抚顺市眼病医院住院患者青光眼类型构成和视力损害

目的 了解抚顺市眼病医院住院患者的青光眼类型构成和视力损害情况.设计以医院为基础的回顾性调查.研究对象 2001年～2005年抚顺市眼病医院住院青光眼患者1428例.方法 参照全国青光眼学组1987年推荐标准对住院青光眼患者进行分类,按照世界卫生组织定义的盲与低视力的标准分析各类青光眼的视力损害情况.主要指标青光眼类型构成比,青光眼的致肓和致低视力的发生率.结果 1428例患者中,男性515例,女913例,平均年龄(63.5 11.5)岁.其中,原发性青光眼1183例(82.8%),继发性青光眼243例(17.0%),先天性青光眼2例(0.1%%).原发性青光眼中,急性闭角型青光眼920例(77.8%),慢性闭角型青光眼225例(19.0%),开角型青光眼38例(3.2%).原发性青光眼中双眼盲54例,占4.6%(54/1183),其中急性闭角型青光眼致肓占68.5%(37/54),慢性闭角型青光眼致盲27.8%(15/54),原发性开角型青光眼致盲3.7%(2/54.),单眼盲220例(18.6%,220/1183),其中急性闭角型青光眼致盲153例69.5%(153/220),慢性闭角型青光眼致肓26.8%(59/220),原发性开角型青光眼致盲3.6%(8/220).结论 以医院为基础的闭角型青光眼的调查表明,原发性闭角型青光眼是抚顺地区住院青光眼患者中的主要类型,而住院闭角型青光眼中,急性闭角型青光眼居多且视力损害严重,如能加强和规范急性闭角型青光眼的早期防治和急诊处理,可大幅度降低青光眼的致盲率.(眼科,2008,17:113-116)     

超声乳化后房人工晶体植入联合小梁切除术

我们对23例曾行三联术的青光眼合并白内障患者进行了临床观察,报告如下。 1 资料和方法 1.1 一般资料 青光眼合并白内障患者23例(23眼),男9例(9眼),女14例(14眼)。年龄56～79岁,平均65.6岁。原发性开角型青光眼5眼(21.5％),慢性闭角型青光眼5眼(21.5％),急性闭角型青光眼9眼(39.1％),继发性青光眼4眼(17.3％)。晶体核硬度:Ⅰ～Ⅳ级,术前视力光感至     

青光眼住院病人5年构成及视力损害分析

目的 对邯郸市眼科医院青光眼的住院病人5年构成和视力损害情况进行分析.方法 对2001～2005年邯郸市眼科医院住院患者中不同类型青光眼进行回顾性分析.结果 962例患者中,男性320例,女642例,平均年龄(61.2±13.6)岁.其中,原发性青光眼794例(82.5%),继发性青光眼127例(13.30%),先天性青光眼13例(1.4%).原发性青光眼中,急性闭角型青光眼424例(53.4%),慢性闭角型青光眼313例(37.4%),开角型青光眼57例(7.1%).原发性青光眼中双眼盲发生率7.9%(63/794),其中急性闭角型青光眼致盲、慢性闭角型青光眼、原发性开角型青光眼所致分别占36.5%(23/63)、52.3%(33/63)、11.1%(7/63);低视力发生率16.8%(134/794),其中急性闭角型青光眼、慢性闭角型青光眼致盲和原发性开角型青光眼所致分别占46.2%(62/134)、30.6%(41/134)和8.9%(12/134).结论 原发性闭角型青光眼是邯郸地区住院青光眼患者中的主要类型,而住院闭角型青光眼中,急性闭角型青光眼居多且视力损害重,如能加强和规范急性闭角型青光眼的早期防治和急诊处理,可大幅度降低青光眼的致盲率.     

