Efficacy of Combined Administration of 0.2% Brimonidine and 0.5% Betaxolol in Treatment of Primary Open Angle Glaucoma and Ocular Hypertension

Purpose： To observe the efficacy of combined use of bri- monidine and betaxolol in treatment of primary open angle glaucoma （POAG） and ocular hypertension. Methods- A total of 54 patients （90 eyes） with POAG and ocular hypertension were randomly divided into three groups （receiving betaxolol, brimonidine and combined administra- tion of betaxolol and brimonidine respectively）. The adminis- tration was given twice daily in all groups （0.5% betaxolol, 0.2% brimonidine and 0.5% betaxolol combined with 0.2% brimonidine）. The changes in intraocular pressure （IOP） were observed before, and 2, 4, 6, and 8 weeks after treatment. In addition, the adverse reactions were also recorded post-treat- ment. Results： The mean lOPs at all the time points after treatment were significantly reduced compared with pre-treatment levels （P〈0.05）. Patients receiving brimonidine had a greater reduc- tion in lOP compared with their counterparts in the betaxolol group but the difference was not statistically significant. The lOP decline was significantly higher in the combined therapy group than in the other two groups （P〈0.01）. Few cases presented with slight discomfort, such as sensation of foreign bodies, ocular irritation, dizziness, headache, fatigue, and dryness of mouth and nose. No severe adverse reactions were noted following administration.Conclusion： Combined use of brimonidine and betaxolol is an efficacious treatment of reducing IOP without severe side effects.     

2%美开朗与0.5%噻吗心安滴眼液治疗开角型青光眼与高眼压症的临床对照研究

目的以噻吗心安滴眼液作对照,在原发性开角型青光眼和高眼压症患者中评价美开朗滴眼液的降眼压、内在拟交感活性作用。方法选择开角型青光眼和高眼压症患者50例50眼,随机分为美开朗组和噻吗心安组2组,各25例25眼。美开朗组滴用2%美开朗眼液,噻吗心安组滴用0.5%噻吗心安眼液,一日2次,共12周,比较两种滴眼液的降眼压作用及局部和全身副作用。结果两组患者用药后眼压均下降,与用药前相比均有显著性差异(P<0.01)。两组间眼压下降值无显著性差异(P>0.05)。用药12周,美开朗组心率平均降低3.6次,噻吗心安组心率平均降低6.5次,两者相比有显著性差异。结论美开朗滴眼液对开角型青光眼和高眼压症患者具有明显的降眼压作用,和噻吗心安滴眼液局部降眼压作用相同,但对心率的抑制作用比噻吗心安小。     

The Objective Measure of Color Vision in Primary Open Angle Glaucoma

Purpose: To objectively evaluate the clinical application of color pattern reversal visual e-voked potential (CPR-VEP) on primary open angle glaucoma (POAG). Methods: CPR-VEP and FM 100-hue test were performed in 31 eyes with POAG and 33 normal eyes. Color pattern stimulation was presented by color monitor controlled by computer program. The reversal rate of the stimulating pattern was 2 Hz and the spatial frequency of the stimulating was 0.53 cycle/degree. The color stimulating pattern include White /Black , Red/Black , Green/Black , Blue/Black , Yellow /Black , Red/Green and Blue /Yellow . Results : CPR-VEP P1 latencies were obviously prolonged in POAG group in comparison with normal control group in equiluminance. All CPR-VEP P1 amplitudes, except Blue/Black P1 amplitude, show no differences between POAG group and normal control group . Conclusion: P1 latencies of all CPR-VEP and P1 amplitude of Blue/Black CPR-VEP were parameters for identifing acquired dyschromatopsia caused by POAG. The results sho     

Influence of Family History as a Risk Factor on Primary Angle Closure and Primary Open Angle Glaucoma in a Chinese population

Purpose: To identify the likelihood of family history as a risk factor for the presence and severity of primary angle closure (PAC) and primary open angle glaucoma (POAG) in a Chinese population.

Methods: All participants were asked to complete a questionnaire and undergo a comprehensive eye examination. Past history of hypertension, diabetes mellitus, hyperopia, high myopia, and family history of glaucoma were recorded. For those patients with a family history of glaucoma, the relationship between the patient and the affected relatives has been specified.

