Posterior vitreous detachment: clinical correlations

BACKGROUND: To evaluate the frequency of, and the factors which are primarily and secondarily associated with, posterior vitreous detachment (PVD), and to correlate the presence of PVD with various demographic and ophthalmic entities. METHODS: The clinical prospective observational cohort study included 1,481 subjects (740 women, 741 men) with a mean age of 63.45 +/- 14.97 years (mean +/- SD; range, 10.3-94.9 years) and a mean spherical equivalent refractive error of +0.68 +/- 2.13 dpt (range, -14.25 to +13.50 dpt). The presence of PVD was assessed by indirect and direct ophthalmoscopy, fundus biomicroscopy and by using a Hruby lens upon pharmacologically dilated pupil. Main outcome measures were frequency of PVD, association with age, refractive error, cataract surgery, diabetes mellitus, arterial hypertension, history of ocular trauma, vitreous hemorrhage, various retinal disorders, nonarteritic anterior ischemic optic neuropathy (AION) and open-angle glaucoma. RESULTS: The occurrence of PVD was significantly correlated with increasing age (p < 0.001), myopic refractive error (p < 0.001), female gender (p < 0.001), and surgical aphakia (p < 0.001). PVD occurred significantly more often bilaterally than unilaterally (p < 0.001). Patients with unilateral PVD were significantly (p < 0.001) younger than the patients with bilateral PVD. PVD was seen significantly (p = 0.038) less frequently in AION than in the remaining study population. The frequency of PVD was lower in eyes with than without diabetic retinopathy (p = 0.095), optic disc neovascularization (p = 0.07) and retinal neovascularization (p = 0.09). There was no significant association between the presence of PVD and macular hole, macular edema, retinal vascular occlusive disorders, age-related macular degeneration and open-angle glaucoma. CONCLUSIONS: These data of a large prospective study of PVD confirm some of the findings of previous smaller and retrospective studies. They also provide new information which may be helpful for the understanding of the pathophysiology of PVD and the role of PVD in the pathogenesis of various retinal and optic disc lesions.     

Prevalence and causes of visual field loss as determined by frequency doubling perimetry in urban and rural adult Chinese

PURPOSE: To determine prevalence and causes of visual field loss (VFL) as determined by frequency doubling perimetry in elderly Chinese individuals. DESIGN: Population-based, cross-sectional cohort study. METHODS: The Beijing Eye Study included 4439 of 5324 subjects (83.4%) who were invited to participate with an age of 40+ years. Visual field was assessed by frequency doubling threshold perimetry. Main outcome measure was an abnormal visual field defined as at least one test location of reduced sensitivity. RESULTS: Of the 4439 people who were examined, 4350 subjects (98.0%; 8617 eyes) provided measurement data by frequency doubling perimetry. In subjects aged 40 to 49 years, the most frequent cause for VFL was degenerative myopia followed by glaucoma, other optic nerve diseases, and cataract. In the subjects aged 60 to 69 years, the most frequent cause for VFL was cataract, followed by glaucoma and degenerative myopia. In the subjects aged 70+ years, the most frequent cause for VFL was glaucoma, followed by cataract and degenerative myopia. VFL was associated significantly with age (P < .001), myopic refractive error (P < .001), rural region (P = .001), low level of education (P = .01), degree of nuclear cataract (P < .001), and intraocular pressure (P < .001). CONCLUSION: In contrast to Western countries, age-related macular degeneration and diabetic retinopathy play a minor role as a cause for VFL in China.     

Does primary intraocular lens implantation prevent "aphakic" glaucoma in children?