5058例青光眼住院患者构成及相关因素分析

目的了解青光眼住院患者的类型构成、性别、年龄分布、变化特点及相关因素。设计回顾性病例系列。研究对象住院的青光眼患者5058例。方法对邢台眼科医院2004年6月-2009年5月间住院的青光眼患者5058例进行统计学分析。主要指标青光眼的类型、年龄、性别及所占的百分比。结果5058例青光眼住院患者中,原发性青光眼、继发性青光眼和先天性青光眼各占青光眼总数的59．07％、37．92％和3．01％,其中原发性闭角型青光眼占原发性青光眼的88．65％,原发性开角型青光眼占11．35％。在原发性闭角型青光眼中,急性闭角青光眼占53．15％,慢性闭角型青光眼占46．85％;其中40岁以上女性占69．54％,男性26．95％。而原发性开角型青光眼患者中,40岁以上女性28．02％,男性占44．5％。2004年6月-2005年5月原发性青光眼住院患者中原发性开角型青光眼占11．32％,而于2008年6月-2009年5月间原发性开角型青光眼占12．44％,统计学检验无显著性差异。结论中原地区青光眼住院患者构成仍以原发性闭角型青光眼为主要类型,原发性开角型青光眼的构成仍然较低,可能与地域经济文化状况有关。     

原发性闭角型青光眼临床分型的探讨

目的 探讨将原发性闭角型青光眼分为原发性急性闭角型青光眼和原发性慢性闭角型青光眼这种分型方法的可行性和科学性。方法 按原发性闭角型青当眼的诊断标准。将325例325眼原发性闭角型青光眼眼的住院患者按有否急性发作的症状和发作后存在的相应体征进行分类统计。结果 325眼原发性闭角型青光眼中,有急性发作症状和体征的89眼,占27.4%;有发作的症状但缺乏发作后的体征者78眼,占24%;无存在任何发作症状和发作后的相应体证者20眼。占6.2%;无法归类者138眼,占42.4%。结论 将原发性闭角型青光眼根据是否存在急性发作的症状和发作后存在的相应体征作为划分急闭和慢闭的标准是不够科学的,这种分类对指导临床的防治工作无实际意义。     

原发性青光眼的统计分析

为了进一步了解我国原发性青光眼的发病情况，搞好防治工作，本文对1986年1月至1992年！2月在我院眼科住院，经过检查确诊的原发性青光眼的发病率、病型构成、发病年龄、眼别、性别等进行统计分析如下。统计结果一、发病率：7年间我院收住院各种眼病3981例，其中原发性青光眼226例，占5．68％。二、患病类型：急性闭角型青光眼155例，占68．58％；慢性闭角型青光眼55例，占24．34％；开角型青光眼16例，占708％。急性闭角型青光眼和慢性闭角型青光眼病的比例为2．82。1；开角型青光眼和闭角型青光眼病的比例为1：13．13。三、患病年龄：急性…     

青光眼视乳头旁脉络膜和视网膜萎缩的眼底血管造影研究

目的了解青光眼患者视乳头旁萎缩（peripapillary atrophy,PPA）即脉络膜和视网膜萎缩的发生频率及脉络膜血供情况。方法选择原发性青光眼患者43例（43只眼）,其中慢性闭角型青光眼16例（16只眼）,开角型青光眼27例（27只眼）,正常对照组33例（33只眼）。采用海德堡视网膜血管造影仪（HRA）对患者进行荧光素眼底血管造影和吲哚氰绿眼底血管造影（ICGA）同步检查,通过荧光素眼底血管造影进行PPAα带和β带的判定,观察其ICGA特点。结果PPAα带的ICGA表现为充盈正常和充盈减弱两种表现,PPAβ带的ICGA显示无脉络膜血管充盈,或仅见大脉络膜血管充盈。PPAα带的发生频率：慢性闭角型青光眼组为87.5％,开角型青光眼组为100,0％,对照组为84．8％,差异无统计学意义（χ^2=4．339,P=0．114）。PPAβ带的发生频率：慢性闭角型青光眼组为31．3％,开角型青光眼组为77．8％,对照组为21．9％,差异有统计学意义（χ^2=19,915,P=0．000）。PPAα带ICGA充盈减弱的发生频率：开角型青光眼组为66．7％,慢性闭角型青光眼组为53.8％,对照组为32.1％,差异有统计学意义（χ^2=6．648,P=0．036）。结论PPAβ带脉络膜血供缺乏,其发生频率以开角型青光眼组最高,慢性闭角型青光眼组次之。PPAα带的发生频率各组间差异无统计学意义,但开角型和慢性闭角型青光眼组的PPAα带较多表现为脉络膜血管充盈减弱,推测可能是PPAβ带扩大的前兆。     

