Podcasts about rnfl

Idiopathic intracranial hypertension (IIH) is characterized by symptoms and signs of unexplained elevated intracranial pressure (ICP) in an alert and awake patient. The condition has potentially devastating effects on vision, headache burden, increased cardiovascular disease risk, sleep disturbance, and depression.  In this episode, Teshamae Monteith, MD, FAAN speaks with Aileen A. Antonio, MD, FAAN, author of the article “Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Antonio is an associate program director of the Hauenstein Neurosciences Residency Program at Trinity Health Grand Rapids and an assistant clinical professor at the Michigan State University College of Osteopathic Medicine in Lansang, Michigan. Additional Resources Read the article: Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Guest: @aiee_antonio Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: Hi, this is Dr Teshamae Monteith. Today I'm interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the June 2025 Continuum issue on disorders of CSF dynamics.  Hi, how are you? Dr Antonio: Hi, good afternoon. Dr Monteith: Thank you for being on the podcast. Dr Antonio: Thank you for inviting me, and it's such an honor to write for the Continuum. Dr Monteith: So why don't you start off with introducing yourself? Dr Antonio: So as mentioned, I'm Aileen Antonio. I am a neuro-ophthalmologist, dually trained in both ophthalmology and neurology. I'm practicing in Grand Rapids, Michigan Trinity Health, and I'm also the associate program director for our neurology residency program. Dr Monteith: So, it sounds like the residents get a lot of neuro-ophthalmology by chance in your curriculum. Dr Antonio: For sure. They do get fed that a lot. Dr Monteith: So why don't you tell me what the objective of your article was? Dr Antonio: Yes. So idiopathic intracranial hypertension, or IIH, is a condition where there's increased intracranial pressure, but without an obvious cause. And with this article, we want our readers---and our listeners right now---to recognize that the typical symptoms and learning about the IIH diagnostic criteria are key to avoiding errors, overdiagnosis, or sometimes even misdiagnosis or underdiagnosis. Thus, we help make the most of our healthcare resources. Early diagnosis and management are crucial to prevent disability from intractable headaches or even vision loss, and it's also important to know when to refer the patients to the appropriate specialists early on. Dr Monteith: So, it sounds like your central points are really getting that diagnosis early and managing the patients and knowing how to triage patients to reduce morbidity and complications. Is that correct? Dr Antonio: That is correct and very succinct, yes. Dr Monteith: And so, are there any more recent advances in the diagnosis of IIH? Dr Antonio: Yes. And one of the tools that we've been using is what we call the optical coherence tomography. A lot of people, neurologists, physicians, PCP, ER doctors; how many among those physicians are well-versed in doing an eye exam, looking at the optic disc? And this is a great tool because it is noninvasive, it is high resolution imaging technique that allows us to look at the optic nerve without even dilating the eye. And we can measure that retinal nerve fiber layer, or RNFL; and that helps us quantify the swelling that is visible or inherent in that optic nerve. And we can even follow that and monitor that over time. So, this gives us another way of looking at their vision and getting that insight as to how healthy is their vision still, along with the other formal visual tests that we do, including perimetry or visual field testing. And then all of these help in catching potentially early changes, early worsening, that may happen; and then we can intervene more easily. Dr Monteith: Great. So, it sounds like there's a lot of benefits to this newer technology for our patients. Dr Antonio: That is correct. Dr Monteith: So, I read in the article about the increased incidence of IIH, and I have to say that I completely agree with you because I'm seeing so much of it in my clinic, even as a headache specialist. And I had a talk with a colleague who said that the incidence of SIH and IIH are similar. And I was like, there's no way. Because I see, I can see several people with IIH just in one day. That's not uncommon. So, tell me what your thoughts are on the incidence, the rising incidence of IIH; and we understand that it's the condition associated with obesity, but it sounds like you have some other underlying drivers of this problem. Dr Antonio: Yes, that is correct. So, as