Color pattern-reversal visual evoked potential in eyes with ocular hypertension and primary open-angle glaucoma

Color pattern-reversal visual evoked potential testing was performed in 99 normal eyes, 27 eyes with ocular hypertension and 30 eyes with primary open-angle glaucoma with the use of black-white, black-red and black-blue color checkerboard stimuli. The PI wave peak time and amplitude of the eyes with ocular hypertension and glaucoma were significantly different from those of age-similar normal eyes, especially on the black-red and black-blue checkerboards (p < 0.001). The differences between the ocular hypertensive and glaucomatous eyes were of less significance. The P1 peak time difference between black-white and black-red checkerboards may serve as an important parameter in the early diagnosis of glaucoma.Abbreviations OH ocular hypertension - POAG primary open-angle glaucoma - NC normal control - CPRVEP color pattern-reversal visual evoked potential     

真空小梁成形术对原发性开角型青光眼及高眼压症的降眼压作用的初步研究

目的观察真空小梁成形术（PNT）对国人原发性开角型青光眼（POAG）及高眼压症患者的降眼压效果。设计前瞻性病例系列。研究对象北京同仁医院2008年11月至2009年2月就诊的POAG及高眼压症患者30例（30眼）。方法人选患者进行眼科一般检查、前房角镜及Humphrey视野检查,测量眼压（压平眼压计）。患者单眼或双眼进行PNT1000型治疗仪（Ophthalmic International公司产）治疗。治疗后1小时、1天、1周、2周、1个月、2个月复查。首次治疗后第7天重复治疗一次。单眼治疗者选治疗眼,双眼者随机选1眼,进行重复测量的方差分析。主要指标眼压。结果30例患者治疗前眼压（23．2±5．3）mmHg,平均应用局部降眼压药物1．47种（0—5种）,治疗后1天、1周、2周、1个月、2个月各时间点眼压分别为（20．0±5．0）mmHg、（19．8±3．8）mmHg、（19．7±4．0）mmHg、（19．3±3．9）mmHg、（19．8±4．0）mmHg,眼压下降幅度分别为3．2mmHg、3．4mmHg、3．5mmHg、3．9mmHg、3．4mmHg,各时间点较治疗前眼压差异有统计学意义（P均〈0．001）.23例（83％）治疗后眼压下降≥15％。结论本文的短期小样本研究显示,真空小梁成形术可安全有效地降低POAG及高眼压症患者的眼压。     

曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症

目的：研究曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症的降眼压效果及安全性。方法：随机选取2013-03/2016-03我院收治的原发性开角型青光眼和高眼压症患者80例80眼,依据不同治疗方法分为两组：曲伏前列素滴眼液组( n=40)和拉坦前列素滴眼液组(n=40),对两组患者的临床疗效、视力、散光度、眼压及不良反应发生情况进行统计分析。结果：曲伏前列素滴眼液组患者治疗的总有效率95%(38/40)显著高于拉坦前列素滴眼液组80%(32/40),差异有统计学意义(P<0.05)。曲伏前列素滴眼液组患者治疗后视力显著高于拉坦前列素滴眼液组,差异有统计学意义(P<0.05),散光度、眼压均显著低于拉坦前列素滴眼液组,差异有统计学意义(P<0.05),不良反应发生率25%(10/40)显著低于拉坦前列素滴眼液组53%(21/40),差异有统计学意义(P<0.05)。结论：曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症比拉坦前列素滴眼液具有较好的降眼压效果及较高的安全性。     