青年原发性闭角型青光眼的临床特征

目的分析青年原发性闭角型青光眼患者的临床特点及治疗效果。方法回顾性分析2009年6月至2019年6月山西省眼科医院17~40岁青年原发性闭角型青光眼51例(61眼)的病历资料,随访时间为6个月至2年。结果本研究中男15例(29.41%),女36例(70.59%),男女比例为1∶2.4。包括急性闭角型青光眼21眼(34.43%),慢性闭角型青光眼40眼(65.57%)。急性闭角型青光眼患者术后的视力较慢性闭角性青光眼提高且眼压控制明显。虹膜囊肿和瞳孔阻滞在急性闭角型青光眼中发生率高。晶状体厚度及眼轴长度在急性闭角型青光眼患与慢性闭角型青光眼差异无统计学意义,但前房深度慢性闭角型青光眼患者较浅。46眼(75.41%)行小梁切除术,14眼(22.95%)行抗青光眼联合白内障手术,1眼(1.64%)未行手术。术后并发症有前房积血、低眼压、脉络膜脱离、浅前房及睫状环阻塞性青光眼,多发生在慢性闭角型青光眼术后。结论青年闭角型青光眼因解剖因素在治疗时有其特殊性,急性闭角型青光眼常伴有虹膜囊肿,晶状体比较厚,而慢性闭角型青光眼常因为眼轴短,发病隐匿,术后容易引起并发症,尤其是睫状环阻塞性青光眼,治疗效果较差。     

手术显微镜下青光眼小梁切除术

在手术显微镜下行小梁切除术８９例１１２例眼，其中急性闭角型青光眼６１眼，慢性闭角型青光眼２３眼，开角型青光眼１９眼，继发性青光眼５眼，先天性青光眼４眼。近期疗效，８９例１１２眼，眼压控制在正常范围内１１１眼（９９．１％），视力提高者６２眼（５５．３％），视野扩大者６９眼（６１．６％），远期疗效：６３例７８眼，随访时间均在１年以上，平均２０个月，眼压控制在正常范围内７７眼（９８．９％），视力提高者４２眼（５３．８％），视野扩大者４７眼（６０．３％），该术疗效提高的原因在于对小梁组织切除部位准确，可靠以及术中组织损伤小，术后形成良好的滤枕有关。     

原发性青光眼对角膜内皮细胞的影响

目的比较不同类型青光眼和正常人的角膜内皮细胞平均密度和六角型细胞百分比变化,探讨不同类型青光眼对角膜内皮细胞的影响。方法选取60~75岁原发性青光眼患者,其中急性闭角型青光眼慢性期50眼,慢性闭角型青光眼96眼,开角型青光眼30眼,对照组为同年龄段的正常人378眼,测量记录角膜内皮细胞平均密度及六角型细胞百分比。测量数据用SPSS11.0进行统计学分析。结果同年龄段急性闭角型青光眼慢性期较对照组统计学有极显著性差异(P<0.01),慢性闭角型青光眼角膜内皮细胞平均密度较对照组统计学有显著性差异(P<0·05),开角型青光眼患者角膜内皮细胞平均密度较对照组无显著性差异(P>0·05),所有青光眼患者六角型细胞百分比较对照组均无显著性差异(P>0·05)。结论60~75岁急性闭角型青光眼慢性期、慢性闭角型青光眼患者的角膜内皮细胞平均密度较同年龄段的正常人下降,开角型青光眼患者角膜内皮细胞平均密度较正常人无明显变化,不同类型原发性青光眼对角膜内皮六角型细胞百分比无明显影响。     

老年人青光眼51例临床分析

目的:分析老年人青光眼的发病特点及危险因素,以探讨防治措施.方法:对51例69眼50岁以上老年人已确诊为青光眼的病例进行发病特点及危险因素的问卷调查与分析.结果:患者51例中,急性闭角型青光眼急性发作期21例25眼(男4例5眼,女17例20眼)、慢性闭角型青光眼17例26眼(男6例9眼,女11例17眼)、开角型青光眼10例15眼(男6例9眼,女4例6眼)、继发性青光眼3例3眼(男2例2眼,女1例1眼).急性闭角型青光眼21例25眼急性发作均有明显诱因,症状明显.慢性闭角型青光眼及开角型青光眼14例22眼有轻微症状,开角型青光眼患者1例2眼有夜盲等症状,余无明显症状.继发青光眼中有2例有明显症状,1例无明显症状.有家族史者11例;解剖因素(浅前房、窄房角)有39例;近视及远视患者有21例;视网膜静脉阻塞致新生血管性青光眼1例;白内障膨胀期继发青光眼1例;长期点用含地塞米松眼药水致糖皮质激素性青光眼1例.结论:老年人青光眼病因复杂、临床表现多样,应给予患者相应的健康宣传,提高患者对疾病的认知能力,做到早就诊、早治疗.     