you mentioned, IIH tends to affect women of childbearing age with obesity. And it's interesting because as you've seen that trend, we see more of these IIH cases recently, which seem to correlate with that rising rate of obesity. And the other thing, too, is that this trend can readily add to the burden of managing IIH, because not only are we dealing with the headaches or the potential loss of vision, but also it adds to the burden of healthcare costs because of the other potential comorbidities that may come with it, like cardiovascular risk factors, PCOS, and sleep apnea. Dr Monteith: So why don't we just talk about the diagnosis of IIH? Dr Antonio: IIH, idiopathic intracranial hypertension, is also called pseudotumor cerebri.  It's essentially a condition where a person experiences increased intracranial pressure, but without any obvious cause. And the tricky part is that the patients, they're usually fully awake and alert. So, there's no obvious tumor, brain tumor or injury that causes the increased ICP. It's really, really important to rule out other conditions that might cause these similar symptoms; again, like brain tumors or even the cerebral venous sinus thrombosis. Many patients will have headaches or visual disturbances like transient visual obscurations---we call them TVOs---or double vision or diplopia. The diplopia is usually related to a sixth nerve palsy or an abducens palsy. Some may also experience some back pain or what we call pulsatile tinnitus, which is that pulse synchronous ringing in their ears. The biggest sign that we see in the clinic would be that papilledema; and papilledema is a term that we only use, specifically use, for those optic nerve edema changes that is only associated with increased intracranial pressure. So, performing of endoscopy and good eye exam is crucial in these patients. We usually use the modified Dandy criteria to diagnose IIH. And again, I cannot emphasize too much that it's really important to rule out other secondary causes to that increased intracranial pressure. So, after that thorough neurologic and eye evaluation with neuroimaging, we do a lumbar puncture to measure the opening pressure and to analyze the cerebrospinal fluid. Dr Monteith: One thing I learned from your article, really just kind of seeing all of the symptoms that you mentioned, the radicular pain, but also- and I think I've seen some papers on this, the cognitive dysfunction associated with IIH. So, it's a broader symptom complex I think than people realize. Dr Antonio: That is correct. Dr Monteith: So, you mentioned TVOs. Tell me, you know, if I was a patient, how would you try and elicit that from me? Dr Antonio: So, I would usually just ask the patient, while you're sitting down just watching TV---some of my patients are even driving as this happens---they would suddenly have these episodes of blacking out of vision, graying out of vision, vision loss, or blurred vision that would just happen, from seconds to less than a minute, usually. And they can happen in one eye or the other eye or both eyes, and even multiple times a day. I had a patient, it was happening 50 times a day for her. It's important to note that there is no pain associated with it most of the time. The other thing too is that it's different from the aura that patients with migraines would have, because those auras are usually scintillating and would have what we call the positive phenomena: the flashing lights, the iridescence, and even the fortification that they see in their vision. So definitely TVOs are not the migraine auras. Sometimes the TVOs can also be triggered by sudden changes in head positions or even a change in posture, like standing up quickly. The difference, though, between that and, like, the graying out of vision or the tunneling vision associated with orthostatic hypotension, is that the orthostatic hypotension would also have that feeling of lightheadedness and dizziness that would come with it. Dr Monteith: Great. So, if someone feels lightheaded, less likely to be a TVO if they're bending down and they have that grain of vision. Dr Antonio: That is correct. Dr Monteith: Definitely see patients like that in clinic. And if they have fluoride IIH, I'm like, I'll call it a TVO; if they don't, I'm like, it's probably more likely to be dizziness-related. And then we also have patient migraines that have blurriness that's nonspecific, not necessarily associated with aura. But I think in those patients, it's usually not seconds long, it's usually probably longer episodes of blurriness. Would you agree there, or…? Dr Antonio: I would agree there, and usually the