Increased aquaporin-1 levels in lens epithelial cells with primary angle-closure glaucoma

AIM: To determine the levels of aquaporin-1 (AQP-1) in the lens epithelial cells (LECs) of primary glaucoma and to clarify its correlation with lens thickness. METHODS: This study comprised 64 eyes of 64 patients with primary glaucoma, who were divided into 3 groups: 25 eyes of 25 patients with acute primary angle-closure glaucoma (APACG), 19 eyes of 19 patients with chronic primary angle-closure glaucoma (CPACG) and 20 eyes of 20 patients with primary open angle glaucoma (POAG). This study also included 12 eyes of 12 patients with senile cataract as controls. The levels of AQP-1 in LECs were examined by real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry. The lens thickness was measured by A-scan ultrasonography. RESULTS: The AQP-1 mRNA levels of LECs were 0.84±0.27, 0.69±0.34, 0.44±0.19 and 0.51±0.21 in APACG, CPACG, POAG and senile cataract group, respectively. The levels of AQP-1m RNA were significantly higher in PACG groups compared with those in senile cataract and POAG group (all P<0.05). The immunohistochemistry showed the AQP-1 expression were strong-positive in PACG groups, but weak-positive in senile cataract and POAG group. A positive correlation was found between AQP-1 mRNA levels and the lens thickness (r=0.645, P<0.001). CONCLUSION: These findings show that the higher expression of AQP-1 in LECs may contribute to increased lens thickness, which might be associated with the occurrence and development of PACG.     

彩色多普勒超声对青光眼眼血流动力学变化的研究

目的：研究青光眼患者眼部血流动力学改变及手术前手的对比。方法：采用多普勒超声检查仪测定48例（78眼）原发性闭角型青光眼（primary close-angle alaucoma,PCAG),6例（12眼）原发性开角型青光眼（primary open-angle glaucoma,POAG),9例（18眼）单侧发病青光眼和26例（52眼）正常对照组的眼动脉（Ophthalmic artery,OA)、视网膜中央动脉（central retinal artery,CRA)的血流动力学参数,同时对11例（19眼）原发性青光眼进行手术前后血流参数的检测对比。结果：PCAG、POAG组、单侧发病青光眼的双眼均较正常对照组OA、CRA显示了明显的舒张末期血流速度（end diastolic velocity,EDV) 降低（P＜0．05）,阻力指数（resistive index,RI)增高（P＜0．05）,手术后OA、CRA的EDV较术前明显增加,RI下降（P＜0．01）。结论：局部血液循环障碍,导致视神经血供不足,对青光眼视神经损害有着重要的影响;手术可降低血管阻力,增加眼局部血液供应,改善并保护青光眼患者的视功能。     

Factors that influence intraocular pressure after cataract surgery in primary glaucoma

Objective: We sought to find predictive factors for favourable postoperative intraocular pressure (IOP) after cataract surgery in patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG).Study Design: Retrospective evaluation of patients who had undergone cataract surgery.Participants: Forty-eight patients with POAG and 48 patients with PACG.Methods: Various clinical factors were evaluated retrospectively in 96 patients. All patients had undergone standard 2.75-3.5 mm limbal incision cataract surgery. Clinical parameters in patients with successful postoperative IOP courses were compared with those in unsuccessful patients. Success was defined as an IOP between 6 and 21 mm Hg, with fewer antiglaucoma medications needed compared with before surgery, and no need of additional glaucoma surgery.Results: In POAG, eyes with a highest preoperative IOP of <31 mm Hg or those being treated with <3 antiglaucoma medications before surgery had a significantly higher probability of success. In PACG, the probability of success was significantly higher if the highest preoperative IOP was <42 mm Hg, the number of antiglaucoma medications before surgery was <3, or the areas of peripheral anterior synechiae were <4 clock hours.Conclusions: Primary small-incision cataract surgery using phacoemulsification and foldable intraocular lens implantation may be the procedure of choice in patients with medically controlled glaucoma and coexisting visually significant cataracts, considering the highest preoperative IOP and number of antiglaucoma medications in POAG and PACG, and the area of peripheral anterior synechiae in PACG.     