PURPOSE: Open-angle glaucoma may develop after surgery for congenital or developmental cataract with an incidence ranging from 3% to 41%. The pathogenesis of "aphakic" (open-angle) glaucoma remains unknown. Despite numerous reported clinical series (>1000 eyes), we are unaware of any reported case of open-angle glaucoma after primary intraocular lens (IOL) implantation for congenital or developmental cataract. We decided to test the hypothesis that primary posterior chamber IOL implantation might decrease the incidence of open-angle glaucoma in children. METHODS: Pseudophakic eyes were collected from surgeons who contributed data to a refractive study and who monitored intraocular pressure on a regular basis. IOL implantation was commonly performed in eyes with a corneal diameter >10 mm. Comparable primary data on aphakic eyes were included from 2 published studies on aphakic glaucoma, which included corneal diameters and the patient's age at surgery. Glaucoma-free survival estimates for each cohort were estimated. RESULTS: Only 1 case of glaucoma was found among 377 eyes with primary pseudophakia (mean age of patient, 5.1 +/- 4.7 years; mean follow-up, 3.9 +/- 2.7 years). There were 14 eyes (11.3%) with glaucoma among 124 aphakic eyes (mean age of patient, 2.7 +/- 2.6 years; mean follow-up time, 7.2 +/- 3.9 years). CONCLUSIONS: We report a decreased incidence of open-angle glaucoma among eyes rendered primarily pseudophakic compared with those that remained aphakic after cataract surgery. We propose 2 theories on the possible mechanism of reduction in the incidence of glaucoma in pseudophakic eyes.     

北京科技大学40～岁职工眼病体检分析

目的:了解北京科技大学40～岁职工的眼健康状况。方法:回顾2007年职工体检报告,从本校2890例参加体检的教职工中,选出40～岁者2101例,分为40～<50,50～<60,60～<70,≥70岁4个年龄组,找出影响视力的主要眼病,分析年龄段分布情况。结果:患病率较高的5种眼病由高到低依次为:眼底动脉硬化(4.6%)、玻璃体混浊(1.8%)、老年性白内障(1.6%)、C/D(杯/盘比值)异常(0.7%)、年龄相关性黄斑变性(0.4%)。除视盘(C/D)异常外其余随年龄增长阳性检出率明显增加。结论:老年性白内障、青光眼、年龄相关性黄斑变性是影响视力的主要眼病。     

A comparative analysis of hemodynamic parameters within the evaluation of the glaucomatous process in patients with myopia

One hundred and eighty (180) persons (363 eyes), mean age 63.7 +/- 5.2, mean follow-up--6.1 +/- 1.2, were investigated. Control group 1 comprised 46 patients (92 eyes) with emmetropia and different-degree myopia; control group 2 had 74 persons (148 eyes) with primary open-angle glaucoma (POAG). The main group had 60 patients (119 eyes) with POAG combined with myopia. The ocular hemodynamics parameters were found to reliably differ, in patients with myopia, without glaucoma and with the anterior-posterior eye axis of 25 mm, from the similar parameters in persons with emmetropia. The process aggravates in myopic patients with glaucoma due to reliably worsened ocular hemodynamics parameters and due to a higher intraocular pressure without any reliably changing systemic hemodynamics. The measuring of ophthalmoplethysmography parameters could be handy in examining the POAG patients with myopia in order to detect if glaucoma is progressing or not.     

Female Reproductive Factors and Major Eye Diseases in Asian Women –The Singapore Malay Eye Study

Abstract

Purpose: To examine the association of reproductive factors and major eye diseases, including glaucoma, age-related macular degeneration (AMD), diabetic retinopathy and cataract, in Asian women.

Methods: The Singapore Malay Eye Study is a population-based cross-sectional epidemiological study which examined 3280 persons (78.7% response) of Malay ethnicity aged 40–80 years; 1704 were female. Information on reproductive factors and use of hormone replacement therapy (HRT) was collected using an interviewer-administered questionnaire. Glaucoma was defined according to the International Society for Geographical and Epidemiological Ophthalmology criteria. Retinal photographs were graded for AMD following the Wisconsin grading system, and diabetic retinopathy according to the modified Airlie House classification system. Cataract was graded according to the Lens Opacity Classification System III.

Results: A total of 1176 women reported having experienced menopause by the time of the study with 1073 (91%) having a natural menopause, 88 (7.5%) a hysterectomy and 9 (0.8%) due to other reasons; HRT was used by 70 (6%) women. Women whose age at menopause was ≤52 years were 3.5 times more likely to have glaucoma (95% confidence interval, CI, 1.23–9.98, p value?=?0.02) than those whose age at menopause was ≥53 years. Age of menopause was not associated with AMD (age-adjusted odds ratio, OR, 1.22, 95% CI 0.65–2.31), diabetic retinopathy (age-adjusted OR 1.01, 95% CI 0.66–1.54) or cataract (age-adjusted OR 1.38, 95% CI 0.95–2.00). Use of HRT was not associated with any of these eye diseases.

