DOCSLIB.ORG

Psychophysical Function in Age-Related Maculopathy Kumari Neelam, FRCS,1,2,3 John Nolan, Phd,1 Usha Chakravarthy, Phd,4 and Stephen Beatty, MD1,2

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Psychophysical Function in Age-Related Maculopathy Kumari Neelam, FRCS,1,2,3 John Nolan, Phd,1 Usha Chakravarthy, Phd,4 and Stephen Beatty, MD1,2 SURVEY OF OPHTHALMOLOGY VOLUME 54 NUMBER 2 MARCH–APRIL 2009 MAJOR REVIEW Psychophysical Function in Age-related Maculopathy Kumari Neelam, FRCS,1,2,3 John Nolan, PhD,1 Usha Chakravarthy, PhD,4 and Stephen Beatty, MD1,2 1Waterford Institute of Technology, Waterford, Republic of Ireland; 2Waterford Regional Hospital, Waterford, Republic of Ireland; 3Alexandra Hospital, National Healthcare Group, Singapore; and 4Queen’s University and Royal Victoria Hospitals, Belfast, United Kingdom Abstract. Age-related macular degeneration (AMD), the late stage of age-related maculopathy (ARM), is the leading cause of blind registration in developed countries. The visual loss in AMD occurs due to dysfunction and death of photoreceptors (rods and cones) secondary to an atrophic or a neovascular event. The psychophysical tests of vision, which depend on the functional status of the photoreceptors, may detect subtle alterations in the macula before morphological fundus changes are apparent ophthalmoscopically, and before traditional measures of visual acuity exhibit deterioration, and may be a useful tool for assessing and monitoring patients with ARM. Furthermore, worsening of these visual functions over time may reflect disease progression, and some of these, alone or in combination with other parameters, may act as a prognostic indicator for identifying eyes at risk for developing neovascular AMD. Lastly, psychophysical tests often correlate with subjective and relatively undefined symptoms in patients with early ARM, and may reflect limitation of daily activities for ARM patients. However, clinical studies investigating psychophysical function have largely been cross- sectional in nature, with small sample sizes, and lack consistency in terms of the grading and classification of ARM. This article aims to comprehensively review the literature germane to psychophysical tests in ARM, and to furnish the reader with an insight into this complex area of research. (Surv Ophthalmol 54:167--210, 2009. Ó 2009 Elsevier Inc. All rights reserved.) Key words. age-related maculopathy color vision hyperacuity perimetry psychophysical tests Spatial vision temporal function visual adaptation I. Introduction life expectancy, and the consequential demographic Age-related macular degeneration (AMD), the ad- shift toward an elderly population will have impli- cations for the socio-economic impact of this vanced stage of age-related maculopathy (ARM), is 24,235 a degenerative condition of the macula characterized disease. Furthermore, the currently available by dysfunction and death of photoreceptors second- therapeutic interventions for this condition are aimed largely at preservation of presenting visual ary to an atrophic (geographic atrophy, GA) and/or 205,320,321,334 a neovascular (choroidal neovascularization, CNV) acuity (VA), even though a significant event. Currently, AMD is the leading cause of blind proportion may achieve some visual gain with the 73,113,119 newer vascular endothelial growth factor inhibition registration in the developed world, with 125,332 CNV accounting for 80--90% of these cases.149,196 therapies. Thus, complete restoration of vision In the future, the prevalence and incidence of remains an unrealistic goal at least within the next ARM is expected to rise because of an increase in decade. Finally, the impact of ARM on the activities 167 Ó 2009 by Elsevier Inc. 0039-6257/09/$--see front matter All rights reserved. doi:10.1016/j.survophthal.2008.12.003 168 Surv Ophthalmol 54 (2) March--April 2009 NEELAM ET AL of daily living, self-care, emotional well-being and adaptation, central visual field, and colour discrim- overall quality of life are important, and are related ination, deteriorate in the early stages of ARM. to disease severity.57,88,92,179,298,354 Therefore pre- Furthermore, longitudinal studies have shown that vention, delay, or arrestation of progression to the some of these parameters, in isolation or in late manifestations of ARM, namely CNV and/or combination, may be of predictive value with respect GA, represent the best means of limiting the impact to the progression to CNV and/or GA with a good of this degenerative disorder on visual health and degree of sensitivity and specificity. quality of life in the elderly population. This article represents an evidence-based and The early stages of ARM are characterized by comprehensive review of psychophysical function in drusen and/or pigmentary changes of the retinal ARM, with particular emphasis on identifying those pigment epithelium (RPE), and herald the loss of parameters of visual function that may be of normal retinal status and, consequentially, an predictive value for disease progression. increased risk for the development