Smith-method assessment of anterior chamber depth for screening for narrow anterior chamber angles

PURPOSE: To compare the axial anterior chamber depth (ACD) using the Smith method, in patients under treatment for primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG), with an age-matched control group. MATERIALS AND METHODS: Triplicate just-touching-slit-length (JTSL) measurements of the axial anterior chamber depth were determined in 198 eyes of 99 patients (39 control; 36 POAG; and 24 PACG) recruited from King Saud University clinics, Riyadh, Saudi Arabia. Goldmann tonometry and gonioscopy were carried out as a part of the patient's routine examination. Subjects with a history of intraocular surgery for glaucoma or any other anterior segment disease were excluded form the study. The average ACD estimate by the JTSL method were compared among the various groups. RESULTS: The average JTSL estimates were: Control group 2.33+/-0.68 mm (axial ACD estimate = JTSL estimate x 1.4); POAG group 1.98+/-0.97 mm; PACG group 0.65+/-0.41 mm. There was no significant reduction (P = 0.068) of the JTSL estimate in the POAG group, compared to the control group. There was a statistically significant (P < 0.001) reduction of the JTSL estimate in the PACG group, compared to both the control and POAG groups. CONCLUSION: The Smith-method JTSL technique may be used for non-invasive rapid screening, to help identify patients at risk of developing angle-closure, during routine examination of patients in the ophthalmology clinic.     

Primary lens extraction for glaucoma management: A review article

Recently, primary lens extraction alone gained more acceptance as an alternative surgical approach for glaucoma management. This view was supported by the advances in phacoemulsification and intraocular lenses with greater safety and visual recovery, in addition to a substantial reduction of intraocular pressure and deepening of the anterior chamber and filtration angle. The decrease in IOP after cataract surgery in primary open-angle glaucoma (POAG) is mild, less predictable, related to baseline levels, and may return to presurgical values after an initial period of reduction. Therefore, the IOP-lowering effect of primary cataract extraction in POAG may be insufficient to achieve adequate IOP control. The IOP reduction after lens extraction is consistently greater in eyes with primary angle closure glaucoma (PACG) than in eyes with POAG. Primary lens extraction in acute PACG eliminates, or at least, reduces the risk of recurrence of acute attacks and deepens the anterior chamber and widens the angle which reduces the risk of progression of peripheral anterior synechiae and development of chronic PACG. Primary lens extraction may be more preferable to glaucoma incisional surgery in mild to moderate PACG eyes with appositional angle closure. The decision to do lens extraction as a primary treatment for glaucoma should be individualized based upon several factors other than the effect on IOP. These factors include patients’ characteristics, surgeons’ skills and preferences, status of glaucoma control, type of cataract and intraocular lens implanted, and potential harm of laser treatment for late capsular opacification and fibrosis.     

Prevalence of glaucoma in a South brazilian population: Projeto Glaucoma

PURPOSE: To assess the prevalence of glaucoma in a South Brazilian population. METHODS: Subjects older than 40 years underwent a screening examination that included a medical interview, slit lamp examination, tonometry, and fundoscopy. Those with suspected glaucoma (based on optic disc appearance and/or intraocular pressure) underwent a comprehensive ophthalmic evaluation during the definitive examination. Glaucoma was diagnosed based on the International Society of Geographical and Epidemiologic Ophthalmology classification. RESULTS: A total of 1636 subjects were examined (76.5% participation rate); 71% of the study population self-reported their race as white and 24% as nonwhite (most black and mixed-black/white). Glaucoma was found in 56 subjects (crude prevalence of all glaucoma: 3.4%; 95% CI, 2.5-4.3), primary open-angle glaucoma (POAG) was found in 40 (2.4%; 95% CI, 1.7-3.2), and primary angle-closure glaucoma (PACG) in 12 (0.7%; 95% CI, 0.3-1.1). Six (12%) subjects with primary glaucoma had a previous diagnosis of the disease. Nonwhite persons had a higher prevalence rate of POAG than did white participants, although this difference was not significant (3.8% vs. 2.1%, respectively, P = 0.11). Unilateral blindness due to primary glaucoma was observed in seven subjects (five POAG/2 PACG), and nonwhites had a higher rate of unilateral blindness than did whites (five versus two cases, respectively, P = 0.014). CONCLUSIONS: Compared to incidence in Hispanic and European populations, PACG was more common among South Brazilians, whereas the POAG rates were similar. The rate of undiagnosed glaucoma was almost 90%. The higher POAG prevalence in the population self-reported as nonwhite may affect the estimation of glaucoma in Brazil, as more than 40% of the population self-report their race as nonwhite.     

