Cambios morfométricos de las células del endotelio corneal en el síndrome pseudoexfoliativo y glaucoma pseudoexfoliativo

ObjetiveTo evaluate the corneal endothelial morphometry and central corneal thickness (CCT) in pseudoexfoliative (PEX) eyes with and without glaucoma and to compare with normal eyes and eyes with primary open-angle glaucoma (POAG).MethodA total of 166 patients were included in this study: 36 eyes with pseudoexfoliation syndrome (PXS), 30 eyes with pseudoexfoliation glaucoma (PXG), 40 eyes with POAG, and 60 normal eyes. Corneal endothelial cell density (ECD), coefficient of variation (CV) in cell size, and percentage of hexagonal cells, were measured using a non-contact specular microscope, whereas CCT was measured with an ultrasonic pachymeter.ResultsECD and percentage of hexagonal cells were lower in PEX groups and in the POAG group compared with normal eyes, while the CV in cell size was greater. There was a tendency for greater cell loss and morphological abnormalities of the corneal endothelial cells in PXG eyes compared to PXS eyes, when all pseudoexfoliative eyes were analyzed together. Changes in endothelial cells increased with age. There were no significant differences in mean CCT between the four groups.ConclusionEndothelial cell density is significantly decreased, and pleomorphism and polymegathism of cells are increased in PEX eyes, particularly when intraocular pressure is high.     

剥脱性青光眼患者视网膜神经纤维层厚度变化分析

目的：比较维吾尔族假性剥脱综合征(PEX)患者、剥脱性青光眼(PEXG)患者视网膜神经纤维层(RNFL)厚度,为早期诊断剥脱性青光眼提供理论依据。

方法：回顾性病例对照研究。选取2018-04/ 2020-06在我院就诊治疗的维吾尔族假性剥脱综合征患者70例70 眼,剥脱性青光眼患者 80例80 眼,按照视野缺损分期分为早中期剥脱性青光眼患者56眼、晚期剥脱性青光眼患者24眼,选取同期本院收治的维吾尔族年龄相关性白内障病例60例60 眼作为对照组。比较四组患者视盘不同位置RNFL厚度。

结果：对照组、假性剥脱综合征组及剥脱性青光眼组患者视野缺损(MD)逐渐加重且剥脱性青光眼组患者MD显著高于假性剥脱综合征组(P<0.01); 假性剥脱综合征组、早中期剥脱性青光眼组及晚期剥脱性青光眼组视盘不同位置RNFL厚度较对照组均变薄(均P<0.01); 假性剥脱综合征组患者视盘平均RNFL、下方、上方RNFL厚度均低于对照组(均P<0.01)); 晚期剥脱性青光眼组患者视盘各个位置RNFL厚度明显低于早中期剥脱性青光眼患者(均P<0.01)。

结论：维吾尔族假性剥脱综合征患者早期RNFL厚度较未患有剥脱综合征人群开始变薄,早期对于假性剥脱综合征患者RNFL进行检测有助于剥脱性青光眼疾病诊断并进行治疗。     

剥脱性青光眼视盘视网膜神经纤维层厚度与视野缺损的相关性

探讨不同时期剥脱性青光眼（PXG）患者视盘视网膜神经纤维层（RNFL）厚度与视野缺损的相关性。方法：病例对照研究。连续性选取2013年1月至2018年1月在石家庄市第一医院青光眼科住院治疗的PXG患者97例（97眼），并将其分为早期PXG组28例，中期PXG组27例，晚期PXG组42例。另选择与PXG组匹配的正常志愿者32例（32眼）作为正常对照组。所有纳入对象均采用SD-OCT对视盘各区RNFL厚度进行扫描，采用单因素方差分析比较4组受检者视盘各区RNFL厚度差异，采用 Pearson相关分析对视盘RNFL厚度与视野平均缺损相关性进行分析。结果：正常对照组及早、中、晚期PXG组平均视盘RNFL厚度分别为（104±11）μm，（92±14）μm，（82±12）μm，（54±18）μm。4组受检者鼻侧、鼻上方、颞上方、颞侧、颞下方、鼻下方及平均RNFL厚度总体差异均具有统计学意义（F=24.38、36.40、47.84、8.70、95.46、54.75、82.28，均P<0.001）。进一步两两比较发现，正常对照组与早期PXG组颞上方、颞下方、鼻下方及平均视盘RNFL厚度差异有统计学意义（均P<0.05）；正常对照组与中期PXG组鼻侧、鼻上方、颞上方、颞下方、鼻下方及平均RNFL厚度差异有统计学意义（均P<0.05）；正常对照组与晚期PXG组各区RNFL厚度差异均有统计学意义（均P<0.001）。中、晚期 PXG组视盘平均RNFL厚度与视野平均缺损呈正相关（r=0.404，P=0.037；r=0.582，P<0.001）。结论：中、晚期PXG眼视盘平均RNFL厚度与视野缺损呈正相关，SD-OCT监测视盘RNFL厚度变化可以作为PXG诊断分期和随访的重要参考指标。     