of CNV and/or GA. A number of investigators have reported, in a cross-sectional fashion, various morphological II. Anatomy of the Macula changes in the fundus, which may be associated The macula lutea refers to a region of the with subsequent development of severe visual loss. posterior retina that measures approximately 5.5 The characteristics of drusen, such as large number mm in diameter, and is exquisitely specialized for and size, confluence, softness, and associated focal central and color vision.289 The macula differs from hyperpigmentation of the RPE, are associated with the rest of the retina by the presence of an an increased risk for progression to the neovascular exceptionally high density of neural elements and stage of this disease.42,43,45,128,269,300 However, the restricted blood supply.247 Furthermore, one of the overall predictive value of such morphological unique feature of the primate macula is the changes is low, possibly reflecting the high presence of xanthophylls, lutein (L) and zeaxanthin incidence of age-related fundus changes.335 In (Z), which provide its eponymous yellow color. addition, the relationship, if any, between morpho- Together, these two xanthophylls are referred to as logical and functional changes in the retina in ARM macular pigment (MP).35 remains unclear. For instance, in a recent study, the MP peaks in the central 1--2 degrees of the fovea, severity of functional deficits in short-wavelength and declines to optically negligible levels by 5--10 sensitive resolution acuity did not correlate well with degrees radial eccentricity, along with shoulders or the severity of morphological changes in ARM.25 flanking peaks around 0.7 degrees eccentricity.94 The early lesions of ARM may be associated with Furthermore, Berendschot et al in a recent study a decrease in VA of approximately two or fewer examined the spatial distribution of MP in 53 optotypes (i.e., letters) when compared with eyes normal subjects using a custom-built scanning laser without such lesions.169 This level of visual deficit is ophthalmoscope (SLO), and they observed a distinct neither clinically meaningful nor reliably detectable, ring pattern at a mean distance of 0.7 degree of the given that the test--retest variability of a logMAR fovea in approximately half of the subjects.27 chart is between one and two lines.18,257 In addition, Additionally, in a few of these subjects, the optical such a level of visual deterioration may pass density of MP was greater at the site of the ring undetected using the conventional Snellen chart, pattern, when compared with the optical density of suggesting, therefore, that VA, the standard test of this pigment at the fovea. visual function typically performed in the clinical It is important to note that, at the macula, L exists setting, is inadequate for the assessment of func- as a single stereoisomer, whereas Z subsists as two tional deficit in early ARM, and is therefore of no separate isomers, zeaxanthin (3R, 30R) and meso- prognostic value with respect to the risk for atrophic zeaxanthin (3R, 30S). Furthermore, both isomers of and/or neovascular changes. Z are present in equal concentrations at the macula; Consequently, other psychophysical tests of vision, however, only zeaxanthin (3R, 30R) is typically which reflect the functional status of the macula, derived from dietary sources.180 It is proposed that may be useful tools for assessing and monitoring a conversion mechanism exists in the retina, patients with early ARM, and may detect subtle whereby L is isomerized to meso-zeaxanthin, and alterations in the macula before morphological this observation may possibly explain the presence fundus changes are apparent ophthalmoscopically, of meso-zeaxanthin in the retina despite its absence and before traditional measures of VA exhibit in a typical diet. deterioration. Indeed, psychophysical studies have The macula may be further subdivided into four demonstrated that several parameters of visual anatomical zones, originally defined by Polyak,246 function, in particular contrast sensitivity, visual and named in relation to the fovea (fovea centralis). PSYCHOPHYSICAL FUNCTION IN ARM 169 The foveola, which is the innermost region of the ically, these cells have a restricted blood supply from macula, corresponds to the visual axis, and is the retina, and depend on the oxygen supplied by characterized by a high density of cone photorecep- the choriocapillaris.201 The blood flow within the tors, absence of retinal vasculature, and dominance choriocapillaris is controlled mainly by sympathetic of Midget pathways arising from these cones.247 It is innervation, and lacks metabolic autoregulatory important to note that short wavelength sensitive capabilities.93 In other words, the choroidal blood cones, rods, ganglion
Load more

Recommended publications
  • Characterising Adaptational Dysfunction in Age-Related Macular Degeneration