白内障超声乳化人工晶状体植入术对早期原发性青光眼眼压控制效果分析

目的 观察早期原发性青光眼行超声乳化联合人工晶状体植入术后眼内压(IOP)控制情况,分析与术后IOP控制效果相关的影响因素.方法 回顾性选择原发性闭角型青光眼(PACG)43例(43只眼)和原发性开角型青光眼(POAG)早期患者32例(32只眼),均行标准3.2mm透明角膜切口白内障超声乳化联合折叠人工晶状体植入术,术后2年定期随访.手术成功标准为:术后IOP保持在6～21mmHg,青光眼神经病变及相应视野缺损无明显进展,无需再行抗青光眼手术治疗.结果 白内障超声乳化联合人工晶状体植入术后,PACG组有28例(65.1%)、POAG组有12例(37.5%)术后IOP控制良好,2年累计生存率之间存在差异(P＜0.05).PACG组成功与失败病例在术前IOP(33.0±5.3)mmHg vs(40.1±3.6)mmHg,P＜0.01、抗青光眼药物数量(2.9±0.9vs4.1±0.4,P＜0.01)、房角粘连范围(2.9±0.5)钟点vs(4.2±0.8)钟点,P＜0.01)之间的差异具有统计学意义,而POAG组成功与失败病例在术前IOP(25.3±3.4)mmHgvs(35.4±3.6)mmHg,P＜0.01、抗青光眼药物数量(1.2±0.4vs2.8±0.9,P＜0.01)之间的差异具有统计学意义.Cox逐步回归分析发现,在PACG组中术前IOP(P＜0.05,RR=1.17)、PAS(P＜0.01,RR=3.971),在POAG组中术前IOP(P＜0.01,RR=1.284),与相应两组术后生存时间具有相关性.结论 在术前PACG患者考虑到IOP和房角粘连范围、POAG患者考虑到IOP的条件下,超声乳化联合人工晶状体植入术对于伴有白内障的早期原发性青光眼,是一种可供选择的有效的控制眼内压的治疗方法.