拉坦前列腺素与噻吗心安治疗原发性开角型青光眼和高眼压症对照研究

目的　以噻吗心安为对照,评估新型异丙酯前列腺素Ｆ２α的苯基替代衍生物拉坦前列腺素（ＰｈＸＡ４１）对于眼压升高病人的降眼压疗效和副作用。方法　３４ 例（６６ 只眼） 原发性开角型青光眼或高眼压症患者入选,随机分组,１７ 例（３２ 只眼）滴用０．０５ｇ·Ｌ－１ 拉坦前列腺素每天１ 次,１７ 例（３４ 只眼）滴用５ｇ·Ｌ－１ 噻吗心安每天２ 次,共治疗１２ｗｋ。结果　１２ｗｋ治疗期间,两种药物均能有效降低眼压（Ｐ＜ ０－０１） ,且效应持续。各次随访均显示,拉坦前腺素的降眼压效果显著优于噻吗心安（Ｐ＜ ０－０５）。１２ｍｏ 时,拉坦前列腺素组的眼压降低了９－５±３－１ｍ ｍＨｇ（３６－８ ％）（１ｍ ｍＨｇ＝ ０．１３３ｋＰａ） ,噻吗心安组降低了７－４±２－６ｍ ｍＨｇ（２９－６％ ）（ Ｐ＜ ０－０１）。拉坦前列腺素治疗后,少数病例发现角膜上皮点状脱落。噻吗心安组的平均心率减少４ 次·ｍｉｎ－１（Ｐ＜ ０－０５） 。结论　０ ．０５ｇ·Ｌ－１ 拉坦前列腺素每天１ 次与５ｇ·Ｌ－１ 噻吗心安每天２ 次相比,具有更强的降眼压作用,而且耐受性良好。因此,拉坦前列腺素将成为青光眼药物治疗的有效选择。     

Initial experience with phacoemulsification and goniotomy using the Kahook dual blade in advanced open-angle glaucoma: Six-month outcomes in Indian eyes

Purpose:The aim of this study was to report our initial experience on the outcomes of phacoemulsification in combination with goniotomy using the Kahook Dual Blade (KDB) in eyes with advanced open-angle glaucoma (OAG).Methods:The outcomes of phaco-goniotomy with KDB in advanced OAG in Indian eyes were retrospectively analyzed. Based on the Hodapp-Anderson-Parrish criteria of visual field defects, severe glaucoma (mean deviation on standard automated perimetry worse than 12 dB) was considered as advance glaucoma. Preoperative, intraoperative, and postoperative data were collected through 6 months of follow-up. Outcome measures included antiglaucoma medications (AGM), the proportion of eyes achieving >1AGM reduction, intraocular pressure (IOP), and visual acuity.Results:Median (interquartile range) number of AGM in eyes that underwent phaco-KDB goniotomy reduced from 2 (2,3) at baseline to 1 (0,1) at 6 months (P = 0.002). Median IOP reduced from 20 (20,26) mmHg at baseline to 14 (12,15) mmHg at 6 months (P = 0.02). The proportion of eyes achieving >1 medication reduction was 88% eyes (8/9). Adverse events noted were IOP spike (22 mmHg) in 2 eyes and intra-op hyphema in 1 eye on postoperative day-1, both resolved in a week with conservative management. Except one eye with central corneal scar due to prior pterygium surgery, 8 eyes had 20/20 vision at 1 week which was maintained till last follow-up.Conclusion:Phacoemulsification with KDB Goniotomy significantly lowered the need for AGM with moderate IOP reduction in advanced OAG eyes. There were no serious complications and the visual recovery was good and early.     

[In Press] Effect of phacoemulsification on intraocular pressure in patients with primary open-angle glaucoma and pseudoexfoliation glaucoma

AIM: To compare the effect of phacoemulsification on intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG). METHODS: A retrospective comparative case series conducted at the Glaucoma Department at the Association for Preventing Blindness in Mexico. The study enrolled consecutive patients having phacoemulsification with IOL implantation and a diagnosis of POAG or PXG. Data about IOP values and number of glaucoma medications used was collected at baseline, month 1, 3, 6 and 12 postoperatively. RESULTS: The study enrolled 88 patients (88 eyes). After phacoemulsification, there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients (P<0.001). In the POAG group, a 20% decrease in IOP values was evidenced, and a 56.5% reduction in the number of medications used at the one-year follow-up. The PXG group showed a 20.39%, and a 34.46% decrease in IOP and number of medications used, respectively. A significant difference in the mean ΔIOP (postoperative changes in intraocular pressure) was evidenced between groups (P=0.005). The reduction of the postsurgical IOP mean values in both groups, the POAG group showed a greater reduction in IOP values compared to the PXG group. CONCLUSION: In both types of glaucoma, phacoemulsification cataract surgery can result in a significant IOP reduction (20%) over a 12-month follow-up period. The number of medications used is also significantly reduced up to 12mo after surgery, especially in the PXG group.     