How are glaucoma patients identified?

PURPOSE: To determine the events that lead to the diagnosis of glaucoma. PATIENTS AND METHODS: This prospective study administered a questionnaire to consecutive patients in a university glaucoma service with questions about the visit at which their glaucoma was diagnosed. RESULTS: Among 308 patients (85% of those eligible) with glaucoma and those suspected of having glaucoma, more than half were diagnosed at a routine examination with no ocular symptom. One hundred fourteen of 202 (56%) of those patients were diagnosed with open angle glaucoma (OAG). Symptoms present at the diagnostic visit were infrequently related to glaucoma. Sixty-one percent of OAG patients (124 of 202) recalled elevated intraocular pressure (IOP) as the sole reason for their initial diagnosis; an additional 12% (24 of 202) recalled a combination of IOP with either disc or visual field findings. Only 18% (36 of 202) recalled being diagnosed due to disc or visual field damage alone. CONCLUSION: The detection of glaucoma is strongly associated with IOP measurement. Glaucoma is most frequently diagnosed at routine visits to eye care specialists at which patients either have no symptoms or have symptoms unrelated to glaucoma. Questionnaire information on large numbers of persons in the health care system may add to our knowledge of practice patterns.     

Autophagy dysregulation mediates the damage of high glucose to retinal pigment epithelium cells

Intraocular pressure (IOP) modifications in patients with acute central/hemicentral retinal vein occlusions (RVOs) consist in IOP reductions and increases. The IOP reduction is due to a transitional hyposecretory phase of the aqueous humor, that increases gradually until 3mo after the venous occlusion onset, and then finally disappears after month 4th. The IOP increases lead to the ocular hypertension and glaucoma. The possible pathogenetic correlations between ocular hypertension/glaucoma and acute central/hemicentral RVOs have been classified into three groups: 1) the venous occlusion precedes the ocular hypertension/glaucoma causing neovascular glaucoma and secondary angle-closure glaucoma without rubeosis; 2) the ocular hypertension and the glaucoma precede the venous occlusion and favor its appearance (ocular hypertension, primary angle-closure, primary angle-closure glaucoma, and open angle glaucomas); and 3) the venous occlusion and the ocular hypertension/glaucoma are mostly age dependent appearances due to common vascular and collagen alterations, lacking a causal connection between the 2 conditions.     

超声乳化治疗白内障合并继发性闭角型青光眼

目的探讨单纯晶状体超声乳化吸出术联合后房型折叠人工晶状体植入术治疗合并有白内障的继发性闭角型青光眼的手术治疗效果。方法继发性闭角型青光眼45例（45眼），其中35例为继发性急性闭角型青光眼，10例为继发慢性闭角型青光眼，患者均有不同程度的晶状体浑浊。人院后均行透明角膜切口晶状体超声乳化吸出术联合后房型折叠人工晶状体植入术。术后随访3月～3年。对治疗效果进行临床分析。结果45例术中、术后没有出现严重的并发症。术后视力提两36例（80．00％），术后视力无明显提高者9例（20．00％）；术后眼压较手术前明显降低。结论单纯晶状体超声乳化吸出术联合人工晶状体植入术是治疗合并有白内障的继发性闭角型青光眼的一种有效的治疗方法。     

Intraocular pressure modifications in patients with acute central/hemicentral retinal vein occlusions