剥脱性青光眼与剥脱综合征黄斑厚度及体积比较

目的：对比分析剥脱性青光眼（PXG）、剥脱综合征（PEX）患者及正常人(CON)黄斑厚度及体积的差异。方法：病例对照研究。连续性选取2014 年5 月至2017 年5 月在石家庄市第一医院住院治疗的PXG病例31例（31眼）,PEX病例16例（16眼）及性别、年龄相匹配的CON 34例（34眼）分别作为PXG组、PEX组、CON组。3 组纳入人员均进行黄斑区OCT-3D模式扫描,并对黄斑各区厚度及体积进行单因素方差分析。结果：CON组、PEX组、PXG组黄斑平均厚度分别为（305±15）μm、（299±12）μm、（289±18）μm,黄斑平均体积分别为（0.94±0.05）μm3、（0.92±0.03）μm3、（0.89±0.06）μm3。3组间黄斑厚度总体差异在鼻内环（NIM）、上内环（SIM）、颞内环（TIM）、下内环（IIM）、上外环（SOM）、颞外环（TOM）、下外环（IOM）区有统计学意义（F=4.887、8.987、7.889、9.489、6.462、6.464、7.964,P < 0.05）,在中心凹厚度（CMT）、中央区（CSF）、鼻外环（NOM）区差异无统计学意义;3组间体积总体差异在NIM、SIM、TIM、IIM、SOM、TOM、IOM区有统计学意义（F=4.352、8.697、7.920、8.513、6.185、6.411、9.095,P < 0.05）,在CSF、NOM区差异无统计学意义。进一步两两比较显示,PXG组与CON组相比,黄斑厚度在NIM、SIM、TIM、IIM、NOM、SOM、TOM、IOM区变薄（P < 0.05）;黄斑体积在NIM、SIM、TIM、IIM、NOM、SOM、IOM区变小（P < 0.05）。PXG组与PEX组相比,黄斑厚度及 体积在SIM、IIM、SOM区变薄（P < 0.05）。结论：与PEX患者及正常人相比,PXG患者黄斑厚度变薄、体积变小,监测黄斑厚度的变化对PXG的临床诊治具有重要意义。     

Prediction of Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma by Using Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio

Purpose: To assess the levels of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with pseudoexfoliation syndrome (PEX) and to compare the NLR and PLR results of patients with PEX, PEX glaucoma (PXG), and healthy controls.

Methods: In total, 34 patients with PEX, 29 patients with PXG, and 42 healthy subjects were enrolled in this retrospective study. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 2 h of blood collection.

Results: There was a significant difference in NLR between PEX and control groups (p = 0.012) and PXG and control groups (p = 0.003). Also, a significant difference was found in PLR values between control and PXG groups (p = 0.024).

Conclusions: Our study for the first time provides evidence that PLR and NLR may be useful for predicting the prognosis of PEX patients and progression to PXG.     