Conclusion: Women who had menopause at a younger age were more likely to have glaucoma. This association needs to be confirmed in other studies.     

Influence of experimental chronic high-pressure glaucoma on age-related macular degeneration in rhesus monkeys

PURPOSE: To assess prospectively whether development of age-related macular degeneration is influenced by experimentally induced chronic high-pressure glaucoma, and whether age-related macular degeneration influences the appearance of the optic nerve head in experimental chronic high-pressure glaucoma in older rhesus monkeys. METHODS: The longitudinal study included 102 eyes of 52 rhesus monkeys. The total study group was divided into a group with experimentally induced unilateral chronic high-pressure glaucoma (n = 40 eyes) and a normal control group (n = 62 eyes). Additionally, arterial hypertension and atherosclerosis were experimentally induced in both study groups in a similar percentage of monkeys. Mean monkey age at the end of the study was 19.6 +/- 3.1 years (range, 13-24 years). The macular region, optic disc, and retinal nerve fiber layer were morphometrically evaluated by color wide-angle fundus photographs taken at baseline and at the end of the study. RESULTS: The degree of age-related macular degeneration, measured as number and area of drusen in the foveal and extrafoveal region of the macula, did not differ significantly between the two study groups. In the glaucomatous group, the degree of macular degeneration was statistically independent of the development of parapapillary atrophy, loss of neuroretinal rim, and decrease in the visibility of the retinal nerve fiber layer. CONCLUSIONS: Development of age-related macular degeneration in rhesus monkeys is independent of concomitant chronic high-pressure glaucoma, including the development of glaucomatous parapapillary chorioretinal atrophy. Conversely, age-related macular degeneration does not markedly influence the course of experimental chronic high-pressure glaucoma or the development of parapapillary atrophy in monkeys.     

The letter contrast sensitivity test: clinical evaluation of a new design

PURPOSE: To compare the reliability, validity, and responsiveness of the Mars Letter Contrast Sensitivity (CS) Test to the Pelli-Robson CS Chart. METHODS: One eye of 47 normal control subjects, 27 patients with open-angle glaucoma, and 17 with age-related macular degeneration (AMD) was tested twice with the Mars test and twice with the Pelli-Robson test, in random order on separate days. In addition, 17 patients undergoing cataract surgery were tested, once before and once after surgery. RESULTS: The mean Mars CS was 1.62 log CS (0.06 SD) for normal subjects aged 22 to 77 years, with significantly lower values in patients with glaucoma or AMD (P<0.001). Mars test-retest 95% limits of agreement (LOA) were +/-0.13, +/-0.19, and +/-0.24 log CS for normal, glaucoma, and AMD, respectively. In comparison, Pelli-Robson test-retest 95% LOA were +/-0.18, +/-0.19, and +/-0.33 log CS. The Spearman correlation between the Mars and Pelli-Robson tests was 0.83 (P<0.001). However, systematic differences were observed, particularly at the upper-normal end of the range, where Mars CS was lower than Pelli-Robson CS. After cataract surgery, Mars and Pelli-Robson effect size statistics were 0.92 and 0.88, respectively. CONCLUSIONS: The results indicate the Mars test has test-retest reliability equal to or better than the Pelli-Robson test and comparable responsiveness. The strong correlation between the tests provides evidence the Mars test is valid. However, systematic differences indicate normative values are likely to be different for each test. The Mars Letter CS Test is a useful and practical alternative to the Pelli-Robson CS Chart.     