    Characterising adaptational dysfunction in age-related macular degeneration A thesis submitted to Cardiff University for the degree of Doctor of Philosophy By Allannah Jayne Gaffney School of Optometry and Vision Sciences Cardiff University August 2012 Supervised by Dr Alison Binns and Dr Tom Margrain Summary Age-related macular degeneration (AMD) is the leading cause of visual impairment in the developed world (Resnikoff et al., 2004). The prevalence of this disease will continue to increase over the coming decades as the average age of the global population rises (United Nations, 2009). There is consequently an urgent need to develop tests that are sensitive to early visual dysfunction, in order to identify individuals that have a high risk of developing AMD, to identify patients that would benefit from treatment, to assess the outcomes of that treatment and to evaluate emerging treatment strategies. An emerging body of evidence suggests that dark adaptation is a sensitive biomarker for early AMD. Cone dark adaptation is of particular interest to clinicians, as it can identify patients with early AMD in a relatively short recording period. Consequently, this thesis aimed to optimise psychophysical and electrophysiological techniques for the assessment of cone dark adaptation in early AMD, in order to maximise its diagnostic potential. A range of psychophysical methods were shown to be capable of monitoring the rapid changes in threshold that occur during cone dark adaptation. An optimal psychophysical protocol for the assessment of cone dark adaptation in early AMD was developed based on the results of a systematic evaluation of the effect of stimulus parameters and pre-adapting light intensity on the diagnostic potential of cone dark adaptation in early AMD.
    [Show full text]
  • Visual Predictors for Poor Mobility Performance in People with Age Related Macular Degeneration
    VISUAL PREDICTORS FOR POOR MOBILITY PERFORMANCE IN PEOPLE WITH AGE RELATED MACULAR DEGENERATION Remy Sheena Mathew, B.Sc A thesis submitted in partial fulfilment of the requirements for admission to the degree of Doctor of Philosophy School of Optometry and Vision Science, University of New South Wales, Sydney, Australia September 2009 Visual predictors for poor mobility performance in people with AMD Originality statement ‘I hereby declare that this submission is my own work and to the best of my knowledge it contains no materials previously published or written by another person, or substantial proportions of material which have been accepted for the award of any other degree or diploma at UNSW or any other educational institution, except where due acknowledgement is made in the thesis. Any contribution made to the research by others, with whom I have worked at UNSW or elsewhere, is explicitly acknowledged in the thesis. I also declare that the intellectual content of this thesis is the product of my own work, except to the extent that assistance from others in the project's design and conception or in style, presentation and linguistic expression is acknowledged.’ Signed …………………………...................... Remy Sheena Mathew. ii Visual predictors for poor mobility performance in people with AMD Copyright and Authenticity Statements COPYRIGHT STATEMENT ‘I hereby grant the University of New South Wales or its agents the right to archive and to make available my thesis or dissertation in whole or part in the University libraries in all forms of media, now or here after known, subject to the provisions of the Copyright Act 1968.
    [Show full text]
  • Normative Value of Photostress Recovery Time Among Various Age Groups in Southern India
    Medical Hypothesis, Discovery &Innovation Optometry Journal Original Article Normative value of photostress recovery time among various age groups in southern India Bhandari Bishwash 1 , De Tapas Kumar 1, Sah Sanjay Kumar 1, Sanyam Sandip Das 1 1 Sankara Academy of Vision, Sankara College of optometry, Bangalore, India ABSTRACT Background: To determine the normative data and reference value for photostress recovery time (PSRT) following exposure of the macula to light, in various age groups within the Indian population. Methods: Cross-sectional observational study performed from November 2015 to July 2016 in the Bangalore district of Karnataka state in India. We examined a total of 1,282 eyes of 641 participants and included those with corrected distance visual acuity (CDVA) scoes lower than or equal to 0.4 Logarithm of the Minimum Angle of Resolution (LogMAR). We performed the photostress procedure under standard conditions using the same approach. Results: The mean ± standard deviation (SD) of the participants’ age was 32.04 ± 15.80, with an age range of 8 to 70 years. The PSRT in participants below 16 years and above 45 years of age were significantly different compared to the 16–25-year-old age group (P < 0.0001 for both). The PSRT values were significantly different between males and females in the reproductive age group (16 to 45 years old) (P < 0.0001), but not in the other age groups. Conclusions: The PSRT values were significantly different in children and older patients compared to the 16 to 25 years age group. We found that as age increased, PSRT increased significantly.