Correlation of Peripapillary Choroidal Thickness and Retinal Nerve Fiber Layer Thickness in Normal Subjects and in Patients with Glaucoma

Purpose: This study was designed to compare the normal and glaucomatous eyes regarding retinal nerve fiber layer (RNFL) thickness and peripapillary choroidal thickness (PCT), and to investigate the correlation of RNFL thickness and PCT. Subjects and Methods: Subjects were selected as a convenience sample of those from a tertiary referral practice of glaucoma. Thirty-two glaucomatous eyes were accepted as group 1; 30 normal eyes were accepted as group 2. Groups were compared for RNFL thickness and PCT. Correlations of RNFL thickness and PCT were assessed for each peripapillary location. Results: Mean inferior and superior RNFL thickness in group 1 were significantly lower than the control group; mean thicknesses of temporal and nasal quadrants were not different in the two groups. Mean PCT at 500 µm distance in the inferior, at 1500 µm distance in the superior, at 500, 1000, and 1500 µm distance in the temporal, and at 1000 and 1500 µm distance in nasal quadrants were found to be significantly thinner in the glaucoma group compared with the control group. Retinal nerve fiber thickness was strongly correlated with PCT at all points of inferior quadrants at 500 µm distance in the superior. There was no correlation between RNFL thickness and PCT at any point in the control group. Conclusion: Peripapillary choroidal thickness was thinner in glaucomatous eyes compared with normal eyes. Correlation of PCT and RNFL thickness found in patients with glaucoma did not exist in normal subjects.     

Automated iris volume analysis and trabecular meshwork length using anterior segment optical coherence tomography - Application in pseudoexfoliation and pseudoexfoliation glaucoma

Purpose:The aim of this study was to evaluate differences in the iris and angle parameters in psuedoexfoliation syndrome (PXF) and pseudoexfoliation glaucoma (PXG) using anterior segment optical coherence tomography (ASOCT).Methods:Patients with PXF or PXG were compared using ASOCT with primary open-angle glaucoma POAG eyes as controls in this noninterventional comparative study conducted at a tertiary eye care center in East India. All angle parameters, TM length, and iris thickness were analyzed from the enhanced depth imaging (EDI) single scans obtained. Quadrant scans were used for the calculation of iris volume using a custom-built in-house software. In particular, the software performs multiple operations including edge detection, connected components, and thresholding to localize and segment the iris. Differences in the iris volume/thickness and TM length in PXF and PXG with POAG were analyzed.Results:A total of 225 eyes were included, which included 75 PXG and 98 PXF cases and 52 POAG with a mean age of 67 ± 9.7 years at presentation. The algorithm repeatability and reproducibility was also established with correlation coefficients more than 99% which was substantiated with Bland-Altman plots. The iris volume (calculated in 197 images of 225 eyes) did not differ significantly in PXF and PXG eyes, although both had significantly greater volume compared to POAG eyes. The iris volume or other angle parameters including TM length did not correlate with clinical variables such as IOP, age, or visual field indices.Conclusion:Iris parameters or TM length do not explain pathogenesis of glaucoma in pseudoexfoliation.     

Total oxidative stress, paraoxonase and arylesterase levels at patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma

AIM:To investigate the oxidative stress status of the aqueous humor and serum of patients with pseudoexfoliation (PEX) syndrome and pseudoexfoliative glaucoma (PEG) and to measure paraoxonase (PON) and arylesterase (ARE) levels.METHODS: A total of 78 patients were enrolled in the study, with 26 patients in each separate group. The patients were divided into three groups:the first group entailed PEX syndrome patients, while the second group consisted of patients with PEG and the third group involved patients with no additional systemic diseases, other than the diagnosis of cataract as control. Total oxidative stress (TOS), total antioxidant capacity (TAC), PON, and ARE levels in aqueous humor and serum were measured.RESULTS: TAC, PON and arylesterase levels in aqueous humor and serum of the PEX syndrome and PEG patients were significantly decreased compared with control group (P<0.05). TOS values were higher in patients with PEX syndrome and PEG than controls (P<0.05). TAC, PON and ARE levels of aqueous humor did not differ significantly between the PEX syndrome and PEG groupsCONCLUSION: These findings are potentially of significance and add to the growing body of evidence for oxidative stress in PEX syndrome and PEG. Decreased antioxidant defense and increased oxidative stress system may play an important role in the pathogenesis of PEX syndrome and PEG.     

