视屏终端工作者泪液中基质金属蛋白酶-9、组织金属蛋白酶抑制剂-1浓度与眼表检查相关性研究

目的 探讨视屏终端(VDT)工作者泪液当中基质金属蛋白酶-9(MMP-9)、组织金属蛋白酶抑制剂-1(TIMP-1)与眼表检查间潜在相关性.方法 前瞻性横断面研究VDT工作者45例(45只眼),进行眼表疾病指数问卷(OSDI)对眼部症状进行登记.依次行泪膜破裂时间(TBUT)、角膜荧光染色、基础泪液分泌试验(SchirmerI).采集受试者右眼泪液标本,应用双抗体夹心酶联免疫吸附法(ELISA)检测泪液眼中MMP-9、TIMP-1的浓度(ng/ml).结果 视屏终端工作者中干眼患病构成比为13.3％,VDT工作者泪液中MM-9浓度与VDT使用时间、角膜荧光染色分级正相关,与泪膜破裂时间负相关.TIMP-1与VDT使用时间、角膜荧光染色分级正相关.结论 测量泪液中MMP-9、TIMP-1浓度具有辅助诊断干眼和量化干眼程度的临床意义.     

Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications

Purpose

To evaluate changes in ocular surface and central corneal sub-basal nerve fiber layer (SBNFL) after topical cyclosporin therapy in chronic glaucoma patients on long-term topical antiglaucoma therapy.

Methods

A prospective comparative study of ocular surface evaluation of chronic glaucoma patients on long-term topical therapy treated concurrently with a topical cyclosporine 0.05% twice daily for 6 months and controls was done. The study parameters evaluated at recruitment and at the 6-month follow-up included details of topical antiglaucoma medications, visual acuity, intraocular pressure, ocular surface evaluation parameters (TBUT, Schirmers I, ocular surface staining scores and ocular surface disease (OSD) index score (OSDI)), central corneal sensation (Cochet Bonnett aesthesiometer), and central confocal microscopy to study the SBNFL density (SBNFLD).

Results

Thirty-two eyes of 16 patients with chronic glaucoma and 30 eyes of 15 normal subjects as controls were studied. Mean TBUT, pre/post CsA treatment was 8.67±3.01/12.24±1.83 s (P=0.007). Mean conjunctival/corneal staining scores pre/post CsA treatment were 3.38±1.93/1.50±0.718 (P=0.00) /5.19±1.82/1.81±0.78 (P=0.098), respectively. Mean OSDI pre/post CsA treatment scores were 30.63±14.61/14.76±6.06 (P=0.007). Mean corneal sensations scores pre/post CsA treatment were 4.64±0.46/4.94±0.39 (P=0.002). Central corneal SBNFLD pre and post CsA treatment was 8811.35±2985.29/10335.13±4092.064 μm/mm² (P=0.0001).

Conclusions

Schirmer''s test, ocular surface staining scores, OSDI, corneal sensations, and corneal SBNFLD showed a statistically significant improvement following a 6-month concurrent topical CsA therapy.     

Incidence and prevalence of glaucoma in severe ocular surface disease

PURPOSE: To describe the incidence and prevalence of glaucoma in a patient population with severe ocular surface disease (OSD). METHODS: A retrospective case series was compiled from all charts of patients in the Cincinnati Eye Institute/University of Cincinnati and University of Minnesota population with a diagnosis of severe OSD from 1991 to 2003. The incidence and prevalence of glaucoma in the overall patient population were identified, and stratified into disease subgroups. RESULTS: Of the 108 eyes evaluated in this study, 71 were diagnosed with glaucoma. The overall prevalence of glaucoma in patients with severe OSD is 65.7%, with a range from 42.9% to 88.4%. Analysis by subgroup shows the highest percentage of patients with concurrent glaucoma fall into the categories of aniridia and chemical injury, and the lowest was noted in those patients with autoimmune or iatrogenic OSD. Overall, the incidence of glaucoma was 20.4%, with a range of 13.6% to 60%. CONCLUSIONS: Compared with previous studies, our results show a significantly higher prevalence of glaucoma in patients with severe OSD. This information warrants increased attention to treatment and management of OSD and concurrent glaucoma.     

