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    Central field perimetry of discriminated targets: I. Results for normal individuals using high-contrast targets
    (Nature Publishing Group, 2009) Yavuz, Gülderen Aktan; Ünver, Y.B.; Bekiroğlu, N.; Presti, Peter; Sinclair, Stephen H.
    Purpose A new perimetry method is described to evaluate central vision under multiple hue, illumination, and contrast conditions; results are described for normal individuals using high-contrast targets. Methods For 70 normal eyes of individuals with varying age, the ETDRS chart acuity was determined as well as discriminated target perimetry using high-contrast targets presented for 250 ms at locations up to 10 degrees eccentricity. Retesting was performed to evaluate for learning and repeatability for the thresholded acuity at each eccentricity. Results The ETDRS acuity averaged 1.15 +/- 0.37 arc min minimum angle of resolution (MAR) with best correction (20/23 equivalence). At fixation, the thresholded acuity for high-contrast targets paralleled the ETDRS acuity and averaged 1.75 +/- 0.85 arc min MAR (20/35 equivalence), and declined with increasing eccentricity in a linear fashion to 5.81 +/- 3.97 arc min (20/116 equivalent) at 10 degrees eccentricity. Linear regression showed Vmar = 1.74 vertical bar 0.330 * eccentricity in degrees (R-2 = 0.966, P < 0.0001). Testing time required similar to 8-10 min per eye. Repeated testing showed only minimal learning experience at the most peripheral locations. The test-retest 95% confidence limits of difference measured 1.12 arc mins MAR at fixation (64% of the mean) and remained approximately the same proportion to the mean thresholded acuity outwards to 10 degrees eccentricity. Conclusion The methodology seems rapid and reliable for measuring discriminatory visual function of optotype targets throughout the central 20 degrees diameter visual field. Eye (2009) 23, 2082-2089; doi:10.1038/eye.2009.177; published online 17 July 2009
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    Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration
    (Nature Publishing Group, 2009) Ünver, Y.B.; Yavuz, Gülderen Aktan; Bekiroğlu, N.; Presti, Peter; Li, Weiye; Sinclair, Stephen H.
    Purpose This pilot study was undertaken to examine the relationships between clinical measures of visual function and anatomic changes occurring in the eyes treated with bevacizumab for choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods A retrospective review was conducted for 50 eyes that had been treated with at least three injections of bevicizumab for CNV due to AMD, and followed for at least 6 months. Vision outcomes included best-corrected ETDRS chart acuity, scored by best-line read (ETDRS line) and by total letters read (ETDRS letter), and two measures obtained from central acuity perimetry with 98% Michelson contrast targets, the best acuity within 6 degrees of fixation (BA6 degrees), and global macular acuity (GMA), representing a weighted average of the acuities thresholded at all intercepts within a 10 degrees radius of fixation. Assessment of anatomic outcomes included fibrosis, atrophy, and subretinal hemorrhage grading on fundus photography, CNV size, pigment epithelial detachment (PED) size and grading of CNV leakage on fluorescein angiography, and central retinal PED, and subretinal fluid (SRF) thickness on optical coherence tomography. Results Logistic regression analysis showed an association between the vision outcomes of EDTRS letter and BA6 degrees with the change in SRF thickness (R-2: 0.47 and 0.35, respectively). The outcome of the vision measurement of GMA was associated with the change in SRF thickness, in CNV thickness, and in CNV fibrosis grade (R-2: 0.34). No association was noted between the outcomes of ETDRS line with the change in any anatomic outcomes. Conclusion Acuity perimetry outcomes in this study seemed to offer improved understanding of the relationship between the vision outcomes and the measured anatomic changes. It seemed that neither ocular coherence tomography nor fluorescein angiography alone offered sufficient morphologic markers for prediction of functional outcomes.