Results: A total of 332 PAC patients, 228 POAG patients and 193 controls were included. Of the 332 PAC patients, 83 (25.00%) had glaucoma family history. Characteristic-adjusted odds ratio (OR) of family history for PAC was 4.82 [95% confidence interval (CI): 2.08–11.19] and for severity of PAC was 1.61 (95% CI: 1.05–2.49). Among first-relatives only parents account for the family history rate of PAC [OR 8.76 (95% CI: 2.00–38.32)]. Of the 228 POAG patients, 49 (21.49%) had a family history of glaucoma. Odds ratio for POAG was 8.38 (95% CI: 3.33–21.07) and for severity of POAG was 1.81 (95% CI: 1.05–3.14). Unlike patients with PAC, only siblings and offspring account for the family history rate of POAG [OR 8.99 (95% CI: 2.38–33.99) and OR 19.23 (95% CI: 1.53–241.24) respectively].

Conclusion: Our study showed that a family history of glaucoma is associated with the presence and severity of PAC and POAG. This supports the finding that screening first-degree relatives will be an effective way to detect glaucoma in a population.     

Lack of Association Between LOXL1 Gene Polymorphisms and Primary Open Angle Glaucoma in the Saudi Arabian Population

Purpose: To investigate whether major single nucleotide polymorphisms (SNPs) in the LOXL1 gene associated with pseudoexfoliation glaucoma are associated with primary open angle glaucoma (POAG) in the Saudi Arabian population.

Methods: The regions of the LOXL1 gene associated with pseudoexfoliation glaucoma, encompassing the three common SNPs, (rs1048661, rs3825942 and rs2165241), were sequenced in a Saudi Arabian dataset consisting of 96 POAG cases and 101 healthy controls.

Results: The allele frequency of the G exfoliation risk allele for SNP rs1048661 in POAG cases and controls was 0.75 and 0.76 (p?=?0.886), respectively and the allele frequency difference was not statistically significant (p?=?0.866). There was no statistically significant difference in the genotypes between patients and controls (p?=?0.261 and 0.156 for genotypes G/G and G/T respectively). As for SNP rs3825942, the frequency of the “G” allele in the POAG patients was comparable to that in the controls (p?=?0.477) and there was no statistically significant difference in genotype G/G and A/G frequency in the study groups. As for SNP rs2165241, the “T” allele frequency in the POAG patients (0.46) was slightly higher than the frequency in controls (0.39), but this difference was not statistically significant (p?=?0.176).

Conclusion: The Saudi Arabian POAG population, similar to all other populations studied to date, demonstrates no association with SNPs associated with pseudoexfoliation glaucoma.     

A Study of Motion Perception in Primary Open Angle Glaucoma

Purpose: To study the features of the motion perception (MP) and explore the worth of the clinical application of MP test in primary open angle glaucoma (POAG).Methods: MPs were recorded from 41 patients (67 eyes) with POAG ang 56 normal subjects (112 eyes) by the MP software in PC compatible computer. Meanwhile , the MP ways and MP sites were analyzed and MP abnormal rate was compared to the clinical parameters and the visual function indices related to glaucoma. . Results: The results showed that the total abnormal rate of MP was 89. 5% in POAG, and the abnormal rate was 81. 6% in early stage of POAG, and MP abnormal degree had positive correlation with C/D, ocular tension and corrected loss variance (CLV), and negative correlation with visual acuity and mean sensitivity (MS), and no correlation with age and short-term fluctuation (SF) in the patients with POAG.Concusion: These results suggest that the MP test provides a newly effctive examination method in diagnosing the early POAG. Eye Science 1996;     

原发性闭角型青光眼流行病学研究进展

青光眼是全球第二大致盲眼病、不可逆性盲最主要的原因。原发性闭角型青光眼(PACG)是亚洲、特别是东亚、中国人中最常见的青光眼类型。随着社会、经济、环境的变化以及诊疗手段的进步,青光眼的流行病学特点不断变化;不同的青光眼诊断标准和分类系统也会导致不同的流行病学调查结果;流行病学的特征又指导着临床干预措施;这一切都密切相关,因此,PACG流行病学状况对青光眼的防治有着重要的意义。本文就国内外PACG流行病学相关研究进展作一综述。     

Role of rs1533428 and rs12994401 in patients with Primary Open Angle Glaucoma in an European population

Purpose: Genetic factors have been shown to play a remarkable role in the pathophysiology of glaucoma. Recently, two polymorphisms (rs1533428 and rs12994401) on chromosome 2p were found to be strongly associated with POAG in an Afro-Caribbean population in Barbados, West Indies. As data with regard to the role of these polymorphisms in a Caucasian population are lacking, the present study was set to investigate a hypothetical association between these polymorphisms and POAG in a Caucasian population.