    [Show full text]
  • The Development of a Clinical Trial Protocol and Functional Biomarkers for Age-Related Macular Degeneration
    The Development of a Clinical Trial Protocol and Functional Biomarkers for Age-Related Macular Degeneration Claire McKeague A thesis submitted to Cardiff University for the degree of Master of Philosophy SCHOOL OF OPTOMETRY AND VISION SCIENCES, CARDIFF UNIVERSITY 2014 SUPERVISED BY DR ALISON BINNS & DR TOM MARGRAIN DECLARATION This work has not previously been accepted in substance for any degree and is not concurrently submitted in candidature for any degree. STATEMENT 1 This thesis is being submitted in partial fulfillment of the requirements for the degree of …………………………(insert MCh, MD, MPhil, PhD etc, as appropriate) STATEMENT 2 This thesis is the result of my own independent work/investigation, except where otherwise stated. Other sources are acknowledged by explicit references. STATEMENT 3 I hereby give consent for my thesis, if accepted, to be available for photocopying and for inter- library loan, and for the title and summary to be made available to outside organisations. Summary Age-related macular degeneration (AMD) is the leading cause of blindness amongst older adults in the developed world. With the predicted rise in the ageing population over the next decades, the prevalence of this debilitating disease will simply continue to increase. The only treatments currently available are for advanced neovascular AMD. The retina is already severely compromised by this stage in disease development. Therefore, there is a pressing need to evaluate potential novel interventions that aim to prevent the development of advanced disease in people with early AMD, to prevent sight loss from occurring. Furthermore, it is necessary to develop tests that are sensitive to subtle changes in visual function in order to evaluate the efficacy of these emerging treatments.
    [Show full text]
  • B.Voc in Optometry B.Voc (OPT) Year -1 Diploma
    B.Voc in Optometry B.Voc (OPT) Year -1 Diploma I Semester S.No. Course Code Subject Content Credit Type 1 BVOPT-101 General Human Anatomy & Physiology General 4 2 BVOPT-102 General biochemistry Skill 4 3 BVOPT-103 Geometrical optics-I Skill 4 4 BVOPT-104 Medical Ethics and Patients Care General 3 5 BVOPT-105 Fundamental of Computers General 3 6 BVOPT-106 General English and soft skill General 2 BVOPTP-101 Practical of CourseBVOPT-101 Skill 2 BVOPTP-102 Practical of CourseBVOPT-102 Skill 2 BVOPTP-103 Practical of CourseBVOPT-103 Skill 2 BVOPTP-104 Practical of CourseBVOPT-104 Skill 2 BVOPTP-105 Practical of CourseBVOPT-105 Skill 2 II Semester S.No. Course Code Subject Type of Credits Course 1 BVOPT-201 Ocular Anatomy and physiology Gen 4 2 BVOPT-202 Physical optics Skill 4 3 BVOPT-203 Geometrical optics II Skill 4 4 BVOPT-204 Optometric Optics –I Skill 2 5 BVOPT-205 Orientation in para clinic science General 3 6 BVOPT-206 Basics of Health Market & Economy General 3 BVOPTP-201 Practical of Course BVOPT-201 Skill 2 BVOPTP-202 Practical of Course BVOPT202 Skill 2 BVOPTP-203 Practical of Course BVOPT-203 Skill 2 BVOPTP-204 Practical of Course BVOPT-204 Skill 2 BVOPTP-205 Practical of Course BVOPT-205 Skill 2 Internship in Hospital B.Voc in Optometry B.Voc (OPT) Year -2Advance Diploma III Semester S.No. Course Code Subject Type of Credits Course 1 BVOPT-301 General and ocular microbiology Gen 4 2 BVOPT-302 Visual Optics- I Skill 3 3 BVOPT-303 Optometric Optics – II Skill 4 4 BVOPT-304 Optometric Instruments Skill 3 5 BVOPT-305 Advance Computing skills Gen 2 6 BVOPT-306 Human Values & Professional Ethics Gen 4 BVOPTP-301 Practical based on BVOPT-301 Skill 2 BVOPTP-302 Practical based on BVOPT-302 Skill 2 BVOPTP-303 Practical based on BVOPT-303 Skill 2 BVOPTP-304 Practical based on BVOPT-304 Skill 2 BVOPTP-305 Practical based on BVOPT-305 Skill 2 IV Semester S.No.
