Increased numbers of higher left intraocular pressures in 428 patients referred to the glaucoma clinic

Seventy-four per cent of 428 patients referred to the glaucoma clinic at Concord Hospital exhibited intraocular pressure (IOP) asymmetry. There was a preponderance of left eyes, in that two-thirds of the patients with asymmetrical pressures had the higher IOP in the left eye. As the degree of asymmetry increased, this trend became more pronounced. In addition, the statistically significant difference between right and left mean IOP among the glaucoma patients was not found among normal controls, even when the order of testing the eyes was reversed.     

Non-contact tonometry synchronized with cardiac rhythm and its relationship with blood pressure

PURPOSE: The main objectives of this study were to determine the differences between non-synchronized intraocular pressure (IOP_N) and intraocular pressure readings synchronized with cardiac pulse and try to determine if these parameters are related to blood pressure values. METHODS: One hundred and sixty-five right eyes from 165 volunteers (107 females, 58 males) aged from 19 to 73 years (mean +/- S.D., 29.93 +/- 11.17) were examined with the Nidek NT-4000, a new non-contact tonometer that allows the measurement of IOP synchronized with the cardiac rhythm. IOP measurements in the four different modes of synchronization were taken in a randomized order. Three measures of each parameter were taken and then averaged. The blood pressure was determined three times with a portable manometer and mean values of systolic and diastolic pressure and the pulse rate were computed. Mean arterial pressure (MAP) was determined as being 1/3 of systolic plus 2/3 of diastolic blood pressure. RESULTS: The mean +/- S.D. values for the standard intraocular pressure (IOP_N: 14.76 +/- 2.86), intraocular pressure in the systolic instant or peak (IOP_P: 14.99 +/- 2.85), intraocular pressure in the middle instant between heartbeats or middle (IOP_M: 14.68 +/- 2.76), and intraocular pressure in the diastolic instant or bottom (IOP_B: 13.86 +/- 2.61) were obtained. The IOP_P was higher than the remaining values. A significant difference in mean IOP existed between IOP_B and the remaining modes of measuring (p < 0.05). Differences were statistically significant for all pair comparisons involving IOP_B. Arterial blood pressure values were systolic 125.5 +/- 14.22, diastolic 77.7 +/- 8.38 and MAP 93.64 +/- 9.44 mmHg. The pulse rate was 77.3 +/- 12.6 beats per minute. Except for the MAP (p = 0.025) there was no significant correlation between different IOP values and systolic or diastolic blood pressure, or pulse rate. CONCLUSIONS: NT-4000 is able to differentiate IOP values when synchronized with the cardiac rhythm and those differences are expected to be within a range of +/-2.5 to +/- 3.0 mmHg. IOP_B seems to be the parameter whose value differs from the non-synchronized and the remaining synchronized parameters in a significant way. Other than a weak association with MAP, no significant correlation between IOP and BP was found. The measurements of IOP readings for the three modes are consistent with timings during the cardiac cycle and IOP pulse cycle.     

高眼压状态下青光眼手术的临床观察

目的探讨高眼压状态下青光眼手术方法的安全性和效果。方法对32例药物降压无效的青光眼患者进行青光眼手术,术后观察出血、滤过泡、前房、眼压及视力的变化。结果术后1月视力提高的21只眼(65.63%);保持不变的11只眼(34.38%);眼压术后≤21mmHg者28只眼(87.5%);用药物控制的4只眼(12.5%)。结论高眼压状态采取手术治疗是安全有效的。     

正常眼压性青光眼确诊时各指标间病变程度的关系

目的　考察正常眼压性青光眼 (normalpressureglaucoma ,NPG)患者确诊时的临床表现 ,探讨各指标间病变程度的关系。方法　 10 5例NPG患者 ,分析眼压曲线的平均状态、波动幅度和双眼对称性 ,观察视野和眼底C/D垂直径比值、盘沿缩窄和视网膜神经纤维层 (RNFL)改变。结果　眼压曲线双眼对称 ,总体波动水平位于 16mmHg上下 ,最高值在 10AM ,最低值在 10PM ,但10PM最低值高于年龄可比的正常人群的平均眼压 (P <0 0 1)。单值眼压分布位于 10～ 2 1mmHg ,峰值与谷值相差约 4mmHg。视野在 5 5例患者为单眼损害 ,在 14 9眼的视野损害中 ,绝大多数损害形态和部位与眼压升高的原发性开角型青光眼 (hp -POAG)相符合 ,但旁中心损害侵入中心固视区者约占 2 2 % ,而在轻度损害中约占 1/3。眼底C/D值右眼为 0 77± 0 15 ,左眼为 0 71± 0 16,二者均大于一般群体上限和早期hp -POAG患者的C/D值 (P <0 0 1) ,但在不同程度损害的视野中差异不显著 (P >0 10 ) ,盘沿缩窄和RNFL缺损的发生率分别为 5 0 %以上和 60 %以上 ,二者差异不显著 (P>0 0 5 )。结论　NPG患者的眼压在绝对值、波动幅度和双眼对称性上均与正常眼压各指标相一致 ,对诊断无定性价值。确诊时眼底C/D值大于早期hp -POAG的C/D值 ,盘沿缩窄和RNFL缺损的     