Abstract：

Objective To assess and find associated factors for favorable postoperative intraocular pressure (IOP) after cataract phacoemulsification with intraocular lens implantation in patients with primary glaucoma on early stage.Methods Forty-five patients (43 eyes) with primary angle closure glaucoma (PACG) and 32 patients with primary open angle glaucoma (POAG) were retrospectively selected.All patients had undergone standard 3.2mm limbal incision phacoemulsification,and 2 years of routine follow-up after cataract surgery.Success was defined as an IOP between 6-21mmHg,with fewer antiglaucoma medications needed than those during pre-operation,no obvious progressions of glaucomatous neuropathy and its coincident visual field loss,and no need of additional glaucoma surgery.Results After phacoemulsification with intraocular lens implantation,there were 28 cases (65.1%) in PACG group and 12 cases (37.5%) in POAG group with well controlled postoperative IOP,and the different of 2-year survival rate was statistically significant (P ＜0.05).There were significant different in the pre-IOP (33.0± 5.3mmHg vs 40.1 ± 3.6mmHg,P ＜0.01),the number ofantiglaucoma medications (2.9± 0.9 vs 4.1± 0.4,P＜0.01) and the extent of peripheral anterior synechiae (PAS) (2.9±0.5 clock hours vs 4.2± 0.8 clock hours,P ＜0.01) between success and failure cases in PACG group.The pre-IOP (25.3±3.4 mmHg vs 35.4±3.6 mmHg,P＜0.01),the number of antiglaucoma medications (1.2± 0.4 vs 2.8± 0.9,P ＜0.01) were significant different between the success and failure cases in POAG group.Cox stepwise regression analysis found that pre-IOP (P ＜0.05,RR=1.17) and the extent of PAS (P ＜0.01,RR=3.971) in PACG group and the pre-IOP (P＜0.01,RR=1.284) in the POAG group was significant associated with the corresponding survival time after cataract surgery.Conclusions Phacoemulsification with intraocular lens implantation may be an alternative procedure for effective IOP control of the patients with primary glaucoma on early stage coexisting with cataract on considering pre-IOP and the extent of PAS in PACG and pre-IOP in POAG.     

Differences in the histopathology and matrix metalloproteinase expression in Tenon's tissue of primary open-angle glaucoma and primary angle-closure glaucoma

PURPOSE: To investigate the differences in the histopathology and matrix metalloproteinase (MMP) expression in the Tenon's tissue of primary open-angle glaucoma (POAG) patients, primary angle-closure glaucoma (PACG) patients, and non-glaucomatous patients. METHODS: POAG and PACG patients, who underwent a trabeculectomy and had no history of ocular disease except glaucoma, were enrolled. The number and instillation period of topical eye drops were reviewed. For the controls, which were patients without glaucoma or a history of ocular surgery, the Tenon's tissue was obtained in the course of retinal detachment surgery. For glaucoma patients, the Tenon's tissue was obtained during the trabeculectomy. H&E and Masson's trichrome staining and immunohistochemistry for MMP-1, MMP-2, and MMP-9 were performed. A total of six eyes of POAG, six eyes of PACG, and four control eyes were evaluated. RESULTS: The duration of topical anti-glaucoma medication and the mean number of anti-glaucoma medications were similar in the POAG and PACG groups. The levels of MMP-1 and 2 were elevated in the POAG and PACG groups compared to the control group (p=0.03, 0.01, respectively). Compared with the control group, the MMP-2 level was higher in the POAG patients (p=0.01), whereas the MMP-1 was higher in the PACG patients (p=0.04). The levels of MMP-9 in the POAG and PACG patients were not significantly different from that of the control patients (p=0.48, 0.26). The levels of MMP-2 were significantly lower in the PACG patients than in the POAG patients (p=0.02). CONCLUSIONS: The MMP expression was altered in the Tenon's tissue of glaucoma patients compared to the control group. The levels of MMP-2 were lower in the PACG patients than in the POAG patients. These results suggest that there may be histopathological differences in the Tenon's tissue of POAG and PACG patients.     

重视原发性青光眼的早期诊断和干预

原发性青光眼是严重的不可逆转的致盲性眼病之一,早期诊断和干预是防止青光眼患者视功能严重丧失的关键措施。近年来,原发性青光眼的基础和临床研究均取得了重要进展,如对原发性闭角型青光眼（PACG）分类的认识,对PACG发病危险因素的认识,对PACG的处理,对原发性开角型青光眼（POAG）视乳头改变的认识,处理原发性青光眼中目标眼压概念的提出等,均有利于原发性青光眼的早期诊断和干预。加强对眼科医师青光眼早期诊断和干预的继续教育,向公众普及青光眼的防治知识,通过公共卫生的途径早期筛查原发性青光眼等措施,将使大量的原发性青光眼患者得到早期诊断和干预,从而降低青光眼的致盲率。     

Optic disc morphology in primary open-angle glaucoma versus primary angle-closure glaucoma in South India