Methods: In total 723 participants were included in this study comprising 366 patients with POAG and 357 control subjects from the southern part of Austria. Genotyping of rs1533428 and rs12994401 was performed using polymerase chain reaction.

Results: Allelic frequencies and genotype distributions of rs1533428 and rs12994401 did not show statistical significance between patients with POAG and control subjects (p < 0.05). Presence of the rs1533428 T-allele was associated with an odds ratio of 0.95 (95% CI: 0.76–1.19; p = 0.69) for POAG, while the rs12994401 T-allele was associated with an odds ratio of 0.94 (95% CI: 0.73–1.21; p = 0.65) for POAG.

Conclusion: Our data suggest that rs1533428 and rs12994401 themselves are unlikely major risk factors for POAG in a Central European population.     

视网膜振荡电位对原发性开角型青光眼早期诊断的意义

目的:评价振荡电位(OPs)在原发性开角型青光眼早期诊断的作用。方法:比较33例(66眼)正常人和30例(58眼)原发性开角型青光眼患者OPs的变化特点,分析不同时期原发性开角型青光眼患者OPs的异常率,同时计算其敏感性和特异性,并与眼压、视力和C/D进行相关分析。结果:原发性开角型青光眼患者与正常人相比OPs总值下降,OPs子波个数减少;原发性开角型青光眼患者OPs总值总的异常率为67.24％,其中较早期为42.86％,早期为65.38％,中晚期为76.00％;OPs总值的敏感性和特异性为67.24％和92.42％;OPs与C/D具有相关性。结论:OPs可以作为原发性开角型青光眼视野改变出现前较早期或早期诊断的指标。眼科学报1996;12:88—92。     

Hemodynamics of Ophthalmic Artery and Central Retinal Artery and Correlation with Other Factors in Patients with Primary Open Angle Glaucoma

Objective : To investigate the hemodynamics of ophthalmic artery (OA) and central retinal artery (CRA) in patients with primary open angle glaucoma(POAG) and analyse the correlation between hemodynamics of OA and CRA and other factors.Methods:The hemodynamics of OA and CRA in normal persons (102 eyes) and glaucoma-tous patients (102 eyes) were measured by Colour Doppler Image (GDI). The linear correlation analysis was made between OA and CRA about each of the following parameters: the peak systolic flow velocity (Vmax), the end diastolic velocity (Vmin). The multiple step-wise regression analysis was taken to investigate the correlation between each of the following hemodynamics of OA and CRA; Vmax and Vmin in 74 eyes with POAG and each of the following related factors in hemorrheology; whole blood apparent viscosity at low, medium and high shear rate, plasma viscosity and hematocrit. The multiple linear regression was applied to investigate the correlation between each of the following hemodynamics of     

荧光素浓度曲线法用于青光眼房水动力学

对原发性开角青光眼（POAG）51眼及对照组60眼作了房水荧光素浓度曲线（FCC）的测定，结果显示对照组房水FCC的荧光素下降率为82．61％，而POAG组的下降率为39．585，二者相比，P＜0．001，差别非常显著。POAG组早期（21眼）与中晚期（30眼）的荧光素下降率，分别为65．66％及28．96％，与对照组相比，P＜0．01，差别非常显著，对房水FCC测定作为POAG早期诊断的指标作出建议。     

A 7-Year Population Study of Primary Angle Closure Glaucoma Admissions and Climate in Taiwan

Purpose: Using data from seven years of hospital admissions in Taiwan, this study sets out to investigate meteorological factors associated with primary angle closure glaucoma (PACG). We investigated the relationship between PACG admissions and five different climate indices. Method: Hospital admissions data from the Taiwan National Health Insurance Research Database (1997 to 2003) provided monthly PACG admission rates (per 100,000 population). We categorized the 4,722 PACG cases by gender and age (including four subgroups: 40–49, 50–59, 60–69, and ≥ 70 years). After adjusting for the time-trend effect, the Auto-Regressive Integrated Moving Average regression method was performed to evaluate the effects of climatic and monthly factors on PACG admission rates. Results: The mean annual rate of PACG admissions across the entire study period was 9.48/100,000 and higher in females than males (11.28 vs. 7.80/100,000). The PACG admissions were significantly higher in March for male patients, and for the 60 to 69-year-old and > 69-year-old age groups (p < 0.05). After adjustment for seasonality, month, and time-trend, a significant association between relative humidity and monthly PACG admission rates was observed for the total data set, for males, and for the 60- to 69-year-old (p < 0.05) populations. No such relationship existed with temperature, rainfall, barometric pressure or hours of sunshine. Conclusion: This is the largest, nationwide, population-based study to investigate the dependence of PACG admission rates on meteorological conditions. PACG admission rates were significantly higher in March and with increased relative humidity. We recommend data be collected from other regions and from other ethnic groups to determine the general pattern worldwide.     