    [Show full text]
  • Photostress Test As a Predictor of Macular Dysfunction in Patients with Asymmetrical Age-Related Maculopathy
    Original Research Article DOI: 10.18231/2395-1451.2017.0017 Photostress test as a predictor of macular dysfunction in patients with asymmetrical Age-related maculopathy Bindu S1,*, Jyothi PT2, Padma B. Prabhu3, Sandhya S4 1,3Associate Professor, 2Professor, 4Assistant Professor, Dept. of Ophthalmology, Govt. Medical College, Kozhikode, Kerala *Corresponding Author: Email: [email protected] Abstract Background: Age related maculopathy causes irreversible central visual loss in elderly population. Photo stress recovery time and Amsler grid evaluation are the tests used to assess the functional integrity of macula. Aim of Study: 1. To determine the Photo stress recovery time (PSRT) in patients with asymmetrical age-related macular maculopathy (ARM) 2. To find out the prevalence and the relation between risk factors, visual acuity, Amsler evaluation and photo stress recovery time. Settings and Design: Hospital based Case series study. Materials and Methods: Out of the 2104 participants above 50years, 37 patients presented with features of age related maculopathy. The systemic and ocular risk factors of ARM was observed. Relevant clinical examination, photo stress test and amsler grid monitoring was done in all patients. Statistical analysis was done using SPSS Version 18. Results: The overall prevalence of age related maculopathy in the study population was 1.76%, and it increases with age. Mean age was 62.84 years ± 7.97. Males were more affected by the disease. Smoking, dyslipidemia, cortical cataract and hyperopia were the most common risk factors. Photo stress recovery time was prolonged in all patients with reduced visual acuity. Even in eyes with good vision it was abnormal in the early stage of the disease before visible change occurred in the macula.
    [Show full text]
  • Dr. Madhura Mali ABSTRACT KEYWORDS INTERNATIONAL
    ORIGINAL RESEARCH PAPER Volume-8 | Issue-7 | July - 2019 | PRINT ISSN No. 2277 - 8179 INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH USE OF PHOTOSTRESS TEST TO STUDY MACULAR FUNCTION IN EYES WITH MACULOPATHIES Ophthalmology Assistant Professor, Department of Ophthalmology, SMT. Kashibai Navale Medical Dr. Madhura Mali College, Pune ABSTRACT Introduction: There are various Psychophysical and Electrophysiological tests to evaluate macular functions. In present era of technology driven diagnostic testing, there is lesser utilization of simpler and cost effective clinical tests. This study was undertaken to evaluate macular function by Photostress test in eyes with and without Maculopathies. Aim: Study various Maculopathies using Photostress test. Methodology: This study was conducted on 389 eyes with maculopathies and 400 normal eyes. A detailed ophthalmic and macular examination with Photostress test was performed in all cases. Results: Maculopathy was commonly observed in age group of 41 to 50 years with a higher prevalence amongst males. 18 types of maculopathies were found in the study, Dry ARMD(25.15%) and Diabetic Maculopathy(8.9%) were most common. Photostress test was positive in 46 out of 389 eyes with maculopathies (11.83%). Conclusion: Photostress test is an useful indicator in early diagnosis of Maculopathies. KEYWORDS Macula, Photostress test, Maculopathy INTRODUCTION the PSRT. Normal range is upto 40 seconds. PSRT increases with age The photoreceptors of the macular area of the retina are responsible for but is independent of pupil size, ametropia and visual acuity.[4] Despite photopic and colour vision. Disturbances in anatomical integrity of the the fact that it is easy to perform and is readily available for clinical use, macula by oedema, inflammation or degeneration results in it is underutilized.