Purpose:The aim of this study was to investigate the optic disc morphology in primary angle-closure glaucoma (PACG) versus primary open-angle glaucoma (POAG) in South Indians.Methods:A total of 60 patients (60 eyes) with PACG and 52 patients (52 eyes) with POAG were included in a cross-sectional observational study. The glaucoma diagnosis was based on a glaucomatous appearance of the optic disc correlating with visual field defects. The glaucoma was graded as early, moderate, or severe, depending upon perimetric loss. All patients underwent an ophthalmic evaluation, including visual field examination and planimetric analysis of 30° stereoscopic color optic disc photographs.Results:The POAG and PACG groups did not differ significantly in a disc or rim area, rim width, and frequencies of disc hemorrhages or rim notches. However, early POAG group (n = 15) had a significantly deeper cup depth (P = 0.01), larger beta zone (P = 0.01), and a higher frequency of localized retinal nerve fiber layer (RNFL) defects (P = 0.02) than early PACG (n = 20).Conclusion:In the early stage of the disease, POAG compared to PACG may be characterized by deeper disc cupping, a larger beta zone of peripapillary atrophy, and a higher frequency of localized RNFL defects. Such differences in early glaucoma may suggest differences in pathophysiology in POAG and PACG.     

Factors associated with undiagnosed open-angle glaucoma: the Thessaloniki Eye Study

PURPOSE: To identify factors associated with undiagnosed open-angle glaucoma (OAG), primary open-angle glaucoma (POAG), and pseudoexfoliative glaucoma (PEXG) in an elderly population in Thessaloniki, Greece. DESIGN: Cross-sectional population-based study. METHODS: Randomly selected subjects > or =60 years (n = 2,554) participated in the study. Subjects were classified as having POAG or PEXG according to specific criteria and using a two-scale definition of glaucoma. Undiagnosed glaucoma was defined as absence of either prior diagnosis of glaucoma or ocular hypertension or prior medical treatment for glaucoma or prior glaucoma surgery. Logistic regression analyses were performed with age, gender, family history of glaucoma, history of cataract surgery, visual acuity, vertical cup-to-disk (C/D) ratio, intraocular pressure, Advanced Glaucoma Intervention Study visual field score, time since last eye doctor visit, and type of OAG as covariates. RESULTS: The prevalence of undiagnosed glaucoma was 57.1% (56/98) for POAG, significantly higher than the prevalence of 34.9% (15/43) for PEXG (P = .017). POAG patients presented three to four times increased risk to be undiagnosed compared with PEXG patients (P = .02 and P = .04, respectively). Patients with OAG who had not visited an ophthalmologist during the last year had six times an increased risk to be undiagnosed (P = .003). In POAG, smaller vertical C/D ratio was statistically significantly associated with an increased risk to be undiagnosed (P = .008). CONCLUSIONS: Lack of regular visits to an ophthalmologist was a major factor for undiagnosed OAG. POAG was more likely to be undiagnosed than PEXG. Since C/D ratio was associated with undiagnosed POAG, standardized protocols involving thorough evaluation of the optic disk are recommended for ophthalmologists.     

Intraocular pressure and visual field loss in primary angle closure and primary open angle glaucomas

AIM: To compare the correlation between visual field loss and the pretreatment intraocular pressure (IOP) in primary angle closure glaucoma (PACG) and primary open angle glaucoma (POAG). METHODS: In a cross sectional observational study of 74 patients (43 PACG, 31 POAG), pretreatment IOP was measured at presentation, before treatment was initiated. The severity of visual field loss was assessed by AGIS score, mean deviation (MD), pattern standard deviation (PSD), and corrected pattern standard deviation (CPSD). Glaucomatous optic neuropathy was assessed from simultaneous stereo disc photographs. RESULTS: There was a stronger correlation between pretreatment IOP and the extent of visual field loss in PACG subjects than in those with POAG for both MD (PACG: Pearson correlation coefficient (r) = 0.43, p = 0.002; r(2) = 0.19), (POAG: r = 0.21, p = 0.13; r(2) = 0.04) and AGIS score (PACG: r = 0.41, p = 0.003; r(2) = 0.17), (POAG: r = 0.23, p = 0.19; r(2) = 0.05 respectively). No such associations were seen for pattern standard deviation (PSD) or corrected pattern standard deviation (CPSD) in either group (p> 0.29). Both horizontal and vertical cup-disc ratio were well correlated with severity of field loss but not with presenting IOP for either diagnosis. CONCLUSIONS: This is consistent with the hypothesis of a greater IOP dependence for optic nerve damage in PACG than POAG and, conversely, a greater importance of other, less pressure dependent mechanisms in POAG compared to PACG.     