Tonography assessment using quantitative and qualitative analysis of the aqueous humor outflow mechanism

Purpose. To perform qualitative evaluation of the aqueous humor (AH) outflow mechanism in glaucoma and nonglaucoma patients by means of tonography assessment and mathematical analysis. Methods. Sixty-two primary open angle and 58 pseudoexfoliation glaucoma patients were recruited in a non-interventional, observational study between 2004 and 2007. Qualitative and quantitative outflow assessment was acquired by means of a digital tonographer and mathematical analysis. Qualitative results were represented using slope analysis of the change of the AH outflow rate over the tonography study. The results were compared to the control group (CG; n=100) as well as to a pseudoexfoliation group (PEX; n=46). Results. Regarding quantitative analysis, glaucoma groups exhibited significantly lower outflow facility compared to nonglaucoma ones (p<0.001). Outflow facility value was significantly correlated to cup to disc ratio (Pearson correlation r=-0.3, p<0.001). Regarding qualitative analysis, the primary open-angle glaucoma (POAG) group presented a significant profile variation at the beginning of the tonography, expressed as an increased resistance of the AH outflow. Both glaucoma groups exhibited profile stabilization at the end of the measurement, suggesting that the outflow rate remained constant, while nonglaucoma groups followed a continuous reduction of the AH outflow rate throughout the study. Conclusions. The POAG, PXG, PEX, and CG groups demonstrated both qualitative and quantitative tonographic profile differences. The observed differences in the glaucoma groups suggest a distinct pathomechanism between POAG and PXG. It is suggested that POAG patients have a temporary disruption of the AH flow pathway, while PXG patients have a generalized increased flow resistance.     

Serum Lipid Levels in Pseudoexfoliation Syndrome

Purpose: To investigate the serum lipid levels in pseudoexfoliation (PEX) syndrome and its association with systemic vascular disorders. Materials and Methods: Patients were divided into three groups: 52 patients with PEX syndrome (group 1), 20 patients with PEX glaucoma (group 2), and 47 control subjects without PEX syndrome or glaucoma (group 3). The fasting serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride levels were evaluated by Beckman Coulter DXC 800/USA biochemical analyzer. Results: The mean LDL values were 138?±?33?mg/dl in group 1, 150?±?37?mg/dl in group 2, and 127?±?36?mg/dl in group 3. The mean LDL values in groups 1 and 2 were found to be significantly higher than that of group 3 (p?=?0.04). The patients in groups 1 and 2 were more often diabetic and hypertensive than group 3 (p?p?Conclusion: Increased LDL values are significantly associated with PEX.     

Retinal nerve fiber layer thickness changes in obstructive sleep apnea syndrome:one year follow-up results

AIM:To investigate the retinal nerve fiber layer (RNFL) thickness changes in patients with obstructive sleep apnea syndrome (OSAS) for one year follow-up. To discuss the possibility of detecting tendency of glaucoma in this population by using spectral domain optical coherence tomography (3D-OCT-2000 Spectral domain).METHODS:After polysomnographic study, all subjects (64 OSAS patients and 40 controls) underwent detailed ophthalmological examination. After these examinations, patients with glaucoma and patients who had ophthalmological and/or systemic disease were excluded from the study. Totally, 20 patients in OSAS group and five patients in controls were excluded from the study in the first examination and follow-up period. The RNFL thickness was assessed with OCT. Forty-four OSAS patients and 35 control subjects were followed up 12mo. RNFL thickness change and OSAS patients were evaluated for severity of disease by Apnea-Hypopnea Index (AHI).RESULTS:Forty-four OSAS patients and 35 controls were enrolled in the study. Statistically significance was found between OSAS patients and controls at the 12^th mo. Average RNFL thickness was found to be significantly lower in last measurements in OSAS patients when compared with first measurements and control subjects (P<0.001, 0.002, respectively). There was a statistically significant correlation among AHI, and RNFL thickness (P<0.05).CONCLUSION:The results suggest that the patients with OSAS were related with a proportional decrease in the RNFL thickness. These patients should be followed up regularly for glaucomatous changes. Detecting more RNFL thinning in severe OSAS was important.     

