新型眼生物测量仪Tomey OA-2000和IOLMaster获得的白内障患者眼生物参数的比较

目的 比较新型眼生物测量仪Tomey OA-2000与IOLMaster获得的白内障患者眼生物参数的差异性和一致性.方法 前瞻性研究.纳入白内障术前检查者74例(74眼),分别应用Tomey OA-2000和IOLMaster进行测量,获得眼轴长度(axial length,AL)、角膜曲率(keratometry,K)、前房深度(anterior chamber depth,ACD)和角膜横径(white to white,WTW)等参数.配对t检验分析两种设备获得的眼生物参数之间的差异.Bland-Altman散点图分析两种设备获得的各生物参数之间的一致性.结果 Tomey OA-2000获得的AL、平坦K(flat K,Kf)值、陡峭K(steep K,Ks)值、平均K(mean K,Km)值、中央角膜厚度(central corneal thickness,CCT) 、ACD、晶状体厚度(lens thickness,LT)、瞳孔直径(pupil diameter,PD)和WTW值分别为(24.26 ±2.71)mm、(44.09±1.76)D、(45.01±1.73)D、(44.55±1.72)D、(518.41 ±34.18) μm、(3.07 ±0.48)mm、(4.48±0.61)mm、(4.07 ±0.95) mm和(11.50±0.52) mm.IOLMaster获得的AL、Kf、Ks、Km、ACD和WTW值分别为(24.33 ±2.69) mm、(44.21±1.74)mm、(45.15±1.76)D、(44.69±1.74) D、(3.04 ±0.46) mm和(11.65 ±0.41)mm.Tomey OA-2000和IOLMaster获得的AL、Kf、Ks、Km、ACD和WTW差值分别为(-0.07 ±0.10)mm(t=-5.99,P ＜0.01)、(-0.12±0.21)D(t=-4.14,P ＜0.01)、(-0.14 ±0.20) D(t=-5.88,P ＜0.01)、(-0.12±0.13)D(t=-7.44,P＜0.01)、(0.03±0.14)mm(t=1.99,P =0.05)和(-0.14 ±0.32)mm(t=-3.73,P＜0.01).两种设备获得的AL、Kf、Ks、Km、ACD的95％一致性界限(LoA)其上下限最大绝对值分别为0.27 mm、0.50 D、0.53 D、0.38 D、0.30 mm,一致性较好;而WTW的95％ LoA为0.78 mm,一致性较差.结论 Tomey OA-2000和IOLMaster获得的AL、K、ACD差异小,一致性好.     

Comparison of ambulatory blood pressure values in patients with glaucoma and ocular hypertension

PURPOSE: To compare systemic arterial blood pressure (BP) and nocturnal hypotension in patients with normal-tension glaucoma (NTG), high-tension glaucoma (HTG), and ocular hypertension. METHODS: Systemic BP was recorded by a portable automated BP monitoring device every 20 min during the day and every 30 min at night in patients with NTG (n=18), HTG (n=22), and ocular hypertension (n=19). Mean systolic, diastolic, and mean arterial BPs were calculated for 24 h, during the day and at night. The mean and maximum nocturnal dip rates were determined for each patient. The number of readings that declined below 90 mmHg for systolic BP and below 60 and 50 mm Hg for diastolic BP was recorded for each group. Statistical significance was set at P<0.05. RESULTS: Minimum, maximum, and mean values of the systolic, diastolic, and mean arterial BPs were not significantly different among groups. There was no difference among groups in the nocturnal dip percentages of systolic and diastolic BPs. The number of systolic BP readings below 90 mmHg was significantly higher in the NTG group compared with the other groups (P<0.001, chi(2) test). CONCLUSION: There may not be any difference among NTG, HTG, and ocular hypertension patients in terms of mean ambulatory BP values. On the other hand, when each individual's ambulatory reading is reviewed, readings may reveal that excessive and repetitive nocturnal drops occur more frequently in some patients with NTG. These hypotensive episodes may be related to the development of glaucomatous damage.     

拉坦前列腺素与噻吗心安治疗原发性开角型青光眼和高眼压症对照研究

目的　以噻吗心安为对照,评估新型异丙酯前列腺素Ｆ２α的苯基替代衍生物拉坦前列腺素（ＰｈＸＡ４１）对于眼压升高病人的降眼压疗效和副作用。方法　３４ 例（６６ 只眼） 原发性开角型青光眼或高眼压症患者入选,随机分组,１７ 例（３２ 只眼）滴用０．０５ｇ·Ｌ－１ 拉坦前列腺素每天１ 次,１７ 例（３４ 只眼）滴用５ｇ·Ｌ－１ 噻吗心安每天２ 次,共治疗１２ｗｋ。结果　１２ｗｋ治疗期间,两种药物均能有效降低眼压（Ｐ＜ ０－０１） ,且效应持续。各次随访均显示,拉坦前腺素的降眼压效果显著优于噻吗心安（Ｐ＜ ０－０５）。１２ｍｏ 时,拉坦前列腺素组的眼压降低了９－５±３－１ｍ ｍＨｇ（３６－８ ％）（１ｍ ｍＨｇ＝ ０．１３３ｋＰａ） ,噻吗心安组降低了７－４±２－６ｍ ｍＨｇ（２９－６％ ）（ Ｐ＜ ０－０１）。拉坦前列腺素治疗后,少数病例发现角膜上皮点状脱落。噻吗心安组的平均心率减少４ 次·ｍｉｎ－１（Ｐ＜ ０－０５） 。结论　０ ．０５ｇ·Ｌ－１ 拉坦前列腺素每天１ 次与５ｇ·Ｌ－１ 噻吗心安每天２ 次相比,具有更强的降眼压作用,而且耐受性良好。因此,拉坦前列腺素将成为青光眼药物治疗的有效选择。     

