourtsoukli, Ioanna. 2005. Aspects of structural and functional assessment in open angle glaucoma. PhD Thesis, Cardiff University.

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Early detection of glaucoma is a prerequisite for effective management of the disease. The study was concerned with aspects of structural and functional assessment in open angle glaucoma. The major part of the study was concerned with the utilization of digital stereoscopic imaging of the optic nerve head in the detection of open angle glaucoma (OAG). Specifically, it addressed possible sources of variability that confound the diagnosis of glaucoma and are associated with the monoscopic, as opposed to stereoscopic, observation of the optic nerve head (ONH) the limited diagnostic value of the features of the peripapillary retina accompanying glaucomatous damage and the between-observer variation in the subjective evaluation of the ONH. The study utilised a dataset of magnification corrected digital images from 51 normal individuals and from 113 patients with OAG. Misdiagnosis of glaucoma was associated with discrepancies in the evaluation of the rim area due to the monoscopic presentation of the ONH masking the presence of focal rim loss, otherwise evident with stereoscopic observation. The frequency and patterns of distribution of the alpha and beta peripapillary atrophy (PPA) were confirmed among normal and glaucomatous eyes but meaningful conclusions on the diagnostic value of PPA were hindered by the clinically broad criteria of this feature. Regression analysis of the global and sectorial rim areas for the discrimination of glaucomatous damage compared favourably with the subjective glaucoma diagnosis by expert observers. The remaining part of the study was concerned with the evaluation of the Total and Pattern Deviation probability analysis in short-wavelength perimetry (SWAP). The material comprised the Humphrey Field Analyzer single field print-outs from standard automated perimetry (SAP) and from SWAP of 53 normal individuals 18 patients with cataract, 22 with OHT and 55 with OAG. Focal visual field loss derived by SWAP was markedly less compared to SWAP indicating wider limits of normality for SWAP. Considerable caution should be exercised before the use of SWAP.

Item Type: Thesis (PhD)
Status: Unpublished
Schools: Optometry and Vision Sciences
Subjects: R Medicine > R Medicine (General)
ISBN: 9781303207068
Date of First Compliant Deposit: 30 March 2016
Last Modified: 09 Jan 2018 21:38

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