Advanced glycation end products and pseudoexfoliation--correlation between clinical outcome and histological findings

BACKGROUND: Pseudoexfoliation syndrome (PXS) as a stress-induced microfibrillopathy often shows a prolonged postoperative course. Formation of advanced glycation end products (AGEs) might be also associated with an increased oxidative stress. This study investigated for the first time immunohistochemically lens capsules of PXS patients for the AGE carboxymethylysine (CML) and correlated the findings with the clinical outcome of the patients. METHODS: 55 patients (22 male, 33 female; mean age 73.9 +/- 14.1 years) with PXS and pseudoexfoliation glaucoma (PXG) after cataract extraction were included. All lens capsules could be investigated immunohistochemically for the AGE CML. Both preoperative biometric data as well as intra- and postoperative courses were included in the investigations, followed by a correlation analysis of the immunohistochemical findings. RESULTS: 29 PXS and 26 PXG patients with a mean axial length of 23.1 +/- 1.1 mm were explored. Both groups showed a postoperative decrease of intraocular pressure and a moderate increase of visual acuity. Intraoperatively, 6 zonulolyses occurred and postoperatively 11 patients showed problems like increases of intraocular pressure. Immunohistochemically, CML could be detected in most of the epithelial cells of the lens capsules but only in a small part of the pseudoexfoliation (PEX) fibrils. A correlation between positive CML immunoreaction and the clinical course was not detectable. CONCLUSIONS: Cataract extraction in patients with PEX glaucoma shows different specialities and risks. The AGE CML was detectable in human lens capsules. A direct correlation between clinical course and immunohistochemical reaction of the PEX fibrils could not be found. Overall, CML seems not to be a valuable predictive factor for the clinical course in patients with PXS and PXG.     

Evaluation of Pentacam-Scheimpflug imaging of anterior segment parameters in patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma

Background: The aim was to evaluate anterior segment parameters in patients with pseudoexfoliation syndrome (PXS) or pseudoexfoliative glaucoma (PXG) with the Pentacam‐Scheimpflug imaging system. Methods: Eighty eyes of 53 patients with PXS (Group 1), 80 eyes of 57 patients with PXG (Group 2) and 80 eyes of 45 control cases (Group 3) were included in the study. Anterior chamber depth, volume (ACV), angle (ACA) width, central corneal thickness (CCT), central 3.0, 5.0 and 7.0 mm corneal volumes and pupil diameters were compared between groups. Results: Although anterior chamber depths in the PXG group were significantly lower than the control group (p < 0.05), there was no statistically significant difference between the PXS group and the control group in means of anterior chamber depth values (p > 0.05). There were no statistically significant differences among PXS, PXG and the control group in mean values of ACV, ACA width, CCT, pupil diameters and central 3.0, 5.0 and 7.0 mm corneal volume (p > 0.05). Conclusions: The anterior chamber depths of PXG patients were lower than those of healthy individuals. Although the difference in anterior chamber depth between PXG patients and normal patients was statistically significant, this finding is unlikely to be of clinical significance. The anterior chamber depths of PXS patients were similar to those of healthy individuals. There were no significant differences in the means of ACV, ACA width, CCT, pupil diameter and corneal volume values on central 3.0, 5.0 and 7.0 mm among patients with PXS, PXG and healthy individuals.     

维吾尔族假性剥脱综合征患者角膜内皮形态学分析

目的：:对比分析维吾尔族假性剥脱综合征（PEX）、剥脱综合征性青光眼（PEXG）、原发性开角型青光眼（POAG）及年龄相关性白内障（ARC）角膜内皮形态学差异。方法：:回顾性病例对照研究。选取2019年7月至2020年8月在中国人民解放军新疆军区总医院全军眼科中心就诊治疗的维吾尔族PEX患者76例（76眼）,PEXG患...     