The Analysis of Pedigree GZ（Guangzhou）.1 with Primary Open Angle Glaucoma

Purpose:To analyze the hereditary modality of primary open-angle glaucoma in China.Methds:The genetic form of Pedigree GZ.1was analyzed using Mandalian hereditary rules.Results:PedigreeGZ.1 had following characteristics:1)The pedigree had four gene-rations,and there existed POAG patients in each generation;2)Each patient had a parent withPOAG.Ifthparents didn‘t suffer from the disease,their children would not.3)The incidence of POAG in the relatives of the patients was1/2,In addition,The age of onset,intraocular pressure,fundus and prognosis was different from each other in the patients.Conclusions:1)Pedigree GZ.1 is inherited as an autosomal dominant trait.2)There exists individual differences of clinical manifestations in POAG patients,Eye Science2000;16:53-55.     

Ocular Dominance in Open-angle Glaucoma: The Shifting Trend Depending on Stage of the Disease

PurposeTo investigate the characteristics and distribution of ocular dominance in primary open-angle glaucoma eyes. In addition, we tried to catch any trend of ocular dominance according to the stage of disease.MethodsTwo hundred participants with bilateral open-angle glaucoma underwent ocular dominant testing by “the hole-in-a-card” test. Using optical coherence tomography, macular ganglion cell-inner plexiform layer, as well as circumpapillary retinal nerve fiber layer thickness were measured and compared according to ocular dominance. Of the two eyes of one subject, the eye with less glaucomatous damage based on mean deviation was considered to be the “better eye” in our study.ResultsOcular dominance was in the right eye in 66% of the population and ocular dominance was positioned in the better eye in 70% of the population (p = 0.001 and p = 0.002, respectively). In conditional logistic regression analyses, right eye and better mean deviation were significantly associated with ocular dominance (p = 0.001 and p = 0.002, respectively). Ocular dominance tends to be present in the better eye and this trend was more apparent as the severity of glaucoma increased. Intereye comparison of visual field indices and retinal nerve fiber layer thickness between dominant versus nondominant eye become apparent in moderate and advanced glaucoma whereas it was not as apparent in early glaucoma.ConclusionsIn glaucomatous eyes, laterality and severity of glaucoma determined ocular dominance. Intereye difference between nondominant and dominant eyes increased with the severity of glaucoma. Our findings suggest the existence of potential reciprocal interactions between ocular dominance and glaucoma.     

早期开角青光眼视网膜光阈值长期波动与昼夜眼压波动关系

用Humphrey视野分析仪测量了早期开角青光眼19例(33眼)及正常人13例(26眼)24小时眼压波动的高峰及低峰时间的视网膜中心30度视野内76点视网膜光阈值长期波动及中心视野10度、15度、30度环上视网膜光阈值。结果显示两组阈值波动差异有高度显著性(P=0.001),阈值长期波动的高低与昼夜眼压波动无相关关系(r=0.09)。中心视野在20度上的波动阈值两组具有高度显著性差异(P=0.001)。表明早期青光眼的中心视野改变在Bjerrum区内。     

Novel Discoveries of Anterior Segment Parameters in Fellow Eyes of Acute Primary Angle Closure and Chronic Primary Angle Closure Glaucoma