MicroRNA-related polymorphisms in pseudoexfoliation syndrome,pseudoexfoliative glaucoma,and primary open-angle glaucoma

Background: Pseudoexfoliation syndrome (PEX) and glaucoma (pseudoexfoliative glaucoma; PEXG, primary open-angle glaucoma; POAG) have mainly been studied for their associations with genes’ polymorphisms. The purpose of this exploratory study was to investigate the role of polymorphisms in genes encoding for micro RNAs (miRNAs) and in genes related to miRNA biogenesis.

Material and Methods: In the present genetic association study, ninety-two polymorphisms were investigated for their contribution to PEX (n = 203), PEXG (n = 38), and POAG (n = 40) pathogenesis compared to a control group (n = 188). The next generation sequencing (NGS) genotypic analysis revealed data for additional 28 variants.

Results: A protective association was found between PEX and polymorphism 11382316 (mir-3161) [odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.47–0.86, p = 0.003], rs2155248 (mir-1304) [OR = 0.66, 95%CI: 0.47–0.94, p = 0.019], and rs28635903 (mir-1268a) [OR = 0.30, 95%CI: 0.10–0.94, p = 0.029]. Polymorphism rs113297757 (mir-3196) was associated with an increased risk of POAG [OR = 7.75, 95%CI: 2.13–28.76, p = 3 × 10^?4]. Polymorphism rs1057035 (DICER) and rs55671916 (XPO5) in the 3?-UTR of genes related to miRNA biogenesis was associated with decreased risk of PEX [OR = 0.65, 95%CI: 0.46–0.92, p = 0.014] and increased risk of PEXG [OR = 2.84, 95%CI: 1.02–7.94, p = 0.038], respectively. The aforementioned associations according to the allelic model were further supported by the genotypic models of statistical analyses.

Conclusions: This is the first study to report distinct associations of PEX, PEXG, and POAG in the same population with variants of genes involved in miRNA biogenesis and with miRNA genes’ polymorphisms. Further studies in larger groups of patients of various origins are needed to confirm the reported preliminary results.     

Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma

AIM: To compare the effect of phacoemulsification on intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG). METHODS: A retrospective comparative case series conducted at the Glaucoma Department at the Association to Prevent Blindness in Mexico. The study enrolled consecutive patients having phacoemulsification with intraocular lens (IOL) implantation and a diagnosis of POAG or PXG. Data about IOP values and number of glaucoma medications used was collected at baseline, 1, 3, 6 and 12mo postoperatively. RESULTS: The study enrolled 88 patients (88 eyes). After phacoemulsification, there was a statistically significant reduction in IOP values and glaucoma medications use compared to baseline in both POAG and PXG patients (P<0.001). In the POAG group, a 20% decrease in IOP values was evidenced, and a 56.5% reduction in the number of medications used at the one-year follow-up. The PXG group showed a 20.39%, and a 34.46% decrease in IOP and number of medications used, respectively. A significant difference in the mean ΔIOP (postoperative changes in IOP) was evidenced between groups (P=0.005). The reduction of the postsurgical IOP mean values in both groups, the POAG group showed a greater reduction in IOP values compared to the PXG group. CONCLUSION: In both types of glaucoma, phacoemulsification cataract surgery can result in a significant IOP reduction (20%) over a 12mo follow-up period. The number of medications used is also significantly reduced up to 12mo after surgery, especially in the PXG group.     