visual aura would precede the headache that is very characteristic of their migraine, very stereotypical for their migraines. And then it would dissipate slowly over time as well. With TVOs, they're brisk and would not last, usually, more than a minute. Dr Monteith: So, why don't we talk about routine imaging? Obviously, ordering an MRI, and I read also getting an MRV is important. Dr Antonio: It is very important because, one: I would say IIH is also a diagnosis of exclusion. We need to make sure that the increased ICP is not because of a brain tumor or not because of cerebral venous sinus thrombosis. So, it's important to get the MRI of the brain as well as the MRV of the head. Dr Monteith: Do you do that for all patients' MRV, and how often do you add on an orbital study? Dr Antonio: I usually do not add on an orbital study because it's not really going to change my management at that point. I really get that MRI of the brain. Now the MRV, for most of my patients, I would order it already just because the population that I see, I don't want to lose them. And sometimes it's that follow-up, and that is the difficult part; and it's an easy add on to the study that I'm going to order. Again, it depends with the patient population that you have as well, and of course the other symptoms that may come with it. Dr Monteith: So, why don't we talk a little bit about CSF reading and how these set values, because we get people that have readings of 250 millimeters of water quite frequently and very nonspecific, questionable IIH. And so, talk to me about the set value. Dr Antonio: Right. So, the modified Dandy criteria has shown that, again, we consider intracranial pressure to be elevated for adults if it's above 250 millimeters water; and then for kids if it's above 280 millimeters of water. Knowing that these are taken in the left lateral decubitus position, and assuming also that the patients were awake and not sedated during the measurement of the CSF pressure. The important thing to know about that is, sometimes when we get LPs under fluoroscopy or under sedation, then these can cause false elevation because of the hypercapnia that elevated carbon dioxide, and then the hypoventilation that happens when a patient is under sedation. Dr Monteith: You know, sometimes you see people with opening pressures a little bit higher than 25 and they're asymptomatic. Well, the problem with these opening pressure values is that they can vary somewhat even across the day. People around 25, you can be normal, have no symptoms, and have opening pressure around 25- or 250; and so, I'm just asking about your approach to the CSF values. Dr Antonio: So again, at the end of the day, what's important is putting everything together. It's the gestalt of how we look at the patient. I actually had an attending tell me that there is no patient that read the medical textbook. So, the, the important thing, again, is putting everything together. And what I've also seen is that some patients would tell me, oh, I had an opening pressure of 50. Does that mean I'm in a dire situation? And they're so worried and they just attach to numbers. And for me, what's important would be, what are your symptoms? Is your headache, right, really bad, intractable? Number two: are you losing vision, or are you at that cusp where your optic nerve swelling or papilledema is so severe that it may soon lead to vision loss? So, putting all of these together and then getting the neuroimaging, getting the LP. I tell my residents it's like icing on the cake. We know already what we're dealing with, but then when we get that confirmation of that number… and sometimes it's borderline, but this is the art of neurology. This is the art of medicine and putting everything together and making sure that we care and manage it accordingly. Dr Monteith: Let's talk a little bit about IIH without papilledema. Dr Antonio: So, let's backtrack. So, when a patient will fit most of the modified Dandy criteria for IIH, but they don't have the papilledema or they don't have abducens palsy, the diagnosis then becomes tricky. And in these kinds of cases, Dr Friedman and her colleagues, when they did research on this, suggested that we might consider the diagnosis of IIH. And she calls this idiopathic intracranial hypertension without papilledema, IIHWOP. They say that if they meet the other criteria for modified Dandy but show at least three typical findings on MRI---so that flattening of the posterior globe, the tortuosity of the optic nerves, the empty sella or the partially empty sella, and even the narrowing of the transverse venous sinuses---so if you have three