Heidelberg Retinal Tomograph (HRT 2) parameters in primary open angle glaucoma and primary angle closure glaucoma: a comparative study in an Indian population

AIMS: To compare the Heidelberg Retinal Tomograph (HRT 2) parameters in patients with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in an Indian population. MATERIALS AND METHODS: Two groups of patients were recruited: group I comprised 78 eyes (78 patients) with POAG and group II 58 eyes (58 patients) with PACG. Based on visual field defects detected by automated perimetry, the groups were further classified into early, moderate, and severe glaucoma. All patients underwent a complete ophthalmic examination as well as an HRT 2 examination. The HRT parameters for the two groups were compared and the sensitivity and specificity of the parameters calculated. RESULTS: All HRT parameters were similar in both groups: 85.9% (95% CI: 78.2, 93.6) of POAG and 81% (95% CI: 72.3, 89.3) of PACG had a positive F. S. Mikeleberg (FSM) discriminant function. Considering outside normal limits and borderline as abnormal, the Moorefield regression analysis had 83.3% (95% CI: 75, 91.6) sensitivity in POAG and 75.9% (95% CI: 64.9, 86.9) in PACG. In early POAG, the FSM discriminant function had a sensitivity of 74.3% (95% CI: 59.8, 88.8) compared to 58.3% (95% CI: 38.9, 77.7) for early PACG. The cup shape measure (p = 0.018) and the Moorfield regression analysis (p = 0.011) had significantly higher sensitivity for early POAG than for early PACG: cup shape measure sensitivity 62.9% (95% CI 46.9, 78.9) for early POAG versus 33.3% (95% CI: 14.4, 52.2) for early PACG and Moorefield regression analysis 74.3% (95% CI: 59.8, 88.8) versus 45.8% (95% CI: 39.9, 65.7). CONCLUSIONS: HRT has moderate sensitivity in the detection of damage leading to glaucomatous field defects. The sensitivity of HRT for early PACG appears to be less than that for early POAG. This may indicate a difference in pathophysiology.     

Lack of association between interleukin-1 gene cluster polymorphisms and glaucoma in Chinese subjects

PURPOSE: A recent study identified single nucleotide polymorphisms (SNPs) within the IL-1 gene cluster at chromosomal locus 2q13 that were associated with reduced risk for primary open-angle glaucoma (POAG) in whites. The purpose of this study was to investigate the association between IL-1 SNPs and glaucoma in Chinese patients with either POAG or primary-angle closure glaucoma (PACG). METHODS: Patients with POAG with a mean IOP without treatment that was consistently <21 mm Hg on diurnal testing were classified as having normal-tension glaucoma (NTG) and those with higher IOP were classified as having high-tension glaucoma (HTG). Subjects with PACG had at least 180 degrees of angle closure on gonioscopy. Genotypes were determined by polymerase chain reaction and restriction digest enzymes at the following loci: IL1A (-889C/T), IL1B (+3953C/T), and IL1B (-511C/T). The association of individual SNPs with glaucoma was evaluated by using chi(2) testing. Haplotype analysis was performed with the PHASE program, with haplotype frequency estimated for combined cases and controls, assuming Hardy-Weinberg equilibrium (HWE) of haplotypes. RESULTS: Of the Chinese subjects studies, 194 had POAG (94 NTG and 100 HTG), 125 had PACG, and 79 were normal control subjects. There was no significant difference in IL-1 SNP or allele frequencies for in subjects with POAG or PACG compared with control subjects, or between NTG and HTG. None of the common haplotypes showed any significant difference between the HTG, NTG, PACG, and normal control subjects. CONCLUSIONS: This study did not find an association between IL-1 gene cluster polymorphisms and glaucoma in this sample of Chinese subjects.     