真空小梁成形术治疗开角型青光眼及高眼压症

目的 观察真空小梁成形术对原发性开角型青光眼和高眼压患者的降眼压效果和安全性.方法 前瞻性病例系列研究.开角型青光眼及高眼压患者100例（100眼）作为研究对象.所有研究对象都接受了全面的眼科检查,包括眼压、计算机视野检查,并进行UBM或前房角镜检查,排除前房角关闭者.进行真空小梁成形术治疗仪治疗.治疗后1d、1周、1月、3月复查.首次治疗后7d重复治疗1次.观察治疗前后眼压变化.结果 100例术前眼压为（24.50±4.14） mmHg（1 mmHg=0.133 kPa）,治疗后1d、1周、1月、3月各时间点眼压为（22.96±3.66） mmHg,（21.27±2.91） mm-Hg,（19.65±2.77） mmHg,（19.80±1.79） mmHg,3个月观察期末与治疗前眼压差异均有统计学意义（P＜0.05）.3个月观察期内,无视力下降者.结论 本文短期研究显示,真空小梁成形术可安全有效地降低开角型青光眼及高眼压患者的眼压.     

原发性开角型青光眼患者不同体位眼灌注压昼夜波动趋势分析

Objective To characterize the circadian fluctuation of ocular perfusion pressure (OPP) in different position  in patients with newly diagnosed, untreatedprimary open-angle glaucoma（POAG）. Design Cohort study. Participants Nineteen patients with POAG (19 eyes) and eighteen healthy controls (18 eyes) were included in the Peking University Shenzhen Hospital. Methods POAG patients and healthy controls were included and underwent 24-hour monitoring of IOP and blood pressure. On 10:00, 14:00, 18:00 and 22:00 o’clock in the daytime, all the subjects were monitored in sitting position, then POAG patients were monitored again after lying down for 5 minutes. On 2:00, 5:00 and 7:00 o’clock at night all the subjects were monitored in supine position, then POAG patients were monitored again after sitting for 5 minutes. Calculating the mean ocular perfusion pressure (MOPP), the systolic ocular perfusion pressure (SOPP) and diastolic perfusion pressure (DOPP) by the formula and analyzing the data. Main Outcome Measures  MOPP, SOPP, DOPP. Results In both groups of habitual position (sitting position in day and supine position in night), the nocturnal MOPP, SOPP and DOPP were lower than diurnal. In both groups, the nocturnal MOPP was lower than diurnal in habitual position (POAG group t=4.092, P=0.000; healthy group t=4.513, P=0.000). However, there was no obvious difference between those two groups (t=-0.973, P=0.350). POAG group had higher 24-hour fluctuation of MOPP (t=2.204, P=0.039), higher nocturnal fluctuation of SOPP (t=3.097, P=0.018), higher nocturnal and 24-hour fluctuation of DOPP than healthy group, all the differences had statistical significance (all P<0.05).  In POAG group , there was no statistical difference between the nocturnal MOPP and the diurnal MOPP in sitting position or in supine position of 24 h (all P>0.05). POAG group had higher 24-hour mean MOPP in sitting position than in supine position, the difference had statistical significance (t=4.306, P=0.001).  Comparing the MOPP of  POAG group  in habitual position with in sitting position of 24 h, there was no statistical difference(t=-2.101, P=0.080). However, POAG group had higher 24-hour mean MOPP in habitual position than in supine position of 24 h, the difference had statistical significance (t=2.707, P=0.035). Conclusions There circadian fluctuation of  OPP in different position in POAG pations can not be treated as the same. The nocturnal MOPP  was lower than diurnal in habitual position, but there was no obvious difference in the 24h-sitting position and 24h-supine position.  (Ophthalmol CHN, 2017, 26: 20-25）     