伴虹膜异色的青光眼睫状体炎综合征

目的　观察青光眼睫状体炎综合征的临床表现及体征 ,探讨伴有虹膜异色的青光眼睫状体炎综合征的临床表现及其预后。方法　青光眼睫状体炎综合征 3 9例 41只眼 ,男 2 5例 ,女 14例 ;年龄 2 8～ 5 4岁 (3 8 3± 10 3 3岁 )。观察眼压、KP、前房、虹膜、眼底及视野等。发作期每 3～ 7天复查一次 ,间歇期 3～ 6月复查一次。随诊时间 5月～ 10年。结果　 3 9例 41眼青睫综合征患者中 ,2例系双眼患病 ;7例 7只眼先后出现青光眼视杯扩大及视野缺损 ,其中 5例伴轻度虹膜异色 ,1例伴有高度近视 ,另有 1例未见其它异常。 5例伴虹膜异色的患者除视杯扩大和视野缺损外 ,其中 1例后期眼压持续升高 ,并最终失明。结论　青睫综合征为一病因不明的复杂的眼部综合征 ,其过程及转归并非完全“良性” ,特别是同时伴有虹膜异色等其它眼部异常者。     

Chitosan-Gelatin Hydrogel Crosslinked With Oxidized Sucrose for the Ocular Delivery of Timolol Maleate

Ocular hypertension due to increased intraocular pressure is a major risk factor for the development of glaucoma. Rapid clearance and low ocular bioavailability are drawbacks of conventional ocular treatments. This requires frequent and long-term application of antiglaucoma drugs which in turn cause local side effects and are a major cause of therapeutic failure due to loss of persistence in using glaucoma therapy. In this study, a semisynthetic, biocompatible, oxidized sucrose crosslinker was developed and used in the formulation of chitosan-gelatin hydrogel for the sustained release of timolol to control ocular hypertension. The swelling properties of the hydrogel showed a strong relationship with the oxidized sucrose concentration. Mucoadhesive properties of the hydrogel were studied and the in vitro release profiles demonstrated that crosslinking with oxidized sucrose reduced the release rate of the entrapped timolol. The results of both in vitro and in vivo studies supported that the formulated hydrogel maintained the release and in turn the efficacy of timolol for a longer period of time compared to the conventional eye drops. This is expected to reduce the frequency of drug application onto the eye surface and in turn enhances patients’ convenience. In conclusion, the developed formulation represents a promising platform for an effective and compliant treatment of ocular hypertension.     

准分子激光原位角膜磨镶术后角膜中央和周边眼压的检查方法及其临床意义

目的 探索准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK）后角膜中央眼压和周边眼压测量的有效性、可靠性及临床意义.方法 LASIK术前、术后1周、术后1个月使用非接触性眼压计对26名患者的52眼的角膜中央眼压和角膜周边眼压进行测量,采用配对t检验比较术后1周、术后1个月与术前眼压的关系,采用Pearson相关分析角膜切削深度与眼压变化的关系.结果 术后1周和1个月中央角膜的眼压分别下降（6.425±2.544）mmHg（1 mmHg=0.133 kPa）和（5.752±3.863）mmHg,周边眼压在术后1周下降（0.921±2.054）mmHg,与术前相比差异有统计学意义（P＜0.01）.术后1个月周边眼压下降（0.158±2.979）mmHg,与术前相比差异无统计学意义（P〉0.05）.角膜切屑深度与术后中央眼压的改变有线性相关（P＜0.05）,但与周边角膜眼压改变无关（P〉0.05）.结论 周边眼压的测量值更接近于实际眼内压值,故LASIK术后测量周边眼压值更为精确和可靠.     

葛根素滴眼液对家兔眼内压的作用

０．５％和１．０％葛根素滴眼液对由眼球结膜下注射地塞米松引起的家兔眼高压模型有降低眼内压（ＩＯＰ）的作用，作用强度和药物浓度之间有相关性。１．０％葛根素滴眼液与０．５％噻吗洛尔滴眼液相比，降ＩＯＰ的趋势相似。但在维持低ＩＯＰ的作用方面，用药后６ｈ后者优于前者；２４ｈ则前者优于后者。０．５％和１．０％葛根素滴眼液均对兔耳缘静脉快速注射葡萄糖而引起的眼压升高有抑制作用。与０．５％噻吗洛尔滴眼液相比作用相似。     

Assessing intraocular pressure by rebound tonometer in rats with an air-filled anterior chamber

Purpose  To compare rebound tonometer and cannulation as methods for measuring intraocular pressure (IOP) in rats. Methods  The accuracy of the TonoLab rebound tonometer was determined in eight cannulated rat eyes. IOP was manipulated by changing air pressure from 20 to 100 mmHg at 10-mmHg intervals, and the IOP was measured with the rebound tonometer at each level. The average value of three repeated pressure readings was recorded. Correlation analysis and comparison with the Bland and Altman method were performed. The intraclass correlation coefficient was calculated to assess intraoperator variability. Results  The IOP values measured with the TonoLab rebound tonometer were well correlated with the actual IOP (r ² = 0.963, P = 0.01). The mean of the difference between the rebound tonometer and actual (cannulation) IOP was 7.41 ± 7.87%. The intraclass correlation coefficient was 0.9, indicating low intraoperator variability. Conclusions  The rebound tonometer showed high accuracy and reliability for IOP measurement in rat eyes.