The LOXL1 gene variations are not associated with primary open-angle and primary angle-closure glaucomas

PURPOSE: Glaucoma is a complex disease involving multiple genetic factors. Recently, single nucleotide polymorphisms (SNPs) in the LOXL1 gene have been implicated in exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) but not in the primary glaucomas. This study was conducted to determine the possible involvement of these SNPs in cases of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). METHODS: The three associated SNPs of LOXL1 (rs1048661, rs3825942, and rs2165241) were screened in 208 unrelated and clinically well-characterized glaucoma cases comprising patients with POAG (n = 112) or PACG (n = 96) along with 105 ethnically matched normal control subjects from Indian populations. Subjects with exfoliative material on the lens and radial pigmentation in the periphery of the lens that could be earlier signs of XFS were excluded. These SNPs were screened by resequencing and further confirmed by PCR-based restriction digestions. Haplotypes were generated with the three SNPs in cases and control subjects, and linkage disequilibrium (LD) and haplotype analysis were performed with the Haploview software, which uses the EM (expectation-maximization) algorithm. RESULTS: The SNPs of LOXL1 did not exhibit any significant association with POAG or PACG, unlike previous studies from Icelandic, Swedish, U.S., and Australian populations with XFS/XFG. Haplotypes generated with these intragenic SNPs did not indicate any significant risk with POAG or PACG phenotypes. The risk haplotype G-G in XFS/XFG in other populations was present in 46% of the normal control subjects in the present cohort. CONCLUSIONS: The results from the present study do not indicate the involvement of the LOXL1 SNPs in POAG and PACG.     

Issues in the epidemiology and population-based screening of primary angle-closure glaucoma

Among Caucasians, it is well known that 75–95% of primary glaucoma is due to open-angle glaucoma (POAG), with angle-closure (PACG) comprising only a very small minority of cases. These figures are reversed among other groups such as Asians and Eskimos, where PACG makes up 80–90% of primary glaucoma. Among Eskimos, the prevalence of PACG has been reported as 2–8%, as compared to 0.1% among Caucasians. It appears that a population tendency toward shallow anterior chambers may explain the excess burden of PACG morbidity. Among Asians, the prevalence of PACG is intermediate between Caucasians and Eskimos. Existing biometrical data do not show a clear tendency toward shallower anterior chambers among Asians. PACG may be screened for on a population basis by means of various techniques that estimate axial or limbal anterior chamber depth, measure intraocular pressure, or evaluate the optic disc or visual fields. Demographic information and medical and family history will also be of great importance in screening for PACG in large populations. Groups at increased risk for the disease include women, individuals over 50, first-degree relatives of PACG probands, and hyperopes.     

