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Neuro-Ophthalmology
Published in Anthony N. Nicholson, The Neurosciences and the Practice of Aviation Medicine, 2017
The discipline of neuro-ophthalmology is concerned with disorders of vision that primarily result from dysfunction of the nervous system as opposed to the eye itself. Neuro-ophthalmology begins and ends with visual function, but it is primarily concerned with disorders of the optic nerve, the visual pathways in the brain and the ocular motor system. The eye is developmentally a part of the nervous system and there is, therefore, much commonality in the spectrum of conditions that affect the eye and the brain. The techniques of examination and the relevant special investigations have developed to a large extent independently in ophthalmology on the one hand and in the clinical neurosciences on the other, and there are few practitioners who are well schooled in both disciplines. It is essential that there are physicians who can sit comfortably with a foot in each camp; otherwise, patients with neurological disorders that affect vision cannot be managed in a coherent manner, having to attend one clinic to have the eye examined and another for the neurological assessment. In the United Kingdom ophthalmology is largely practised by ophthalmologists trained in surgery, whereas in other parts of the world most ophthalmologists do not undertake surgery, although the training is the same. An ophthalmic physician with a sound background in medicine who is as competent as surgical colleagues in the diagnosis of eye disease has become a rarity.
Glaucoma Detection Using Optical Coherence Tomography Images: A Systematic Review of Clinical and Automated Studies
Published in IETE Journal of Research, 2022
Hina Raja, Muhammad Usman Akram, Taimur Hassan, Aneeqa Ramzan, Amtual Aziz, Hira Raja
The ganglion cell layer (GCL) analysis opens new ingresses in the field of neuro-ophthalmology for detecting and monitoring optic neuropathies. GCL analysis demonstrates a high correlation with perimetry, thus facilitating the future predications and staging of the disease [65]. Wang et al. [66] investigated the significance of retinal ganglion cell layer (GCL) thickness in a glaucoma patient using FD-OCT and manual segmentation. Horizontal scans were obtained from one eye of 20 and 26 control and glaucoma patients, respectively. Manual segmentation extracted various layers and their thicknesses were determined; patients were separated into two groups depending on their foveal sensitivity. The thicknesses of the RNFL and RGC+ inner plexiform layer (low sensitivity group) were less than that of the high sensitivity group. Furthermore, the thinning of RGC + IPL showed association with the loss in the visual field test (10–2). The conclusion was made that local measures of retinal ganglion cell layer thickness showed a qualitative agreement with the VF.