Prevalence of Pseudoexfoliation Syndrome in Turkish Patients with Senile Cataract

Purpose: To investigate the prevalence of pseudoexfoliation syndrome (PEX) among Turkish patients with senile cataract. Materials and Methods: Records of 352 eyes of 352 patients who underwent cataract surgery were analyzed in this retrospective study. The presence of PEX, type of cataract, intraocular pressure (IOP), glaucoma, age-related macular degeneration, and systemic diseases (coronary artery disease, hypertension, diabetes mellitus) were recorded. Results: The overall prevalence of PEX syndrome was detected to be 11%. The mean age of PEX patients was significantly higher than without PEX (74.4?±?7.2 years and 69.3?±?11.4 years, respectively, p?=?0.004). The most common cataract type in the PEX patients was mixed-type cataract determined in 51.2% of patients. IOP was significantly higher in eyes with PEX than in eyes without it (16.1?±?4.5?mmHg and 14.7?±?3.8?mmHg, respectively; p?=?0.03). Moreover, the prevalence of age-related macular degeneration was found to be significantly higher, and prevalence of glaucoma slightly higher in PEX patients than without PEX. Conclusion: Pseudoexfoliation syndrome is a common condition in Turkish people. PEX is associated with mixed type of cataract, age-related macular degeneration, and elevated IOP. Therefore, PEX patients should be checked for concomitant diseases.     

Prevalence and causes of visual impairment in The Barbados Eye Study

OBJECTIVE: To determine the prevalence and causes of low vision and blindness in a predominantly black population. DESIGN: Population-based prevalence study of a simple random sample of Barbados-born citizens aged 40 to 84 years. PARTICIPANTS: Four thousand seven hundred nine persons (84% participation). METHODS: The standardized protocol included best-corrected visual acuity (with a Ferris-Bailey chart), automated perimetry, lens gradings (LOCS II), and an interview. Participants with visual acuity of worse than 20/30, other positive findings, and a 10% sample also had an ophthalmologic examination that evaluated the cause and extent of vision loss (resulting from that cause), if any. MAIN OUTCOME MEASURES: Low vision and blindness were defined as visual acuity in the better eye between 6/18 and 6/120 and visual acuity worse than 6/120, respectively (World Health Organization [WHO] criteria). RESULTS: Of the 4631 participants with complete examinations, 4314 (93%) reported their race as black, 184 (4%) reported their race as mixed (black and white), and 133 (3%) reported their race as white or other. Low vision was found in 5.9% of the black, 2.7% of the mixed, and 3.0% of white or other participants. Bilateral blindness was similar for black and mixed race participants (1.7% and 1.6%, respectively) and was not found in whites. Among black and mixed participants, the prevalence of low vision increased with age (from 0.3% at 40-49 years to 26.8% at 80 years or older). The prevalence of blindness was higher (P < 0.001) for men than women at each age group (0.5% versus 0.3% at ages 40-49 and 10.9% versus 7.3% at 80 years or more). Sixty percent of blindness was due to open-angle glaucoma and age-related cataract, each accounting for more than one fourth of cases. Other major causes were optic atrophy or neuropathy and macular and other retinal diseases. Few cases of blindness were due to diabetic retinopathy (1.4%), and none were due to age-related macular degeneration. CONCLUSIONS: Using the WHO criteria, prevalence of visual impairment was high in this African-origin population, particularly at older ages. Most blindness was due to open-angle glaucoma and cataract, with open-angle glaucoma causing a higher proportion of blindness than previously reported. The increased prevalence of blindness in men may be due to the increased male prevalence of glaucoma in this population and warrants further investigation. Results underline the need for blindness prevention programs, with emphasis on effective treatment of age-related cataract and enhancing strategies for early detection and treatment of open-angle glaucoma.     

康柏西普在眼部新生血管性疾病中的应用进展

康柏西普是中国自主研发的一种抗血管内皮生长因子新药。自从2013年被中国国家食品药品管理总局批准用于临床,康柏西普在治疗湿性年龄相关性黄斑变性、脉络膜新生血管、黄斑水肿等眼部新生血管性疾病过程中显示出可靠的安全性和疗效。针对不同的疾病,康柏西普的治疗策略有所不同。本文就近年来康柏西普在湿性年龄相关性黄斑变性、糖尿病性黄斑水肿、病理性近视脉络新生血管、新生血管性青光眼、未成熟儿视网膜病变、角膜新生血管等眼部新生血管性疾病中的应用进展进行综述,总结探讨康柏西普的用药适应证、给药方案和治疗效果。期待康柏西普的用药适应证会更广,给药方案会更多,为眼部新生血管性疾病的治疗带来新的思路。     