of these, then potentially you can call these cases as idiopathic intracranial hypertension without papilledema. Dr Monteith: Plus, the opening pressure elevation. I think that's key, right? Getting that as well. Dr Antonio: Yes. Sometimes IIHWOP may still be a gray area. It's a debate even among neuro-ophthalmologists, and I bet even among the headache specialists. Dr Monteith: Well, I know that I've had some of these conversations, and it's clear that people think this is very much overdiagnosed. So, that's why I wanted to plug in the LP with that as well. Dr Antonio: Right. And again, we have not seen yet whether is, this a spectrum, right? Of that same disease just manifesting differently, or are they just sharing a same pathway and then diverging? But what I want to emphasize also is that the treatment trials that we've had for IIH do not include IIHWOP patients. Dr Monteith: That is an important one. So why don't you wrap this up and tell our listeners what you want them to know? Now's the time. Dr Antonio: So, the- again, with IIH, with idiopathic intracranial hypertension, what is important is that we diagnose these patients early. And I think that some of the issues that come into play in dealing with these patients with IIH is that, one: we may have anchoring bias. Just because we see a female with obesity, of reproductive age, with intractable headaches, it does not always mean that what we're dealing with is IIH. The other thing, too, is that your tools are already available to you in your clinic in diagnosing IIH, short of the opening pressure when you get the lumbar puncture. And I need to emphasize the importance of doing your own fundoscopy and looking for that papilledema in these patients who present to you with intractable headaches or abducens palsy. What I want people to remember is that idiopathic intracranial hypertension is not optic nerve sheath distension. So, these are the stuff that you see on neuroimaging incidentally, not because you sent them, because they have papilledema, or because they have new headaches and other symptoms like that. And the important thing is doing your exam and looking at your patients. Dr Monteith: Today, I've been interviewing Dr Aileen Antonio about her article on clinical features and diagnosis of idiopathic intracranial hypertension, which appears in the most recent issue of Continuum on disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Thank you again. Dr Antonio: Thank you. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

In this week's issue Mitomycin C during dacryocystorhinostomy may improve anatomic outcomes with less clear evidence for improved functional success Case series suggests the incidence of severe neutropenia after intra-arterial chemotherapy may be higher than previously reported For primary open-angle glaucoma, RNFL thickness measured by OCT may have lower diagnostic accuracy in eyes of African compared to European descent.  RPE culture volumes were found to influence RPE physiology and should be optimized for future in vitro studies

CJ Stroud has a record-breaking performance in Houston Texans win over the Bucs, the Minnesota Vikings continue to show incredible resiliency and the Baltimore Ravens are showing they are legit. On today's episode, Joe Marino and Kyle Crabbs break down the NFL action from Week 9. Key topics include the Houston Texans, CJ Stroud, Minnesota Vikings, Kevin O'Connell, Josh Dobbs, Atlanta Falcons, Baltimore Ravens, Lamar Jackson, Miami Dolphins, Mike McDaniel, Buffalo Bills, Josh Allen, Joe Burrow, Cincinnati Bengals, Kansas City Chiefs, Patrick Mahomes, Philadelphia Eagles, Seattle Seahawks, Jalen Hurts, Geno Smith, Washington Commanders, Sam Howell, Bryce Young and more! Follow & Subscribe on all Podcast platforms…

CJ Stroud has a record-breaking performance in Houston Texans win over the Bucs, the Minnesota Vikings continue to show incredible resiliency and the Baltimore Ravens are showing they are legit. On today's episode, Joe Marino and Kyle Crabbs break down the NFL action from Week 9. Key topics include the Houston Texans, CJ Stroud, Minnesota Vikings, Kevin O'Connell, Josh Dobbs, Atlanta Falcons, Baltimore Ravens, Lamar Jackson, Miami Dolphins, Mike McDaniel, Buffalo Bills, Josh Allen, Joe Burrow, Cincinnati Bengals, Kansas City Chiefs, Patrick Mahomes, Philadelphia Eagles, Seattle Seahawks, Jalen Hurts, Geno Smith, Washington Commanders, Sam Howell, Bryce Young and more!  Follow & Subscribe on all Podcast platforms…