青光眼住院患者的疾病构成及民族特点流行病学调查

目的:了解青光眼住院患者的病型构成、性别、年龄分布、族别(维吾尔族)及其变化特点,为青光眼的防治研究提供新的流行病学资料。方法:选取2005-01/2010-01在本院眼科住院的青光眼手术患者2953例,根据出院诊断分为包括急性型与慢性型闭角型青光眼(PACG),原发性开角型青光眼(POAG),先天性青光眼(CG)和继发性青光眼(SG)。统计住院患者的年龄、性别、民族分布,分析其内部构成及变化趋势。结果:PACG,POAG,CG,SG各占青光眼总数的54.6%,15.2%,2.3%,27.9%。PACG的构成比逐年(63.1%～54.1%)下降,POAG的构成比在2007-01/2008-01达高峰(21.0%),CG的构成比平稳,SG的构成比(23.9%～33.5%)逐年增高;维吾尔族患者在闭角型青光眼中所占百分比逐年增高(23.0%～35.3%),在开角型青光眼中所占百分比亦逐年增高(7.9%～26.7%),在CG中所占百分比波动较大,在SG中所占百分比平稳。<40岁的维吾尔族男性患者在闭角型、开角型青光眼中,所占百分比逐年增高,<40岁的维吾尔族女性患者开角型青光眼中,所占百分比逐年增高,在闭角型青光眼中,所占百分比有下降趋势;≥40岁的维吾尔族女性患者在闭角型青光眼中,所占百分比逐年增高。结论:闭角型青光眼仍然是我国青光眼的主要类型,SG的防治研究不容忽视,在新疆维吾尔族住院患者的青光眼构成比逐渐增加,≥40岁的维吾尔族女性人群应特别注意闭角型青光眼的筛查,但开角型青光眼的防治研究不能忽视,<40岁的维吾尔族男、女性群体均是开角型青光眼防治的重点。     

青光眼住院病人的构成比变化特点

目的:了解住院青光眼病人的内部构成比变化,为青光眼的防治研究提供新的流行病学资料。方法:青光眼病区1990年7月～1996年6月住院患者3156人,按出院诊断、性别及年龄分组,分析其内部构成及变化趋势,并与1977年7月～1982年7月的资料比较。结果:闭角型青光眼占青光眼总数的55.86％,40岁以上女性患者居多,原发性开角型青光眼和糖皮质激素诱发开角型青光眼的比重增大,分别为19.25％和4.35％,患病对象集中在年轻男性。结论:我国原发性开角型青光眼的患病率并不低,在作好闭角型青光眼防治工作的同时,必须加强原发性开角型青光眼和糖皮质激素诱发开角型青光眼的防治,重点对象为年轻的男性患者。眼科学报1997;13:96～99。     

我国东北地区原发性青光眼与转脂蛋白E基因多态性研究

目的研究我国东北地区原发性开角型青光眼（POAG）和原发性闭角型青光眼（PACG）患者与转脂蛋白E（APOE）基因之间的相关性。方法应用聚合酶链式反应扩增技术（PCR）和限制性片段长度多态性技术（RFLP）对36例POAG、69例PACG患者及57例对照者的APOE基因进行分型,分别计算各组APOE等位基因、基因型频率。结果POAG的ε3／ε4、PACG的ε2／ε4基因型频率（分别为41．7％、43．5％）明显高于对照组（分别为14．0％、21．1％,P〈0．05）;POAG和PACG组APOE的84等位基因频率（分别为37．5％、39．2％）明显高于对照组（17．5％,P〈0．05）,POAG组的82等位基因频率（8．3％）明显低于对照组（15．8％,P〈0．05）。结论APOE的84等位基因可能是原发性青光眼患者发病的危险因子,82等位基因对POAG的发生可能具有一定的保护作用.     

Normal tension glaucoma and Alzheimer disease: comorbidity?

Purpose: To investigate whether normal tension glaucoma (NTG) is associated with increased risk of developing dementia/Alzheimer disease (AD). Methods: A total of 69 patients with NTG were identified in the case note files in the Glaucoma Clinic, University Hospital of Copenhagen (Rigshospitalet), Denmark from 1980 to 2001. The rate of a subsequent diagnosis of dementia as recorded in nationwide health care registers from 1980 to 2005 was estimated and compared with the rate for the general population [standard mortality rate (SMR) = observed number of cases of dementia/expected number of cases of dementia]. Results: The 69 patients had a median age of 64 years (quartiles 57 and 73) at the time of the diagnosis, and the average follow‐up period was 12.7 years. The SMR_dementia was 0.20 (95% CI 0.01–1.11). No patient developed AD. Conclusion: Normal tension glaucoma was not associated with an increased risk of developing dementia/AD.