Relationship between vision impairment and eye disease to vision-specific quality of life and function in rural India: the Aravind Comprehensive Eye Survey

PURPOSE: To determine the impact of vision impairment and eye diseases on vision-specific quality of life and visual function in an older population of rural southern India. METHODS: Presenting and best-corrected visual acuity and burden of eye diseases were determined in a population aged 40 years and older, identified through a random cluster sampling strategy from 50 villages of rural south India. A questionnaire validated previously for use in this population was used to ascertain quality of life and visual function. Visual acuity measurements were obtained with illiterate E Early Treatment Diabetic Retinopathy Study (ETDRS) charts. Cataract was graded and defined based on the Lens Opacities Classification System (LOCS) III. Macular degeneration was defined based on the classification system proposed by the International ARM Epidemiologic Study Group. Glaucoma was defined based on results of clinical examinations including optic disc and visual fields. Analyses were performed to explore the relationship of overall and subscale quality-of-life and visual function scores with presenting acuity in the better-seeing eye, specific eye diseases, and demographic variables. RESULTS: Information on quality of life and visual function were available for 5119 (99.4%) of 5150 study subjects. The mean presenting visual acuity in the better eye was 0.76 +/- 0.53 logMAR (logarithm of the minimum angle of resolution) units. Age, education, occupation, presenting acuity in the better eye, and presence of a cataract, glaucoma, or refractive error were independently associated with overall quality-of-life and vision function scores. After adjustment for demographic variables and ocular disease, persons with vision impairment or bilateral blindness based on presenting visual acuity had lower scores across all domains of quality of life and vision function. Scores for subscales of quality-of-life and vision function domains were significantly lower among those with age-related cataract and glaucoma compared with persons without those eye diseases. CONCLUSIONS: Presenting vision in the better eye was associated with quality of life and vision function in this older population of rural south India. Subjects with glaucoma and age-related cataract had an associated decrease in quality of life and vision function, independent of presenting visual acuity in the better eye.     

Attributable risk estimates for cataract to prioritize medical and public health action

PURPOSE: Cataract is the most common cause of blindness in the world. The purpose of this study was to estimate the population attributable risk associated with identified risk factors for cortical, nuclear, and posterior subcapsular (PSC) cataract in a representative sample of the Victorian population aged 40 years and older. METHODS: Cluster, stratified sampling was used and participants were recruited through a household census. At locally established test sites, standardized clinical examinations were performed to assess cataract and personal interviews were conducted to quantify potential risk factors. Multivariate logistic regression was used to determine the independent risk factors associated with the three types of cataract, and the population attributable risk was calculated. RESULTS: A total of 3271 (83% of eligible) of the urban residents and 1473 (92%) rural residents participated. The urban residents ranged in age from 40 to 98 years (mean, 59 years), and 1511 (46%) were men. The rural residents ranged in age from 40 to 103 years (mean, 60 years), and 701 (48%) were men. The overall prevalence of cortical cataract was 12.1% (95% CL 10.5, 13.8), nuclear cataract 12.6% (95% CL 9.61, 15.7), and PSC cataract 4.93% (95% CL 3.68, 6.17). Significant risk factors for cortical cataract included age, female gender, diabetes for greater than 5 years, gout for greater than 20 years, arthritis, myopia, average annual ocular UV-B exposure, and family history of cataract (parents or siblings). Significant risk factors for nuclear cataract included age, female gender, rural residence, age-related maculopathy, diabetes for greater than 5 years, smoker for greater than 30 years, and myopia. The significant risk factors for PSC cataract were age, rural residence, thiazide diuretic use, and myopia. Of the modifiable risk factors, ocular UV-B exposure explains 10% of the cortical cataract in the community, and cigarette smoking accounts for 17% of the nuclear cataract. CONCLUSIONS: Because of the near universal exposure to UV-B in the environment, ocular protection has one of the highest modifiable attributable risks for cortical cataract and would therefore be an ideal target for public health intervention. Quit smoking campaigns can be expanded to incorporate information about the excess cataract in the community associated with long-term smoking. Nonmodifiable risk factors such as age, gender, and long-term medication use have implications for the timely referral and treatment for those at higher risk of cataract.     