选择性激光小梁成形术治疗高眼压症和不同病程原发性开角型青光眼的疗效观察

目的 对比选择性激光小梁成形术(selective laser trabeculoplasty,SLT)治疗高眼压症(ocular hypertension,OHT)和早期、中期原发性开角型青光眼(primary open-angle glaucoma,POAG)的效果.方法 根据病情将120例120眼患者分为OHT组(40例40眼)、早期POAG组(40例40眼)和中期POAG组(40例40眼),3组均使用532 nm倍频Q开关Nd:YAG激光器行SLT,激光单脉冲3 ns,光斑直径400 nm,初始能量为0.6mJ,以0.1mJ逐渐递减,至刚好出现香槟样气泡时为治疗能量,治疗范围为360°,术后1d、1周、1个月、3个月及6个月随访,主要观察SLT治疗前后的眼压变化情况.结果 治疗后1d～6个月,OHT组、早期POAG组和中期POAG组术后各个时间点的眼压均较术前下降,差异均有统计学意义(均为P＜0.05).各组内,SLT术后各时间点的眼压相比,差异亦均有统计学意义(均为P＜0.05).OHT组、早期POAG组和中期POAG患者基线眼压分别为(25.95±1.80) mmHg(1 kPa =7.5 mmHg)、(24.66±1.55) mmHg和(25.62±2.67) mmHg,差异有统计学意义(P＜0.05).当剔除基线眼压的影响之后,术后1d、1周、1个月、3个月、6个月,3组间的眼压相比差异均有统计学意义(均为P＜0.05).在各组内,术后各时间点的眼压相比,差异亦均有统计学意义(均为P＜0.05).与校正后的基线眼压相比,OHT组SLT术后眼压下降的幅度最大,其次是早期POAG组,中期POAG组下降的幅度最小.结论 SLT对于OHT和POAG患者具有良好的降眼压效果,SLT的治疗效果随POAG患者的病情严重程度逐次递减.     

视觉电生理和视野检查对原发性开角型青光眼早期诊断的敏感性

目的:探讨多种视觉电生理联合全自动视野计检查对原发性开角型青光眼早期诊断中的敏感性,为临床早期诊断提供客观敏感的指标。方法:选择10例(20眼)原发性开角型青光眼患者和正常对照者10例(20眼)分别进行闪光视网膜电图(FERG)、图形视网膜电图(PERG)、图形视觉诱发电位(PVEP)检查;还对正常对照组、青光眼组中各5例(10眼)进行多焦视网膜电图(mERG)检查;青光眼组10例(20眼)和正常对照组8例(16眼)行蓝黄视野(B/Y)、标准视野(W/W)检查。结果:PERG的异常率较高,PERG的潜伏期延长较敏感,mERG二阶反应黄斑区振幅下降,随离心度的增大,振幅逐渐变小,潜伏期延长,PVEP的P100波振幅降低,潜伏期延长。B/Y视野异常与W/W视野异常比较有显著差异(P <0.01)。结论:B/Y视野检查联合多种视功能检查对原发性开角型青光眼早期诊断较敏感。早期诊断中的B/Y视野敏感性高;若眼压差大,眼底C/D未出现改变,则PERG可作为较敏感观测指标。     

剥脱性青光眼与原发性开角型青光眼行青白联合手术疗效观察

目的：比较剥脱性青光眼(PXG)与原发性开角型青光眼(POAG)行青光眼白内障联合手术的临床疗效。

方法：回顾性选取2015-01/2018-01于我院住院治疗的PXG患者38例40眼作为PXG组，另选取基线资料相匹配的POAG患者36例46眼作为POAG组。观察两组患者行小梁切除+白内障超声乳化摘除+人工晶状体植入术后视力、眼压、抗青光眼药物使用数量及并发症发生情况，并根据标准A(IOP≤21mmHg)、B(IOP≤18mmHg)评定手术疗效，手术完全成功定义为满足上述标准且不进行药物治疗，手术条件成功定义为满足上述标准但需进行药物治疗(≤3种)。

结果：术后两组患者视力均较术前改善，眼压均明显降低，抗青光眼药物使用数量均减少。术后1、3mo两组手术完全成功率及条件成功率均无差异(P>0.05)。术后6mo，1、2a，根据标准A，PXG组手术条件成功率(90%、80%、74%)均略低于POAG组(91%、86%、82%，均P>0.05)，手术完全成功率(50%、40%、29%)均明显低于POAG组(85%、64%、61%，均P<0.05)； 根据标准B，PXG组手术条件成功率(70%、70%、59%)略均低于POAG组(80%、80%、75%，均P>0.05)，手术完全成功率(45%、30%、18%)均明显低于POAG组(78%、61%、54%，均P<0.05)。