Senile and presenile cataract: comparison of patients operated in the year 1990-2000

PURPOSE: To compare some epidemiological features (e.g. mean age) of patients operated for senile and presenile cataract in the year 1990 and 2000. MATERIAL AND METHOD: Data of 106 consecutive patients with senile or presenile cataract operated in May 1990 and 110 patients operated in April and May 2000, were compared. Some cataract risk factors were analysed: cataract in family, diabetes, steroid therapy, refractive error, rural residency, outdoor occupation, smoking., visual acuity and age of patients. RESULTS: There was significantly higher age (69 vs. 60 years) and lower number of patients with very low visual acuity (less than 0.1) in group undergoing cataract surgery in 2000. We did not noted significant differences regarding sex, cataract in family, presence of diabetes, steroid therapy, myopia, rural residency, outdoor occupation, smoking. CONCLUSIONS: In 10 years period increase of age and decrease in number of patients with very low visual acuity in group operated for senile and presenile cataract could be observed.     

曲伏前列素和噻吗心安治疗开角型青光眼和高眼压症的对照研究

目的:以噻吗心安为对照,观察曲伏前列素滴眼液降眼压效果及安全性。方法:采用随机对照法,0.04g/L曲伏前列素滴眼液1次/d或5g/L噻吗心安滴眼液2次/d,治疗原发性开角型青光眼和高眼压症,共34例,疗程12wk,观察眼压及不良反应。未发现其他眼部改变和全身副作用。结果:试验组平均日间眼压以24.83±2.97mmHg降至16.13±2.92mmHg;对照组从23.96±3.62mmHg降至16.14±2.97mmHg。试验组结膜充血较对照组明显增加。结论:曲伏前列素滴眼液对控制原发性开角型青光眼和高眼压症的眼压是有效和安全的。     

OA-2000测量的长眼轴白内障患者眼球生物学参数分析

目的 分析长眼轴白内障患者眼球生物学参数特点。设计回顾性病例系列。研究对象2021年6月至2022年4月在北京同仁医院眼科就诊的白内障患者1000例(1000眼)。方法采用OA-2000测量眼轴长度(AL),根据测得AL将患者分为正常眼轴对照组(22 mm≤AL<26 mm)和长眼轴组(AL≥26 mm),长眼轴组根据眼轴长度进一步分为4组:A组(26 mm≤AL<28mm)187眼;B组(28 mm≤AL<30 mm)140眼;C组(30 mm≤AL<32 mm)130眼;D组(AL≥32 mm)93眼。对正常眼轴及长眼轴组眼、长眼轴各亚组的眼球生物学参数进行比较,并分析眼轴长度与眼球生物学参数、年龄与眼球生物学参数之间的相关性。主要指标AL、角膜曲率(Kf、Ks、Km)、前房深度(ACD)、晶状体厚度(LT)、角膜横径(WTW)。结果长眼轴组患者Kf、Ks、Km、角膜散光、ACD、LT、WTW分别为(43.07±1.61)D、(44.65±1.71)D、(43.91±1.62)D、(1.52±0.77)D、(3.28±0.47)mm、(4.55±0.41)m...     

Clinical and epidemiological aspects in ocular tuberculosis

150 new cases of ocular tuberculosis, representing 1% of total tuberculose cases, was diagnosticated during the last 10 years, in both Ophthalmological and Pneumophtisiological Clinics of Craiova. Ocular tuberculosis is the local manifestation of a general latent tuberculosis; the uveal diseases represent 46% of cases of ocular tuberculosis. 51 of 150 cases of ocular tuberculosis was corioretinal forms, which evaluated uni or bilateral, with one and multiple focares; in only one case we constated a coroidian tuberculom form.     

Comparison of latanoprost monotherapy with timolol-dorzolamide combination in patients with open-angle glaucoma or ocular hypertension

PURPOSE: To compare the efficacy and safety of latanoprost monotherapy to dorzolamide combined with timolol from pooled data of five multicenter, randomized, 3-month, observer-masked trials with identical study design. METHODS: Patients who were on a beta-blocker or dual therapy where one agent was a beta-blocker were eligible after a 2- to 4-week run-in period on timolol 0.5%, twice daily. Patients then either discontinued timolol treatment and received latanoprost monotherapy n=345) or continued on timolol and received dorzolamide add-on therapy (n=352). Data from these 697 patients were included in the meta-analysis. RESULTS: From an overall baseline of 22.8mmHg, the mean IOP reduction was 4.8mmHg (21%) in latanoprost-treated patients and 4.1mmHg (18%) in timolol + dorzolamide-treated patients p<0.001). A reduction in diurnal IOP of >=20% was achieved in 54% of the latanoprost-treated patients compared with 44% of the timolol + dorzolamide-treated patients. There was no marked difference between the two groups in the incidence of ocular and systemic events. CONCLUSION: This meta-analysis provides further support that a switch to latanoprost monotherapy can be an alternative to combined treatment with timolol + dorzolamide.