针灸联合人工泪液治疗对干眼症患者眼表功能的影响分析

目的 探讨针灸治疗对干眼症患者眼表功能的影响.方法 回顾性分析2010年1月至2013年12月于我院就诊的干眼症患者84例(168眼)临床资料,其中采用针灸联合人工泪液治疗者42例(观察组),采用单纯人工泪液治疗者42例(对照组).两组均随访1～6个月,平均3个月,观察两组治疗前后眼表功能变化,相关指标包括泪膜破裂时间(break-up time,BUT)、Schirmer Ⅰ试验(Schirmer Ⅰ test,SIT)、角膜荧光素染色(fluorescein,FL)、视功能评分等,对结果进行统计比较.结果 与治疗前比较,观察组治疗后BUT、视功能评分显著延长或增高,差异均有统计学意义(均为P＜0.05),而对照组差异均无统计学意义(均为P＞0.05);治疗后观察组BUT、视功能评分均显著高于对照组,差异均有统计学意义(均为P＜0.05).与治疗前比较,2组治疗后SIT值均显著延长,差异均有统计学意义(均为P＜0.05);2组治疗后SIT值比较,虽然观察组高于对照组,但差异无统计学意义(P＞0.05).与治疗前比较,2组治疗后FL评分显著降低,差异均有统计学意义(均为P＜0.05);治疗后2组FL评分比较,差异无统计学意义(P＞0.05).结论 针灸联合人工泪液是治疗干眼症的一种有效方法,能显著改善干眼症患者的泪膜稳定性,增加泪液分泌,减少眼表损害.     

Intraocular pressure control with Ahmed glaucoma drainage device in patients with cicatricial ocular surface disease-associated or aniridia-related glaucoma

To analyze the control of intraocular pressure (IOP) with an Ahmed glaucoma drainage device (AGDD) in two groups of glaucoma patients—one with cicatricial ocular surface disease (COSD) and one with aniridia. This is a retrospective comparative case series of nine patients (11 eyes) with COSD and six patients (8 eyes) with aniridia who underwent AGDD surgery to control IOP. The main outcome measure in both groups was stability of IOP between 6 and 21 mmHg. Mean IOP decreased significantly in both groups after AGDD surgery (29.6 ± 8.7 vs 14.7 ± 2.5, p = 0.008 in the COSD group; 26.3 ± 8.2 vs 15.3 ± 5.8, p = 0.008 in the aniridia group). Over a mean post-surgery follow-up of 37.1 months in the COSD group, we managed to control IOP in nine eyes; IOP control was successful in 87 % of eyes at 12 months and 58 % of eyes at 26 months. Over a mean post-surgery follow-up of 37.4 months in the aniridia group, we managed to control the IOP in seven eyes; IOP control was successful in 87 % of eyes at 12 months. AGDD surgery had no significant deleterious effect on visual acuity in either group. A severe complication occurred in one eye (1/8) in the aniridia group (lost vision due to retinal detachment) and in one eye (1/11) in the COSD group (tube exposure). AGDD surgery is effective in controlling IOP and has a low complication rate in COSD and aniridia patients; however, some of the complications are severe and prompt management is needed to prevent deleterious results.     

Evaluation of ocular surface temperature and retrobulbar haemodynamics by infrared thermography and colour Doppler imaging in patients with glaucoma

BACKGROUND: Ocular surface temperature (OST) could berelated to retrobulbar haemodynamics in patients with glaucoma. AIMS: To compare OST measurements in patients with glaucoma and healthy controls, and to investigate the correlation between OST, intraocular pressure (IOP) and retrobulbar haemodynamics in patients with glaucoma. METHODS: 32 patients with primary open-angle glaucoma (POAG) and 40 controls were included in the study. The parameters considered both in patients with POAG and in controls were IOP and OST values measured by infrared ocular thermography. Colour Doppler imaging was used to determine haemodynamic parameters in ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCAs) in patients with POAG. RESULTS: OST values were significantly lower in patients with POAG than in controls (p<0.001). OST was negatively related with resistivity index of OA (p<0.001), CRA (p = 0.001) and SPCAs (p<0.001), and positively related with end-diastolic velocity of OA (p = 0.02) and SPCAs (p = 0.05). CONCLUSION: This study suggested that OST could be a marker of impaired retrobulbar haemodynamics in patients with glaucoma.     