结论：PXG及POAG患者实施青光眼白内障联合手术后能够显著提高视力、降低眼压，两者短期手术成功率相似，但PXG患者远期手术成功率明显偏低，且无法达到低标准眼压控制。     

Travoprost compared with other prostaglandin analogues or timolol in patients with open-angle glaucoma or ocular hypertension: meta-analysis of randomized controlled trials

BACKGROUND: It is still uncertain whether travoprost has comparable or better efficacy compared with other prostaglandin analogues or timolol in patients with open-angle glaucoma or ocular hypertension. The authors performed a meta-analysis of randomized controlled trials to evaluate the incidence of reported side-effects and intraocular pressure (IOP)-lowering effect of travoprost versus other prostaglandin analogues (latanaprost, bimatoprost, unoprostone) or timolol. METHODS: Systematic literature retrieval was conducted in Pubmed, EMBASE, Chinese Bio-medicine Database and Cochrane Controlled Trials Register to identify the potentially relevant randomized controlled trials. The statistical analysis was performed by RevMan 4.1 software that was provided by the Cochrane Collaboration. The outcome measures were the incidence of reported side-effects (hyperaemia, iris pigmentation, eyelash changes) and mean IOP pooled over treatment visits. RESULTS: In total, 12 articles involving 3048 patients with open-angle glaucoma or ocular hypertension were included in this meta-analysis. The combined results showed that travoprost 0.004% was more effective than timolol or travoprost 0.0015% in lowering IOP, but not more effective than bimatoprost or latanoprost. Travoprost 0.004% caused a higher percentage of hyperaemia than timolol, latanoprost, or travoprost 0.0015%. There was an increased incidence of pigmentation with travoprost than timolol. Travoprost 0.004% caused a higher percentage of eyelash changes than timolol, latanoprost, or travoprost 0.0015%. CONCLUSION: According to data available, travoprost is more effective than timolol in lowering IOP in patients with open-angle glaucoma or ocular hypertension. Compared with other prostaglandin analogues, travoprost appears to be equivalent to bimatoprost and latanoprost. Although a limited number of local side-effects were reported, no serious treatment-related side-effects were reported.     

原发性开角型青光眼的系统性危险因素

眼压异常升高是原发性开角型青光眼最主要的危险因素。临床目前一直沿用以眼压为靶点的青光眼诊疗模式。近年来发现,循环血流、体质指数、颅内压、营养代谢、中医偏颇体质类型、某些系统性疾病等多种系统性危险因素可能与青光眼发生、发展和转归相关。纠正系统性危险因素能否延缓青光眼进展被日益关注,成为潜在的青光眼辅助诊疗靶点。本文对各类青光眼系统性危险因素进行介绍,倡导重视系统性危险因素,提出以系统危险因素评估和个性化眼体同治相结合的青光眼诊疗体系。（眼科,2022,31:325-329）     

Fluorescein filling defects of the optic nerve head in normal tension glaucoma, primary open-angle glaucoma, ocular hypertension and healthy controls