PurposeTo investigate the biometric differences of anterior segment parameters between fellow eyes of acute primary angle closure (F-APAC) and chronic primary angle closure glaucoma (F-CPACG) to get information about differences between APAC and CPAC.MethodsPatients with F-APAC and F-CPACG without prior treatment were enrolled from glaucoma clinics. Parameters were measured on ultrasound biomicroscopy images, including pupil diameter, lens vault (LV), anterior chamber depth, anterior chamber width, iris area, iris thickness (IT 750 and 2000), angle-opening distance (AOD 500 and 750), trabecular-iris space area (TISA 500 and 750), trabecular iris angle (TIA 500 and 750), trabecular–ciliary angle, and ciliary process area. Multivariate logistic regression analysis was performed to determine the most important parameters associated with F-APAC compared with F-CPACG.ResultsFifty-five patients with APAC and 55 patients with CPACG were examined. The anterior chamber depth, IT 750, AOD 750, trabecular iris angle 750, and trabecular–ciliary angle were smaller, and LV and ciliary process area were greater in F-APAC as compared with F-CPACG (P ≤ 0.01). Multivariate logistic regression showed that thinner IT 750, smaller AOD 750, and larger LV were significantly associated with F-APAC (P < 0.01). IT 750 (area under the curve, 0.703) performed relatively better than AOD 750 (area under the curve, 0.696) in distinguishing F-APAC from F-CPACG, with the best cutoff of 0.404 mm and 0.126 mm, respectively.ConclusionsCompared with F-CPACG, F-APAC had thinner peripheral iris, narrower anterior chamber angle, shallower anterior chamber depth, greater LV, larger and anteriorly positioned ciliary body. IT 750, AOD 750, and LV played important roles in distinguishing eyes predisposed to APAC or CPAC.     

盘沿面积、视杯面积与视盘面积比对原发性开角型青光眼早期诊断的意义

将原发性开角型青光眼３４例４９眼和正常对照组１２例２３眼的ＮＲＡ／ＤＡ和ＣＡ／ＤＡ进行比较，检测结果显示：正常对照组ＮＲＡ／ＤＡ＝０．７５±０．００５，ＣＡ／ＤＡ＝０．２６±０．００４，开角型青光眼早期组ＮＲＡ／ＤＡ＝０．５８±０．０６８，ＣＡ／ＤＡ＝０．４８±０．００８，开角型青光眼中晚期组ＮＲＡ／ＤＡ＝０．２７±０．０１２，ＣＡ／ＤＡ＝０．７４±０．１０９。两组相比均有极显著差异（Ｐ＜０．００１），认为ＮＲＡ／ＤＡ、ＣＡ／ＤＡ均可做为原发性开角型青光眼早期诊断的重要客观指标。     

The Characteristics of Interaction between Color and Motion Perception in PrimaryOpen Angle Glaucoma

Purpose: To investigate the characteristics of interaction between color and motion perception in primary open angle glaucoma (POAG) and measure motion perception of B,G and R cones, thus find a more sensitive method to diagnose the visual nerve damage in POAG. Methods : Motion perceptions of B,G and R cones were isolated by blue , green and red vertical line stimulus displayed on the yellow , purple and blue background respectively, then measured the displacement threshold and flicking threshold of motion perception from each cones in POAG, and compared it with the age-match normals.Results:The displacement threshold and flicking threshold of motion perception from B,G and R cones were all damaged in POAG compared with the normals, and the motion perception of G and B cones was deficits more obviously than the R cones.Conclusion: These findings support the suggestion that color provides an input to human motion perception. Magnocellular and parvocellular pathway may be significandy damaged in POAG, whi     

The Study of Relationships between the Damage of Visual Function and Hemorrheology, Ocular Rheography, as well as Other Related Factors in Patients with Primary Open Angle Glaucoma (POAG)

Researches of glaucoma visual function damage, hemorrheololgy, ocular rheography and other related multiplex factors, with computed multifactorial stepwise regresion analysis, indicate that the elevation of intraocular pressure (IOP) is not the only factor to induce visual impairment. POAG patients are shown to have markedly reduced diastolic purfussion pressure in ophthalmic artery, besides prolonged filling time of the retinal artery and vein, diminished erythrocyte deformability and increased platelet adhesion rate. The characterility of ocular rheographic changes in POAG patients of controlled IOP suggest that the abnormal changes of hemorrheololgy be responsible for the damage of visual function. The abnormal changes of plasma viscosity, blood apparent viscosity, blood viscoelasticity, hematocrit, mean red cell volume etc could be found in addition to the reduction of PO2, SQ2% and trace elements (Cr, Zn, Mg, Fe) in patients with POAG. Computed multiply stepwise regression analysts and Bayes discrimination were made among the deteriorate rate of quantitative visual field and 28 factors from the combined investigation. Only the hemorrheological index could be introduced into the multiply regression equations. The more the damage of visual function in POAG patients, the more accurate the discriminatory effect. Based upon the results, and the reports of articles published as well as the search of 1982-1989 Compact Combridge MEDLINE Medical data base, the new clinical concept could be presented that POAG might belong to the scope of blood hyperviscosity syndromes. When IOP elevation and the decrease of ocular artery pressure existed, the damage of visual function in POAG patients should be deteriorated.