    [Show full text]
  • Photostress Recovery in Chronic Open Angle Glaucoma
    Br J Ophthalmol: first published as 10.1136/bjo.72.9.641 on 1 September 1988. Downloaded from British Journal of Ophthalmology, 1988, 72, 641-645 Photostress recovery in chronic open angle glaucoma MARK D SHERMAN AND PAUL HENKIND* From the Department ofOphthalmology, Albert Einstein College ofMedicine and Montefiore Medical Center, Bronx, New York, USA SUMMARY Photostress recovery time was measured in 30 eyes from 15 patients with chronic open angle glaucoma, and 30 eyes from 15 individuals of a similar age group with no ophthalmological disorder. The average recovery time in patients with glaucoma was 70 47 (SD 35-39) seconds. The average recovery time in the control population was 41-97 (SD 17.34) seconds. This difference was statistically significant (p<O0OO1). There was a small positive correlation between age and recovery time in the control population, whereas there was no correlation between age and recovery time in the glaucoma group. There was no correlation between visual acuity and recovery time for either group. There was also no correlation between intraocular pressure and recovery time for the glaucoma group. It was not possible to control for pupillary dilatation in this study. However, it has been previously demonstrated that pharmacological meiosis will not delay photostress recovery time in normal subjects. This is the first report of photostress recovery testing in patients with chronic open angle glaucoma. The results are discussed in terms of the pathophysiology of glaucoma and previous photostress studies in patients with macular disease. copyright. Photostress recovery time (PSRT) has frequently the time required for the eye to return to baseline been used as a quantitative measure of macular visual acuity once the illumination period is over.
    [Show full text]
  • Suitability and Repeatability of a Photostress Recovery Test Device, the Macular Degeneration Detector (MDD-2), for Diabetes and Diabetic Retinopathy Assessment
    Technological University Dublin ARROW@TU Dublin Articles 2013 Suitability and Repeatability of a Photostress Recovery Test Device, the Macular Degeneration Detector (MDD-2), for Diabetes and Diabetic Retinopathy Assessment James Loughman Technological University Dublin, [email protected] Matthew Ratzlaff University of KwaZulu-Natal Brittany Foerg Mater Misericordiae University Hospital, Dublin See next page for additional authors Follow this and additional works at: https://arrow.tudublin.ie/otpomart Part of the Optometry Commons Recommended Citation Loughman, J., Ratzlaff, M., Foerg, B., Connell, P.:Suitability and Repeatability of a Photostress Recovery Test Device, the Macular Degeneration Detector (MDD-2), for Diabetes and Diabetic Retinopathy Assessment. Retina, 2013. This Article is brought to you for free and open access by ARROW@TU Dublin. It has been accepted for inclusion in Articles by an authorized administrator of ARROW@TU Dublin. For more information, please contact [email protected], [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License Authors James Loughman, Matthew Ratzlaff, Brittany Foerg, and Paul Connell This article is available at ARROW@TU Dublin: https://arrow.tudublin.ie/otpomart/35 SUITABILITY AND REPEATABILITY OF A PHOTOSTRESS RECOVERY TEST DEVICE, THE MACULAR DEGENERATION DETECTOR (MDD-2), FOR DIABETES AND DIABETIC RETINOPATHY ASSESSMENT JAMES LOUGHMAN, PHD,*† MATTHEW RATZLAFF, BSC,‡ BRITTANY FOERG, BSC,* PAUL CONNELL, MD‡ Background: Diabetic retinopathy can result in impaired photostress recovery time despite normal visual acuity and fundoscopic appearance. The Macular Degeneration Detector (MDD-2) is a novel flash photostress recovery time device. In this study, we examine the repeatability of the MDD-2 in normal and diabetic subjects.
