Perimetric progression in open angle glaucoma and the Visual Field Index (VFI)

PURPOSE: To evaluate the changes in the Visual Field Index (VFI) in eyes with perimetric glaucomatous progression, and to compare these against stable glaucoma patients.

PATIENTS AND METHODS: Consecutive patients with open angle glaucoma with a minimum of 6 reliable visual fields and 2 years of follow-up were identified. Perimetric progression was assessed by 4 masked glaucoma experts from different units, and classified into 3 categories: "definite progression," "suspected progression," or "no progression." This was compared with the Glaucoma Progression Analysis (GPA) II and VFI linear regression analysis, where progression was defined as a negative slope with significance of <5%.

RESULTS: Three hundred ninety-seven visual fields from 51 eyes of 39 patients were assessed. The mean number of visual fields was 7.8 (SD 1.1) per eye, and the mean follow-up duration was 63.7 (SD 13.4) months. The mean VFI linear regression slope showed an overall statistically significant difference (P<0.001, analysis of variance) for each category of progression. Using expert consensus opinion as the reference standard, both VFI analysis and GPA II had high specificity (0.93 and 0.90, respectively), but relatively low sensitivity (0.45 and 0.41, respectively).

CONCLUSIONS: The mean VFI regression slope in our cohort of eyes without perimetric progression showed a statistically significant difference compared with those with suspected and definite progression. VFI analysis and GPA II both had similarly high specificity but low sensitivity when compared with expert consensus opinion.

Protecting peaceful protest:The OSCE/ODIHR and freedom of peaceful assembly

This article reviews ongoing work to increase awareness of, and raise standards in relation to, freedom of peaceful assembly across Europe, the South Caucasus, and Central Asia. The work is led by the Office of Democratic Institutions and Human Rights (ODIHR) at the Organisation of Security and Co-operation in Europe (OCSE). The article begins by highlighting the importance of freedom of peaceful assembly within democratic societies, and then describes the development of the ODIHR Guidelines on Peaceful Assembly. The article outlines some of the key issues of contention relating to the regulation of freedom of assembly, and discusses the process of reviewing the existing and draft legislation against the standards articulated in the Guidelines. In this context, the article also explores the potential for constructive engagement between government, civil society, and the OSCE to facilitate legislative amendments that respect key human rights norms and principles. Finally, the article reviews recent developments in training monitors of public assemblies with the aim of building local monitoring capacity and thus developing an evidence base of the practical implementation of laws relating to freedom of peaceful assembly. © The Author (2009). Published by Oxford University Press. All rights reserved.

Protected area networks and savannah bird biodiversity in the face of climate change and land degradation

The extent to which climate change might diminish the efficacy of protected areas is one of the most pressing conservation questions. Many projections suggest that climate-driven species distribution shifts will leave protected areas impoverished and species inadequately protected while other evidence suggests that intact ecosystems within protected areas will be resilient to change. Here, we tackle this problem empirically. We show how recent changes in distribution of 139 Tanzanian savannah bird species are linked to climate change, protected area status and land degradation. We provide the first evidence of climate-driven range shifts for an African bird community. Our results suggest that the continued maintenance of existing protected areas is an appropriate conservation response to the challenge of climate and environmental change.

Relationship between socioeconomic deprivation or urban/rural residence and visual acuity before cataract surgery in Northern Scotland

Purpose: To evaluate the influence of socioeconomic factors on visual acuity before cataract surgery. ?Methods: The medical case notes of 240 consecutive patients listed for cataract surgery from January 1, 2010, at Grampian University Hospital, Aberdeen, were reviewed retrospectively. Patients with ocular comorbidity were excluded. Demographics, postal codes, and visual acuity were recorded. Scottish Index of Multiple Deprivation was used to determine the deprivation rank. Home location was classified as urban or rural. The effect of these parameters on preoperative visual acuity was investigated using chi-square tests or Fisher exact test as appropriate. ?Results: A total of 184 patients (mean 75 years) were included. A total of 127 (69%) patients had visual acuity of 6/12 or better. An association was found between affluence and preoperative visual acuity of 6/12 or better (?2trend = 4.97, p = 0.03), with a significant rising trend across quintile of deprivation. There was no evidence to suggest association between geographical region and preoperative visual acuity (p = 0.63). ?Conclusion: Affluence was associated with good visual acuity (6/12 or better) before cataract surgery. There was no difference in preoperative visual acuity between rural and urban populations.