AIM: To explore levels and determinants of awareness and knowledge about glaucoma among patients. METHODS: This was a cross-sectional study that included adult patients from October to the end of December 2018. A semi-structured questionnaire was designed by the researchers to measure the levels of awareness and knowledge about 18 basic information about glaucoma. The sheet was divided into 4 domains: types of glaucoma; risk factors; clinical features; and management. A knowledge score (KS, range= 0-18) was calculated, with higher scores indicating higher levels. RESULTS: A total of 383 patients responded to the questionnaire, 61.9% males, mean±SD age was 38.5±12.94 years old, and 61.6% had a university degree or higher. Of them, 6.3% and 23.2% reported personal and family history of glaucoma, respectively. The most frequently reported source of information about glaucoma was another person with glaucoma (28.2%), followed by physicians (24.8%) and TV (19.6%). Knowledge by item ranged from 3.1% to 82.5% correctness rate, while KS showed mean=5.91 and median=5; and reliability testing of the knowledge scale showed Cronbach’s alpha=0.782. Higher KS were found among respondents with higher educational level (P =0.036), diabetes history (P=0.025), and personal (P<0.001) and family (P<0.001) history of glaucoma. CONCLUSION: This study reveals low awareness and knowledge levels about glaucoma among the attendees of a local eye care hospital, where several misconceptions about disease risk factors, clinical features, and management are identified.     

The prediction of glaucoma from ocular biometric data. Part 2. An evaluation.

A method of glaucoma prediction from ocular biometric data has been described previously. A study was undertaken to evaluate the performance of the existing multiple regression equations (prediction systems) on data obtained from an independent sample consisting of 22 angle-closure glaucoma, 29 open angle glaucoma and 44 normal subjects. This performance, found by comparing the predicted and actual classification for this sample, was such that between 2 and 7% false positives and 12 and 27% false negatives were found on the equations differentiating glaucoma from normal subjects; and between 14 and 27% false positives, with 10 to 14% false negatives on the equations classifying the glaucoma subjects as angle-closure or open angle. From these results the efficiency of glaucoma prediction from ocular biometric data would appear to be equal to that of the combined tonography and provocative tests, provocation with corticosteroids and visual field screening.     

虹膜周边切除术47例临床观察

随访观察近五年虹膜周边切除术病人47例78眼。检查、记录其视力、眼压、房角图，对比二小时暗室低头试验前后高低眼压变动下房角变化情况。结果表明：宽基底虹膜周边切除术对急闭临床前期和间歇期，慢闭早期和混合性期，虹膜根赘合并单青均有较好的疗效。提示对虹膜周边切除术后眼压升高及二小时暗室低头试验结果阳性的“残余性”青光眼患者均需作进一步补充性治疗。同时也应避免因选择术式不当造成的“医源性”青光眼。     

The prediction of glaucoma from ocular biometric data. Part 1. An application of multiple regression analysis.

Two sets of multiple regression equations (prediction systems) were derived from the analysis of ocular biometric data obtained from glaucoma patients (16 open angle; 16 angle-closure) and 75 normal subjects. Discriminant scores were established for both sets of equations which minimised the number of false negatives. One set, the 'Glaucoma Equations' was applied to the data to segregate the glaucoma from the normal subjects. The other prediction system, the 'Classification Equations,' was then applied to the group defined as glaucomatous to discriminate between patients in the angle-closure and open angle categories. The performance of these equations, obtained by comparing the predicted and actual classifications for this sample, was such that between 9 and 12% of false positives and 0 and 3% false negatives were found on the 'Glaucoma Equations' and between 6 and 12% of false positives with no false negatives on the 'Classification Equations.'     

Etiology, pathogenesis, and diagnosis of neovascular glaucoma

Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that is most frequently caused by severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion, and ocular ischemic syndrome. Uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and likely predominant agent involved in the pathogenesis of intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis and neovascular glaucoma is divided into four stages: prerubeosis, preglaucoma, open angle glaucoma, and angle-closure glaucoma.     

白内障超声乳化联合房角粘连分离术治疗闭角型青光眼合并白内障

目的:观察白内障超声乳化人工晶状体植入联合房角粘连分离术治疗闭角型青光眼的疗效以及术后房角形态的改变。方法:白内障超声乳化联合房角分离术治疗闭角型青光眼48例(54眼),对手术前后的视力、眼压、视野、中央前房深度、房角形态进行对照观察。结果:术后随访3～6mo,54眼中48眼视力较前有明显提高。54眼前房深度均加深,术前前房深度(1.612±0.354)mm,术后前房深度(3.296±0.243)mm。54眼术后眼压明显降低,术前眼压(22.42±3.53)mmHg,术后眼压(13.52±3.24)mmHg。房角镜检查术后1mo和3mo随访房角均开放,未发现房角再粘连。48例术后6mo复查视野无缩小。结论:白内障超声乳化房角分离术可有效治疗闭角型青光眼合并白内障的患者。