    [Show full text]
  • Submitted in Partial Fulfillment of Requirements Of
    DISSERTATION ON A CLINICAL STUDY ON CYSTOID MACULAR EDEMA DUE TO VEIN OCCLUSION AND ITS MANAGEMENT Submitted in partial fulfillment of requirements of M.S.OPHTHALMOLOGY BRANCH – III REGIONAL INSTITUTE OF OPHTHALMOLOGY MADRAS MEDICAL COLLEGE CHENNAI – 600 008 THE TAMIL NADU DR.M.G.R.MEDICAL UNIVESITY CHENNAI APRIL 2017 CERTIFICATE This is to certify that the dissertation titled, “A CLINICALSTUDY ON CYSTOID MACULAR EDEMA DUE TO VEIN OCCLUSION AND ITS MANAGEMENT is a bonafide record ofthe research work done by DR.SHALINI. S, post graduate in the RegionalInstitute of Ophthalmology & Government Ophthalmic Hospital, MadrasMedical College and Research Institute,Chennai-08,submitted in partialfulfillment of the regulations laid down by the Tamil Nadu Dr. M.G.R.Medical University, Chennai for the award of M.S.OphthalmologyBranch III, under my guidance and supervision during the academic years2014 - 2017 Prof. Dr. M Rajakumari MS. Prof. Dr.WaheedaNazir., MS.DO Head of the department, Director and Superintendent Uvea and Retina services, Regional institute of ophthalmology Regional institute of ophthalmology, Government ophthalmic hospital Government ophthalmic hospital, Madras medical college Madras medical college, chennai-8. Chennai 8 PROF. DR.M . K MURALIDHARAN, M.S MCH., DEAN n Madras Medical College & Government General Hospital, Chennai – 600 003 DECLARATION BY THE CANDIDATE I hereby declare this dissertation entitled “A CLINICAL STUDYON CYSTOID MACULAR EDEMADUE TO VEIN OCCLUSION AND ITS MANAGEMENT is a bonafide and genuineresearch work carried out by me under the guidance ofProf.Dr. M RajakumariM.S , D.O DATE : PLACE DR. SHALINI.S ACKNOWLEDGEMENT I express my sincere thanks and gratitude toProf.Dr.M K Muralidharan.
    [Show full text]
  • Symbols and Abbrevations
    City Research Online City, University of London Institutional Repository Citation: Vemala, R. (2018). Loss of chromatic sensitivity in patients with age-related maculopathy - correlation with structural changes in the retina. (Unpublished Doctoral thesis, City, University of London) This is the accepted version of the paper. This version of the publication may differ from the final published version. Permanent repository link: https://openaccess.city.ac.uk/id/eprint/26212/ Link to published version: Copyright: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. Reuse: Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. City Research Online: http://openaccess.city.ac.uk/ [email protected] Loss of chromatic sensitivity in patients with age-related maculopathy - correlation with structural changes in the retina Mrs Roopa Vemala Doctor of Philosophy Applied Vision Research Centre School of Health Sciences City, University of London January 2018 CONTENTS Table of Contents TABLE OF FIGURES: ................................................................................................................................
    [Show full text]
  • Evaluation of Macular Function Tests with Diabetic Retinopathy
    Jemds.com Original Research Article Evaluation of Macular Function Tests with Diabetic Retinopathy Abhinav Ashok Agrawal1, Niharika Krishna Shetty2 1, 2 Department of Ophthalmology, Sri Siddhartha Medical College Hospital and Research Center, Sri Siddhartha Academy of Higher Education University, Tumakuru, Karnataka, India. ABSTRACT BACKGROUND Diabetic retinopathy (DR) is reported to be the leading cause of vision loss in adults Corresponding Author: aged between 20–74 years. Early detection and prompt evaluation is essential to Dr. Niharika Krishna Shetty, C-1403, Wing 1, Vaishnavi ARS prevent the blindness related to diabetes. Simple and quick out-patient department Gardenia, Subrotho Mukherjee (OPD) tests are essential for early detection of maculopathy in diabetes, which will Road, Jallahalli (West), enhance the treatment and rehabilitation. The purpose of this study was to evaluate Dasarahalli, Bangalore – 560057, the correlation of photo stress test and Amsler’s grid test with diabetic retinopathy Karnataka, India. and maculopathy. We also wanted to study the variation in photo stress test and the E-mail: [email protected] patterns of visual disturbances using Amsler grid in different stages of diabetic retinopathy. DOI: 10.14260/jemds/2021/307 METHODS How to Cite This Article: Agrawal AA, Shetty NK. Evaluation of All patients with type 2 diabetes were included for a study duration of one year. A macular function tests with diabetic cross sectional study design was planned. Anterior and posterior segment evaluation retinopathy. J Evolution Med Dent Sci was done. Photo stress test was performed with a torch light and the recovery time 2021;10(20):1463-1468, DOI: was recorded.
    [Show full text]