Long-term efficacy of argon laser trabeculoplasty

Long-term efficacy of 360 degrees argon laser trabeculoplasty was studied in 118 eyes of 93 patients with uncontrolled chronic open-angle glaucoma. The mean intraocular pressure (IOP) decrease was 8.9 +/- 5.4 mmHg (mean +/- standard deviation [SD] in 71 eyes at 1 year, 9.3 +/- 4.3 mmHg (mean +/- SD) in 51 eyes at 3 years, and 10.3 +/- 3.9 mmHg (mean +/- SD) in 28 eyes at 5 years. The probability of success at 4 years (decrease in IOP greater than or equal to 3 mmHg, IOP less than or equal to 19 mmHg, stable visual field, stable optic nerve, and no further laser or surgical intervention) was 52%. Pretreatment IOP, diagnosis, previous operations, age, and sex were not significant determinants for success or failure. Eyes receiving argon laser trabeculoplasty before cataract surgery maintained control of IOP after surgery. Failure was most common in the first year after treatment (23%), and thereafter failure occurred at a rate of 7 to 10% per year.     

Nuclear sclerotic cataract in young patients in Taiwan

PURPOSE: To document the clinical features of discrete nuclear sclerosis in young patients. SETTING: Chang-Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China. METHODS: The medical records of all patients younger than 45 years with nuclear sclerosis who had cataract surgery at 1 hospital were retrospectively reviewed. Patients with congenital cataract, ocular trauma, ocular disease in addition to myopia, and systemic disease associated with cataract were excluded. The patients' age, sex, bilateral lens status, axial length, original and preoperative refractive status, and preoperative and postoperative best corrected visual acuities (BCVAs) were recorded. RESULTS: Fifty-five eyes of 35 patients aged 32 to 45 years met the study criteria. Nuclear sclerotic cataract was bilateral in 20 patients. The mean age at surgery was 40.64 years +/- 3.63 (SD). The mean refraction before the development of cataract was -7.80 +/- 3.57 diopters (D) and the mean preoperative refraction, -17.40 +/- 6.05 D. The mean axial length was 28.09 +/- 2.31 mm. The postoperative BCVA was 20/22 or better in 53 eyes (96.4%). CONCLUSIONS; In patients younger than 45 years with cataract in Taiwan, nuclear sclerosis was not a rare cause of visual loss and axial myopia was strongly associated with the formation of nuclear sclerosis. Bilateral sclerosis was observed in most cases. Patients with an axial length greater than 27.0 mm had the greatest risk. Surgical treatment was therapeutic.     

Hepatocyte growth factor is increased in the aqueous humor of glaucomatous eyes.

PURPOSE: To assess the concentrations of hepatocyte growth factor (HGF) in the aqueous humor of eyes with glaucoma compared with control eyes with cataract only. METHODS: Concentrations of HGF were measured in aqueous humor aspirates taken during anterior segment surgery from 84 patients, of whom 72 had glaucoma (38 cases of primary open-angle glaucoma, 17 angle-closure glaucoma, and 17 exfoliative glaucoma) and 12 had cataract only, using a sandwich enzyme-linked immunosorbent assay kit. RESULTS: Hepatocyte growth factor was detected in all samples. The concentration in eyes with cataract only was 563.3 +/- 178.8 pg/mL (mean +/- standard deviation), which was significantly lower than that in eyes with glaucoma (967.1 +/- 514.7 pg/mL, P < 0.01). Eyes with exfoliative glaucoma had significantly higher HGF concentrations (1,425.5 +/- 586.7 pg/mL) than did eyes with primary open-angle glaucoma (855.0 +/- 341.5 pg/mL) and angle-closure glaucoma (759.4 +/- 511.4 pg/mL) (P < 0.01). There was no effect of age, sex, or history of medical, laser, or surgical treatment on the aqueous humor HGF concentration (P > 0.05). Aqueous humor and plasma HGF concentrations were measured and compared in 28 patients. The aqueous humor HGF concentration (908 +/- 586.2 pg/mL) was significantly higher (P < 0.01) than the plasma concentration (521.3 +/- 183.1 pg/mL). No significant correlation could be found between aqueous humor and plasma HGF concentrations. CONCLUSIONS: The relatively high concentration of HGF in human aqueous humor suggests that HGF may play an important role in ocular physiology and disease. The higher concentration in patients with glaucoma may indicate a response to injury.     