BACKGROUND: To evaluate fluorescein filling defects of the optic nerve head in normal tension glaucoma (NTG), primary open-angle glaucoma (POAG), ocular hypertension (OHT) and controls. METHODS: Forty patients with NTG (mean age 55 +/- 10 years), 40 patients with POAG (mean age 55 +/- 11 years), 40 patients with OHT (mean age 53 +/- 13 years), and 40 age-matched controls (mean age 54 +/- 11 years) were included in a prospective study. Video fluorescein angiograms were performed by means of a scanning laser ophthalmoscope. The extent of absolute filling defects of the optic nerve head was assessed (as a percentage of the disc area) using digital image analysis. Visual fields were tested by automatic static perimetry (Humphrey Field Analyzer, programme 24-2). RESULTS: Absolute filling defects were significantly larger in patients with NTG (12.2 +/- 15.5%) and POAG (12.9 +/- 13.1%) compared to patients with OHT (1.2 +/- 3.6%) and healthy controls (0.1 +/- 0.5%) (p < 0.0001). The area under the receiver operating characteristic (ROC) curve was 0.806 for NTG vs healthy controls, and 0.812 for POAG vs OHT. Absolute filling defects are significantly correlated to the global indices mean deviation (r = -0.63, p < 0.0001), pattern standard deviation (r = 0.61, p < 0.0001), and corrected pattern standard deviation (r = 0.62, p < 0.0001) and significantly correlated to horizontal (r = 0.50, p < 0.0001) and vertical (r = 0.53, p < 0.0001) cup-to-disc-ratios. CONCLUSIONS: Fluorescein filling defects of the optic disc representing capillary dropout are present in NTG and POAG. The extent of these filling defects is correlated to visual field loss and morphological damage. Fluorescein angiography may be useful in the diagnosis and management of NTG and POAG.     

Comparison of total/active ghrelin levels in primary open angle glaucoma, pseudoexfoliation glaucoma and pseudoexfoliation syndrome

AIM: To investigate the levels of ghrelin (Gh), acylated ghrelin (AGh) and AGh/Gh ratio in the humor aqueous (HA) of cases with pseudoexfoliation syndrome (PXS), pseudoexfoliation glaucoma (PXG), primary open angle glaucoma (POAG) and to compare these with control subjects. METHODS: A prospective examination was made of the total Gh, and AGh levels in HA of 67 patients undergoing cataract surgery. Patients were divided into 4 groups. HA samples were aspirated at the beginning of the surgery, stored at -70oC. Gh and AGh quantification was performed with ELISA kits and the AGh/total-Gh ratios were calculated. ANOVA, Kruskal-Wallis, Chi-square and post-hoc tests were used for statistical analysis. RESULTS: Total Gh levels in HA were 189.2±45.6 pg/mL in the control group, 199.2±32.9 pg/mL in PXS, 180.6±20.9 pg/mL in PXG and 176.8±21.4 pg/mL in POAG groups (P>0.05). AGh levels in HA were 23.09±5.01 pg/mL in the control group, 24.13±5.22 pg/mL in PXS, 22.29±1.55 pg/mL in PXG and 19.69±2.93 pg/mL in POAG groups (P>0.05). The ratio of AGh/Gh was 10.3%±2.34% in the control group, 13.03%±2.58% in PXS, 12.3%±1.54% in PXG and 11.79%±1.41% in POAG groups (P=0.044). The difference between the PXS and control groups was significant (P=0.03). CONCLUSION: In spite of statistically insignificant results, the HA total Gh levels were lower than those of the control subjects but not parallel with the AGh levels in glaucoma patients. The relative increase in the AGh/Gh ratio in glaucoma cases supports the view that proportional increases of AGh might play a role in the pathogenesis of glaucoma.     