术前应用人工泪液对白内障合并干眼患者术后眼表的影响

目的:探究在白内障超声乳化联合人工晶状体植入术前,应用人工泪液对白内障合并干眼症患者术后泪膜功能及干眼的影响。方法:纳入2018-06/2019-06在我院接受超声乳化联合人工晶状体植入术前合并干眼症的白内障患者107例107眼。随机分为对照组:术前未使用人工泪液;研究组:术前1wk使用0.1%玻璃酸钠人工泪液滴眼液。观察并分析两组患者术前、术后7、30d的临床症状评分、泪膜破裂时间检查(BUT)、基础泪液分泌试验(SⅠt)以及角膜荧光染色评分(FL)情况。结果:两组术前OSDI评分(28.59±8.10 vs 29.08±9.18分)、BUT(5.15±0.47 vs 5.02±0.53s)、SⅠt(6.86±0.98 vs 6.71±1.02mm/5min)、FL评分(3.96±0.89 vs 3.76±0.83分)均无差异(P>0.05)。术后7、30d,研究组OSDI评分(42.12±10.54、48.71±9.74分)和FL评分(5.10±1.12、4.55±1.04分)显著低于对照组,研究组BUT(3.29±0.54、3.56±0.45s)与SⅠt(5.62±0.91、5.21±0.73mm/5min)均显著高于对照组(P<0.05)。结论:超声乳化联合人工晶状体植入术前应用人工泪液可明显改善术后早期干眼症状,恢复泪膜功能,防止术后干眼症加重。     

异基因造血干细胞移植患者泪液中IL-36的表达情况及其与眼表微环境的相关性分析

目的:通过检测异基因造血干细胞移植(allo-HSCT)患者泪液中IL-36(α、β、γ)的表达情况,研究其与眼表微环境的相关性,并进一步分析其表达与眼部移植物抗宿主病(oGVHD)的关系。方法:前瞻性研究。选取2020-01就诊于我院血液科,行allo-HSCT患者35例70眼,另选取年龄、性别相匹配的健康志愿者35例70眼做为正常对照组。allo-HSCT组受检者术后随访3次,每3mo 1次,对术后是否出现眼部症状的受检者分为oGVHD组和非oGVHD(Non-oGVHD)组。对受试者进行眼表疾病指数(OSDI)问卷调查、泪液分泌试验(Schirmer试验)、泪膜破裂时间(TBUT)、角膜荧光素钠染色(FL)、结膜印迹细胞学染色(CIC)评估眼表状况,并用ELISA检测受检者泪液中IL-36(α、β、γ)表达水平。结果:正常对照组中,IL-36(α、β、γ)表达水平分别为74.32±5.27、70.02±8.43、97.41±8.66pg/mL;allo-HSCT组中,IL-36(α、β、γ)基线表达水平分别为77.27±7.03、74.53±7.53、100.77±9.74pg/...     

Retraction Note to: Assessment of ocular surface disease in glaucoma patients with benzalkonium chloride-preserved latanoprost eye drops: a short-term longitudinal study

Graefe's Archive for Clinical and Experimental Ophthalmology -     

Long term treatment with sodium hyaluronate-containing artificial tears reduces ocular surface damage in patients with dry eye

BACKGROUND/AIMS: Several studies have reported that sodium hyaluronate is able to improve both symptoms and signs in patients with dry eye but none have demonstrated an improvement of conjunctival epithelial cell abnormalities of the ocular surface. The aim of this study was to explore the effect of sodium hyaluronate-containing eye drops on the ocular surface of patients with dry eye during long term treatment. METHODS: A randomised double blind study was undertaken in 86 patients with medium to severe dry eye (that is, rose bengal and/or fluorescein test score of at least 3, tear film break up time <10 seconds, or Schirmer's test <5.5 mm). Patients were treated with either preservative-free sodium hyaluronate or saline for 3 months at a dose of one drop 4-8 times a day. Bulbar impression cytology, slit lamp examinations, and subjective symptoms were evaluated after 1, 2, and 3 months. Impression cytology was considered the primary efficacy parameter of the study. RESULTS: The efficacy analysis was performed on a total of 44 patients who were able to fully adhere to the protocol. After 3 months of treatment sodium hyaluronate improved impression cytology score (p = 0.024 v baseline). At the same time also the difference with respect to placebo was statistically significant (p = 0.036). Study medication was well tolerated and no treatment related adverse events occurred during the study. CONCLUSIONS: Sodium hyaluronate may effectively improve ocular surface damage associated with dry eye syndrome.