The Eger Macular Stressometer: pilot study

PURPOSE: To evaluate the sensitivity of the Eger Macular Stressometer (EMS) for early screening of age-related macular degeneration (AMD) in a clinical practice. We examined the null hypothesis that AMD eyes have EMS recovery times (RTs) that do not differ from eyes with cataract, diabetic retinopathy, or glaucoma. DESIGN: The design of this study was a nonrandomized clinical trial. METHODS: Ninety-two eyes from 92 patients with vision 20/80 or better, age 50 and older, of either gender, and any ethnic origin, were recruited into one of four groups: AMD (30 eyes), normal or mild cataract (30 eyes), diabetic retinopathy (16 eyes), and glaucoma (16 eyes). Recovery times were obtained with the EMS, according to manufacturer's instructions. RESULTS: The mean (SD) [median] RT for the AMD group was 11.8 (7.6) [9] seconds, the normal/cataract group 10.0 (4.3) [9] seconds, the diabetic retinopathy group 8.4 (3.0) [8] seconds, and glaucoma group 8.6 (2.4) [8] seconds. Recovery time did not appear to be related to group (P =.58), age (P =.50), visual acuity (P =.52), or sex (P =.23). CONCLUSIONS: We found EMS RT distributions did not differ between AMD, cataract, diabetic retinopathy, and glaucoma groups. The EMS in its current form is not a sensitive screening tool for AMD. Further testing is needed to examine EMS sensitivity with other macular diseases such as central serous choroidopathy and diabetic macular edema.     

高度近视与原发性开角型青光眼关系的研究进展

近年来,在青光眼及近视发病机制研究中发现,高度近视与原发性开角型青光眼的发病有明显相关性.高度近视眼底病理改变是开角型青光眼的高危因素,且高度近视眼底改变与早期开角型青光眼眼底改变容易混淆,造成青光眼早期诊断困难.如何从高度近视患者中早期发现青光眼,并进行早期干预治疗成为难点.本文回顾分析近年文献,对高度近视与原发性开角型青光眼的关系做一综述.     

Prevalence of myelinated retinal nerve fibres in urban and rural adult Chinese populations: the Beijing Eye Study

PURPOSE: To determine the prevalence of myelinated retinal nerve fibres in the elderly Chinese population. METHODS: The Beijing Eye Study, a population-based, cross-sectional cohort study, included 4439 subjects out of the 5324 invited to participate (response rate 83.4%) with an age of > 40 years. The present investigation consisted of 8663 eyes of 4378 (98.6%) subjects for whom readable fundus photographs were available. RESULTS: Myelinated retinal nerve fibres were detected in 35 eyes (29 subjects) with a prevalence rate of 0.4 +/- 6.3%[95% confidence interval (CI): 0.27, 0.54] per eye and 0.7 +/- 8.1% (95% CI: 0.42, 0.90) per subject. The myelinated nerve fibres were located most often in the temporal inferior region, followed by the temporal superior region and the nasal region. Prevalence of myelinated nerve fibres was not associated statistically with age, gender, refractive error, visual acuity (VA), intraocular pressure, cataract, glaucoma and age-related macular degeneration. CONCLUSION: Myelinated retinal nerve fibres are present in about seven out of 1000 elderly Chinese in northern China, without association to VA, refractive error, glaucoma and macular degeneration.     

The impact of Vision 2020 on global blindness

INTRODUCTION: Recent data suggest that there are 37 million blind people and 124 million with low vision, excluding those with uncorrected refractive errors. The main causes of global blindness are cataract, glaucoma, corneal scarring (from a variety of causes), age-related macular degeneration, and diabetic retinopathy. CONCLUSION: It would appear that the global Vision 2020 initiative is having an impact to reduce avoidable blindness particularly from ocular infections, but more needs to be done to address cataract, glaucoma, and diabetic retinopathy.