Cosmetic Upper Blepharoplasty

Abstract

Purpose: To investigate the frequency of Alzheimer-related dementia in patients with pseudoexfoliation syndrome (PEX). Methods: Sixty-seven patients with PEX and 67 age-, gender-, and educational-background-matched control subjects were compared for the presence of Alzheimer-related dementia according to DSM- IV-TR. The effects of cataract, glaucoma, additional ocular and systemic disease on the dementia incidence were also evaluated in patients with PEX and the control group. Results: The frequency of Alzheimer-related dementia was higher in patients with PEX (p?=?0.0001). The frequency of dementia in patients who had cataract was higher than in patients without cataract (p?=?0.003). There was also an association between additional ocular disease and dementia (p?<?0.05). However, there was no association between systemic disease and dementia (p?>?0.05). Furthermore, there was no difference for the frequency of dementia between patients who had glaucoma or not among patients with PEX (p?=?0.953). Conclusion: The increased frequency of Alzheimer-related dementia in patients with PEX is important and a possible association between PEX and Alzheimer’s disease could be present.     

Evaluation of the Choroid,Fovea, and Retinal Nerve Fiber Layer in Patients with Rheumatoid Arthritis

Purpose: To evaluate the effect of rheumatoid arthritis (RA) on choroid, retinal nerve fiber layer (RNFL), and foveal thickness using spectral domain optical coherence tomography (OCT).

Methods: Fifty patients with RA and forty-one healthy volunteers were enrolled in this study. The subfoveal, perifoveal choroidal, RNFL, and foveal thicknesses were measured by spectral domain OCT.

Results: The mean subfoveal, nasal, and temporal choroidal thicknesses in RA individuals were significantly higher than those in the control group (p ? 0.05). However, there was no significant difference between the RA and healthy group regarding RNFL and foveal thickness (p ? 0.05). A significant correlation was found between rheumatoid factor (RF) and the subfoveal temporal choroidal thickness.

Conclusion: Choroidal thickness in RA patients was higher than that in healthy participants. Choroidal thickening showed a positive correlation with RF, which may be an indicator for systemic vasculitis.     

Does the Stage of Keratoconus Affect Optical Coherence Tomography Measurements?

Purpose: To employ optical coherence tomography (OCT) to examine the relationship of changes in the retinal nerve fiber layer (RNFL) and macular thickness as well as ganglion cell (GC) parameters with the stage of keratoconus (KC), and to compare these changes with a control group. Methods: A total of 84 eyes of 68 patients with KC and 29 eyes of 29 normal age-matched subjects underwent RNFL, macular thickness measurements, and ganglion cell analysis using Cirrus high-definition (HD) OCT. Patients with KC were classified according to the Amsler–Krumeich Classification. The measurements were analyzed in all quadrants for each KC stage and compared with control subjects. Results: All RNFL, macular thickness, and ganglion cell parameters varied significantly among the groups (all p<0.001, analysis of variance). An increase in the stage of KC was correlated with decreased RNFL thickness, macular thickness, and ganglion cell parameters. Conclusions: RNFL, macular thicknesses, and ganglion cell parameters in all KC stages were lower than those in the control group. The RNFL, macular thickness, and ganglion cell parameters of the Grade 1 KC group were most similar to those of the control group. The severity of irregular astigmatism at the same stages of KC had a significant effect on OCT measurements. It may therefore be beneficial to know the amount of change/deviation in OCT measurements in keratoconus patients and to report which parameters exceed the standards so that OCT can be used to correlate the stage of keratoconus with the extent of the ocular disorder.     

Refractive Outcomes of Uneventful Cataract Surgery in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

PurposeTo compare the refractive outcomes after cataract surgery between patients with and without pseudoexfoliation, and to evaluate the risk factors of refractive error.MethodsRetrospective review of 210 eyes with pseudoexfoliation (study group) and 510 normal eyes (control group) that underwent uneventful phacoemulsification with intraocular lens implantation. The study group included pseudoexfoliation syndrome and pseudoexfoliation glaucoma (PXG) subgroups. The main outcome measure was refractive error, defined as the difference between the target refraction and postoperative refraction in diopter (D). A refractive error >±1.0 D was identified as a large-magnitude refractive error. The frequency of the large-magnitude refractive error was compared between study and control groups, and also between each subgroup and normal eyes. The factors influencing refractive error were analyzed by logistic regression.ResultsThere was a significantly higher frequency of a refractive error >± 1.0 D and hyperopic error >1.0 D in the study group than in the control group (p = 0.001 and p = 0.003, respectively). In the multivariate logistic regression analysis, PXG and poor preoperative visual acuity were related with a large-magnitude refractive error (p = 0.001 and p = 0.02, respectively) Refractive error >± 1.0 D and hyperopic error >1.0 D were noted more often in PXG eyes that had an intraocular pressure spike >25 mmHg at postoperative first 24 hours (p = 0.01 and p=0.03, respectively).ConclusionsThe eyes with pseudoexfoliation were at a high risk for refractive error, especially in the presence of glaucoma. In PXG, the only significant risk factor for refractive error was observed to be the presence of an intraocular pressure spike.     