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.06.28.546061v1?rss=1 Authors: Lorenceau, J. Abstract: We present a method for mapping multifocal Pupillary Response Fields in a short amount of time, using a visual stimulus covering 40 degrees of visual angle, divided in 9 contiguous sectors, simultaneously modulated in luminance at specific, incommensurate, temporal frequencies. We tested this multiple Pupillary Frequency Tagging (mPFT) approach with young healthy participants (N=36), and show that the spectral power of the sustained pupillary response elicited by 45 seconds of fixation of this multipartite stimulus reflects the relative contribution of each sector/frequency to the overall pupillary response. We further analyze the phase lag for each temporal frequency as well as several global features related to pupil state. Test retest performed on a subset of participants indicates good repeatability. We also investigate the existence of structural (RNFL)/functional (mPFT) relationships. We then summarize results of clinical studies conducted with mPFT on patients with neuropathies and retinopathies and show that the features derived from pupillary signal analyzes, the distribution of spectral power in particular, allows sorting patients from healthy participants with excellent sensitivity and specificity. This method thus appears a convenient, objective and fast tool for assessing the integrity of retino-pupillary circuits, as well as idiosyncrasies, that permits to objectively detect or follow-up retinopathies or neuropathies in a short amount of time. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Christopher K.S. Leung, MD, MB ChB, chairperson and clinical professor for the Department of Ophthalmology at The University of Hong Kong School of Clinical Medicine, recaps his article—“Retinal Nerve Fiber Layer Optical Texture Analysis”—from the November/December issue of Glaucoma Today. In the article, Dr. Leung describes RNFL Optical Texture Analysis, an algorithm to uncover the optical texture and trajectories of individual axonal fiber bundles, which may help to identify RNFL defects in early and advanced glaucoma.

Chris Maathuis and Ron Futrell of 8NewsNow Las Vegas talk about Raiders first workouts (OTA's) of 2022 season and the possibility of Colin Kaepernick joining the Raiders.

Homer, Heidi and T3RaiderFax explore why Raider Nation reaches worldwide and then look at how free agency and the draft set up the Las Vegas Raiders for the future.Show Notes:https://www.onlynationpod.com/ep-63-raider-nation-worldwide/

Guest: Alessandro Jammal, MD Associate in Research, Ophthalmology Duke Eye Center Durham, North Carolina

Chris Maathuis and Ron Futrell of 8 News Now talk about the Las Vegas Raiders heartbreaking loss to the Chiefs and the upcoming game against the Falcons. Coach Jon Gruden and Derek Carr join the podcast with their interviews. Also, Thanksgiving Day football discussed.

Back in the Crow's Nest We're back to breakdown Week 2's loss to the KC Chiefs: The Good, The Bad, and The Ugly. We'll also take a look towards Week 3's tilt against the Minnesota Vikings. Despite and dismal outcome, there were positive takeaways from the Raiders Week 2 match-up vs their AFC West Rival. What went wrong and what can we expect moving forward? Bobby joins us as he fills in for Che who calls in remote this week. Che helps us analyze the ups and downs from the Raiders second home game in 2019. Cain joins us later in the show to dissect the upcoming challenge in Minnesota. Last but not least, we hear from some of your voicemails and live calls.  All this and more on this week's episode of The Pillaging Podcast! Stay Tuned in… The #1 Raiders Podcast in Raider Nation! Listen every week on iTunes, SoundCloud, and Stitcher Radio. Download the official Pillaging App on the Apple App Store and Android! Be sure to subscribe to our YouTube channel for future live broadcasts. Check out our shop and sport some Pillaging gear! Also, Leave us a message to be played on the show: (408) 909-PJFF. Follow us on Instagram: @The_Pillaging_Podcast #cnpn #raiderspodcast #pillagingpodcast #pj4f #raiders #raidernation #life #oaklandraiders #rnfl #justwinbaby #oakland #commitmenttoexcellence #silverandblack #football #beastmode #derekcarr #lasvegas #jongruden #oaktown #raiderfan #raidersallday #raider #raiderfans #lasvegasraiders #raidersalldayeveryday #townbidness  #trentbrown #KCvsOAK #OAKvsMIN #podcast #raiderspodcast #cnpn  

Da Tailgate boys interview Dusty Evely @dustyevely from @cheeseheadTV & @packadaypodcast about the Green Bay Packers & also Case Dillon @susuhme_rNFL from The Detroit Lions Podcast @DetLionsPodcast about of course...The Detroit Lions. We also get into a little news of the week & react to the two interviews. 

