الفهرس 
COPD ReviewOnly 14 pages are availabe for public view
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Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory disorder highly caused by smoking, and is characterized by progressive, partially reversible airway obstruction and lung hyperinflation, systemic manifestations, and increasing frequency and severity of exacerbations.
COPD is also characterized by persistent inflammation of respiratory airways, lung parenchyma and its vasculature. The inflammatory process in COPD is different from that in asthma. Expiratory flow limitation is the pathophysiological hallmark of COPD. Expiratory flow limitation with dynamic collapse of the small respiratory airways compromises the ability of patients to expel air during expiration, resulting in lung hyperinflation due to air trapping. Acute-on-chronic hyperinflation has been shown to contribute to shortness of breath during exercise and acute exacerbation in COPD.
It has been recently declared that COPD may cause considerable retinal and optic nerve damage.
Visual evoked potential (VEP, the electrical potential difference generated in response to visual stimuli, provide a functional measurement of optical pathway. Moreover, this evaluation can provide valuable evidence of optic nerve involvement in the primary stages of ophthalmic disease.
Furthermore, non- arthritic anterior ischemic optic neuropathy in middle-aged people is associated with high prevalence of COPD. Therefore we aimed to study the rate of optic neuropathy in COPD patients by VEP evaluations.
In the current study 30 included patients, 85% of the patients were males and 15% were females. The mean of age was 45.5±5.4 years. Patients were classified into mild, moderate and severe according to GOLD criteria. The special habits detected among the studied cases were tobacco smoking.
Thirty COPD patients were included in this study and full investigation needed to prove the relation between COPD and optic nerve abnormalities, out of 30 COPD patient 7 out 10 severe COPD patients demonstrated VEP latency as a result of our investigation that there is latency in Visual evoked potential (VEP) that indicate the correlation of COPD disease and the optic nerve disease increase P100 which is considered latency.
Limitations of the study:
1) Small sample size due to narrow selective criteria of COPD patients due to associated comorbid conditions where patients should be excluded such as: diabetes mellitus, ischemic heart diseases, hypercholestrinemia, retinal detachment.
2) Uncooperative patients as elderly patients as they could not continue all required investigation so they were excluded.
3) Severe COPD was hardly and risky to perform the required investigations so some of these patients were excluded sometimes due to their unhealthy condition.
4) The study was time consuming were several investigations are required in more than one hospital due to unavailability of some radiological investigation and different medical department radiology, neurology, ophthalmology and chest departments.