EDI-OCT评估妊娠高血压疾病眼底病变中视网膜和脉络膜厚度的改变

目的：采用光学相干断层扫描增强深部成像(enhanced depth imaging optical coherence tomography,EDI-OCT)技术观察和比较不同程度妊娠高血压疾病(pregnancy-induced hypertension syndrome,PIH)眼底病变患者黄斑区视网膜和脉络膜厚度的变化。

方法：对确诊为PIH的孕产妇150例289眼进行散瞳眼底检查和黄斑EDI-OCT检查,并根据Duke-Elder分期标准对患者进行分组P1(血管痉挛期组)、P2(血管硬化期组)、P3(视网膜病变期组),以眼底正常患者作为对照组P0(眼底正常组),分别对每组患者的黄斑区各象限视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度、中心凹处视网膜厚度和脉络膜厚度分别进行测量。

结果：本研究150例289眼妊娠高血压疾病患者中,眼底正常者36例72眼(24.9%),有眼底病变者114例217眼(75.1%)。不同程度眼底病变的PIH患者视网膜和脉络膜厚度有不同改变。血管硬化期组黄斑中央区(central subfield,CSF)、中心凹视网膜厚度和脉络膜厚度均低于眼底正常组,差异有统计学意义(P<0.05)。视网膜病变期组黄斑区各象限神经纤维层(retinal nerve fiber layer,RNFL)厚度、中心凹视网膜厚度和脉络膜厚度均显著高于其他三组,差异有统计学意义(P<0.05)。

结论：EDI-OCT是研究PIH相关眼底病变的重要工具之一,借助EDI-OCT观察和分析PIH眼底病变患者黄斑区视网膜和脉络膜厚度的改变,对深入研究 PIH所引起的视网膜和脉络膜局部微循环的病理性改变具有重要意义。     

Cirrus HD OCT检测近视眼视网膜神经纤维层厚度的研究

目的：应用Cirrus HD OCT检测近视眼视网膜神纤维层厚度,探讨近视眼神经纤维层厚度分布特点及其与屈光度的关系。 方法：将近视眼106例196眼分为低、中、高度近视组和正常对照组38例60眼,应用Cirrus HD OCT进行以视盘为中心,直径3.46 mm圆周的RNFL厚度测量,计算各组平均、各象限及各钟点RNFL厚度,各近视组分别与正常对照组对比,研究近视眼RNFL厚度与屈光度的关系。 结果：各近视组平均、上方象限及下方象限RNFL厚度较正常对照组变薄,其中中度、高度近视与正常对照组相比有统计学差异（ P〈0.05）,鼻侧象限RNFL厚度变薄,无统计学显著性差异（ P〉0.05）,颞侧象限RNFL厚度增加,有统计学差异（ P〈0.05）;各近视组2：00,6：00,12：00位RNFL厚度较正常对照组变薄,有统计学差异（ P〈0.05）,8：00,9：00,10：00位RNFL厚度较正常对照组增加,有统计学差异（ P〈0.05）,中、高度近视1：00,5：00位厚度较正常对照组变薄,有统计学差异（P〈0.05）。 结论：近视眼平均、上方及下方象限、2：00,6：00,12：00位RNFL厚度较正常对照组变薄,颞侧象限、8：00,9：00,10：00位RNFL厚度较正常对照组相比明显增加,这是近视眼RNFL厚度的特点,当临床出现RNFL厚度异常时,应考虑屈光度的影响,综合评价其临床意义;近视眼7：00,8：00,10：00,11：00位RNFL厚度与正常对照组相比均未变薄,出现异常变薄时,应考虑青光眼可能。