Da Tailgate boys interview Dusty Evely @dustyevely from @cheeseheadTV & @packadaypodcast about the Green Bay Packers & also Case Dillon @susuhme_rNFL from The Detroit Lions Podcast @DetLionsPodcast about of course...The Detroit Lions. We also get into a little news of the week & react to the two interviews. 

Join AJ and G as they chat to Case @sosuhme_rNFL from the @DetLionsPodcast for our 2018 #Lions season preview!

Hintergrund: Die konventionelle Weiss-auf-Weiss-Perimetrie zählt zum Goldstandard der Glaukom-Diagnostik. Der Verlust achromatischer Kontrastempfindlichkeit ist aber als sensorischer Ausfall ein Spätsymptom und markiert den Beginn einer lokalen Erblindung. In diversen Studien konnte nachgewiesen werden, dass ein Verlust an chromatischer Kontrastempfindlichkeit im kurzwelligen Bereich des Farbspektrums perimetrischen Gesichtsfelddefekten vorausgehen kann. Eine quantitative Bestimmung peripherer Farbkontrastempfindlichkeit erlaubt der Arden-Computergraphik-Farbtest. Ziel dieser Querschnittsstudie war zum einen, Unterschiede in der peripheren Farbkontrast-Sensitivität zwischen einer größeren Gruppe von Glaukom-Patienten (n=50), sogenannten präperimetrischen Diagnosegruppen (Patienten mit okulärer Hypertension, Patienten mit V.a. Glaukom, n=41) und augengesunden Patienten (n=19) zu finden, und zum anderen die Bestimmung von Zusammenhängen zwischen peripheren Farbkontrast-Verlusten im kurzwelligem Bereich (Tritanachse) und zu diesem Zeitpunkt gegebenenfalls bestehenden Pathologien der Papillenmorphologie. Hierfür wurde sowohl der Mittelwert der Farbkontrastempfindlichkeit der einzelnen Quadranten, als auch die Farbkontrastempfindlichkeit eines einzelnen Quadranten (hier „Field Low Left“) mit den entsprechenden HRT II-Parametern (global oder ein einzelner Sektor) korreliert. Patienten und Methodik: Insgesamt wurden 110 Patienten in die Studie miteingeschlossen, und in die Diagnosegruppen „Glaukom“ (n=50), „V.a. Glaukom“ (n=26), „OCH“ (n=13) und „Augengesund“ (n=21) eingeteilt. Bei allen Patienten wurde eine Messung mit dem HRT II zur Erhebung quantitativer Papillen-Mekmale, und der Arden-Computergraphik-Farbtest durchgeführt. Darüber hinaus erfolgte jeweils eine Gesichtsfelduntersuchung, eine Visusbestimmung, eine allgemeine Anamnese, eine ausführliche Medikamentenanamnese und die Bestimmung der im bisherigen Krankheitsverlauf maximalen Tensiowerte. Die Papillenmorphologie wurde anhand qualitativer Merkmale von einem erfahrenen Untersucher in folgende Gruppen eingeteilt: „glaukomatöser Papillenbefund“, „grenzwertiger Papillenbefund“ und „unauffälliger Papillenbefund“. Nichtparametrische Tests: Im Kruskall-Wallis-Test zeigten die Variablen „Field mean“ und „Field LowL“ einen signifkanten Unterschied (p=0,039 bzw. p=0,023) zwischen den Diagnosegruppen. Im Mann-Whitney-Test erfüllen „Field LowL“-Werte die Kriterien einer Zusammenfassung 66 Signifikanz-Adjustierung und unterscheiden sich zwischen den Diagnosgruppen „Glaukom“ und „Augengesund“ statistisch signifkant (p=0,006). Ergebnisse der bivariaten Korrelation: Sowohl im Gesamtkollektiv, als auch in der Diagnosegruppe „Glaukom“ zeigte der Farbkontrast-Schwellenwert des unteren linken Quadranten („Field LowL“) im Unterschied zum Mittelwert der Farbkontrast-Schwellenwerte der Einzel-Quadranten („Field mean“) die stärkeren und häüfigeren Zusammenhänge zur Papillenmorphologie. In der Gruppe „Glaukom“ zeigte „Field LowL“ statistisch signifikante Zusammenhänge zu den meisten stereometrischen Parametern des HRT II: „cup area“ (r=0,547, p=0,000), „rim area“ (r=0,456, p=0,001), „cup/disc area ratio“ (r=0,525, p=0,000), „rim/disc area ratio“ (r=0,525, p=0,000), „cup volume“ (0,453, p=0,001), „rim volume“ (r=0,409, p=0,003), „height variation contour (r=0,38, p=0,006), „cup shape measure“ (r=0,345, p=0,012), „mean RNFL thickness“ (r=0,404, p=0,004) und „RNFL cross sectional area“ (r=0,381, p=0,006). In den präperimetrischen Diagnosegruppen „V.a. Glaukom“ und „OCH“ konnte nur in der „OCH“-Gruppe ein statistisch hochsignifikanter Zusammenhang (r=0,764, p=0,001) zwischen „Field LowL“ und dem stereometrischen Paramter „height variation contour“ gefunden werden. Ergebnisse der partiellen Korrelation: Bei Konstanthalten des Einflusses der Variable „age“ in der Glaukom-Gruppe zeigt „Field mean“ einen moderaten, statistisch signifikanten Zusammenhang zu den HRT-II-Parametern „height variation contour“ (r=0,348, p=0,008) und „CLM temporal-inferior“ (r=0,371, p=0,005). Bei Herauspartialisieren der Variable „disc area“ konnten alle in der bivariaten Korrelation gefundenen Zusammenhänge beibehalten werden. Bei Konstanthalten des Einflusses der mittleren Defekttiefe der Gesichtsfelduntersuchung („MD in dB“) zeigten sich keine statistisch signifikanten Zusammenhänge. Im Unterschied dazu zeigte der Quadranten-Schwellenwert „Field LowL“ in der Glaukom-Gruppe sowohl bei Konstanthalten des Einflusses des Alters, als auch der Papillengröße, als auch der mittleren Defekttiefe der Gesichtsfeld-Untersuchung statistisch signifikante Zusammenhänge zu allen auch in der Pearson-Korrelation gefundenen stereometrischen HRT-II-Parametern, wobei die Zusammenhangs-Stärke bei Herauspartialisieren von „disc area“ und „MD in dB“ schwächer ausfiel als in der bivariaten Korrelation; bezüglich der Kontrollvariable „MD in dB“ sind es: „cup area“ (r=0,457, p=0,001), „rim area“ (r=0,290, p=0,033), „cup/disc area ratio“ (r=0,419, p=0,003), „rim/disc area ratio“ (r=0,419, p=0,003), „cup volume“ (0,333, p=0,017), „rim volume“ (r=0,319, p=0,021), „height variation contour (r=0,304, p=0,027), „cup shape measure“ (r=0,260, Zusammenfassung 67 p=0,05), „mean RNFL thickness“ (r=0,411, p=0,004) und „RNFL cross sectional area“ (r=0,354, p=0,012). Der in der bivariaten Korrelation in der „OCH“-Gruppe gefundene, starke Zusammenhang zwischen „Field LowL“ und dem stereometrischen Paramter „height variation contour“ zeigte sich auch bei Herauspartialisieren des Alters und der mittlerern Defekttiefe der Gesichtsfeld-Untersuchung: r=0,686, p=0,01 bzw. r=0,794, p=0,002, jedoch nicht bei Herauspartialisieren der Variablen „disc area“ (r=0,001, p=0,499). Der überwiegende Teil der in den präperimetrischen Diagnosegruppen gefundenen Zusammenhänge zeigte sich jedoch statistisch nicht signifikant. Ergebnisse der Regressionsanalyse: Sowohl nichtstereometrische Parameter wie Alter, Augeninnendruck und Ergebnisse der Gesichtsfelduntersuchung, als auch die stereometrischen Parameter des Heidelberg-Retina-Tomographen-II zeigen einen statistisch signifikanten Einfluss auf die Ergebnisse des Computergraphik-Farbtests. Während der Einfluss von nichtstereometrischen Parametern einen stärkeren Einfluss auf die Variable „Field mean“ als auf die Variable „Field LowL“ aufweist (r2=0,445, p=0,000 versus r2=0,359, p=0,001), verhält es sich mit den stereometrischen HRT-II-Parametern umgekehrt: Sie zeigen den stärkeren Einfluss auf die Variable „Field LowL“ (r2=0,603, p=0,000 versus r2=0,188, p=0,048). Schlussfolgerung: Die Diagnose „Glaukom“ setzt sich aus den Ergebnissen unterschiedlicher Untersuchungen zusammen. Zu den Eckpfeilern der Glaukom-Diagnostik zählen Papillenveränderungen, erhöhter Augeninnendruck, Gesichtsfelddefekte und schließlich das Alter und die Familienanamnese eines Patienten. In den letzten Jahrzehnten hielt vor allem die qualitative Messung der Papillenmorphologie und umgebender Netzhaut-Strukturen (HRT, OCT, GDX, u.a.) Einzug in die Glaukom-Diagnostik. Gemeinsam mit psychophysikalischen Tests, die Gesichtfelddefekte nachweislich vor dem Verlust an Kontrastempfindlichkeit in der Weiss-auf-Weiss-Perimetrie aufzeigen, erweitert und ergänzt sie die klassische Glaukom-Diagnostik. In dieser Arbeit konnte zunächst bestätigt werden, dass sich die Ergebnisse des Arden-Computergraphik-Farbtests bei einer erstmals großen Gruppe von Glaukom-Patienten signifikant von den Ergebnissen der Kontrollgruppe augengesunder Patienten unterscheiden. Im weiteren konnte erstmals gezeigt werden, dass auch unter Berücksichtigung des Alters und der Ergebnisse der Gesichtsfelduntersuchung ein überwiegend hochsignifikanter Zusammenhang zwischen einem funktionellen Test (Arden- Computergraphik-Farbtest) und einem modernen, rein morphologischen Test (HRT II) bei Glaukompatienten besteht. Die Einzel-Quadranten-Analyse (hier der funktionell linke untere Zusammenfassung 68 Quadrant) zeigte hier die stärksten Zusammanhänge zu den Parametern „cup area“, „rim area“, cup/disc area ratio“ und „rim/disc area ratio“ und ist dem Mittelwert der Schwellenwerte aller Quadranten überlegen. Die statistisch signifikanten Veränderungen entsprechen dem temporal-superioren Bereich der Papille, in dem in frühen und in mäßig fortgeschrittenen Glaukom-Stadien erste Verluste des neuroretinalen Randsaums zu beschrieben sind (Tuulonen A & Airaksinen PJ, 1991, Jonas JB et al., 1993). Dem Arden-Computergraphik-Farbtest kommt somit ein hoher Stellenwert in der Glaukomdiagnostik zu. Die Kombination von Funktion und Morphologie erhöht die Validität in der Glaukomdiagnostik; eine Eignung als Screening-Test, der zwischen präperimetrischen Diagnosegruppen unterscheidet, konnte allerdings nicht bestätigt werden.