高眼压症及原发性开角型青光眼患者的24 h眼压波动规律

目的 通过24 h眼压测量来深入分析对比高眼压症与原发性开角型青光眼(POAG)患者的眼压曲线特征。方法 收集2016年1月~2019年3月在我科门诊诊断为高眼压症的患者52例(104眼)及POAG尚未接受降眼压治疗的患者38例(76眼)。入院后行24 h眼压检查,用非接触性眼压计从早9时起每隔2 h测量眼压1次,至次日7时结束。分析2组患者的平均眼压,峰值眼压及时间点,谷值眼压及时间点,昼夜眼压波动及双眼眼压压差值及其分布情况,比较2组眼压波动的异同点。结果 104眼高眼压症患者的平均眼压为(18.73±1.71)mmHg(1 mmHg=0.133 kPa),平均峰值眼压为(22.36±2.40) mmHg,平均谷值眼压为(15.63±2.09) mmHg,平均昼夜眼压波动为(6.72±2.24) mmHg。76眼POAG患者的平均眼压为(20.65±2.53) mmHg,平均峰值眼压为(25.78±2.81) mmHg,平均谷值眼压为(17.45±2.54) mmHg,平均昼夜眼压波动为(8.34±2.37) mmHg。2组的峰值及谷值眼压值分布最多的时间点均为凌晨3时及夜晚21时,大部分患者的峰值眼压时间点在门诊时间之外。高眼压症组中昼夜眼压波动位于5~8 mmHg的占比最大,为54.81%(57/104),POAG组中昼夜眼压波动>8 mmHg的占比最大,为53.95%(41/76)。高眼压症组中,16例患者经24 h眼压检查后监测到眼压波动异常,占比为30.77%(16/52);POAG组中经24 h眼压检查后有29例患者可以监测到眼压波动异常,占比为76.32%(29/38)。结论 24 h眼压监测中,POAG患者较高眼压症患者的平均眼压、峰值眼压、谷值眼压、昼夜眼压波动及双眼压差均有增加。对于24 h眼压发现眼压波动较大的高眼压症患者应在后续加强密切随访,而对于POAG患者24 h眼压监测可在治疗前提供眼压的基线水平,为后续治疗提供参考及评估依据,因此建议将24 h眼压作为高眼压症及POAG的常规检查手段。     

Analysis of aerobic exercise influence on intraocular pressure and ocular perfusion pressure in patients with primary open-angle glaucoma: A randomized clinical trial

Purpose:To investigate the change pattern of ocular perfusion pressure (OPP) and intra-ocular pressure (IOP) after short-term and long-term aerobic exercise.Methods:In this prospective, single-masked, randomized clinical trial, 123 patients with a primary open angle glaucoma that locally used prostaglandin analog alone were randomly divided into the exercise and control groups. In the short-term study, all individuals underwent a cycling exercise at moderate intensity (20% Wmax for 10 minutes) and high intensity (60% Wmax for 5 minutes). During the long-term study, the exercise group is characterized by regular jogging exercise lasting for 30 minutes during 6: 00–10: 00 in the morning for 3 months, with the exercise frequency of at least 20 times per month, and with the intensity reflected by the target heart rate. The control group is designed as a group with irregular exercise.Results:After short-term aerobic exercise, IOP significantly decreased, whereas the ocular perfusion pressure (OPP) significantly increased. The decreasing amplitude of IOP is related to the baseline of IOP, the intensity of exercise, gender, and so on. After 3 months of long-term exercise, the changes in the IOP level of the exercise group indicated a decreasing trend.Conclusion:The significant decrement of IOP and the increment of OPP suggest that aerobic exercise is beneficial for patients with primary open-angle glaucoma and appropriate aerobic exercise is appropriate in treating glaucoma patients.Trial registration:ChiCTR, ChiCTR-TRC-10001055. Registered one October 2010-Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj = 8483     

非穿透性小梁切除联合小梁切开术治疗原发性开角型青光眼

目的观察非穿透性小梁切除联合小梁切开术治疗原发性开角型青光眼的临床效果。方法对10例12眼原发性开角型青光眼患者行非穿透性小梁切除联合小梁切开术,术中应用丝裂霉素C,术后观察视力、前房反应、眼压、滤过泡情况,随诊时间3月。结果10例12眼术前眼压(36.6±11.8)mmHg(1kPa=7.5mmHg),术后1d(6.2±2.8)mmHg,术后1周(7.3±3.7)mmHg,术后2周(9.6±4.2)mmHg,术后1月(12.7±4.7)mmHg,术后2月(11.5±4.2)mmHg,术后3月(12.2±4.4)mmHg。术后视力均达到或高于术前水平。12眼均有功能型滤泡。术中、术后均未出现浅前房及前房炎症反应。有1例术中少量前房出血,于术后1d全部吸收。结论非穿透性小梁切除联合小梁切开术能安全、有效地治疗原发性开角型青光眼,成功率高于单纯性非穿透性小梁手术。