青光眼是一种由于眼内压(intraocular pressure,IOP)升高致使视神经萎缩和视野缺损的疾病,是全球范围内主要致盲性眼病之一,也是中重度视力损害(moderate and severe vision impairment,MSVI)的第四大致盲原因[1]。原发性青光眼是最常...青光眼是一种由于眼内压(intraocular pressure,IOP)升高致使视神经萎缩和视野缺损的疾病,是全球范围内主要致盲性眼病之一,也是中重度视力损害(moderate and severe vision impairment,MSVI)的第四大致盲原因[1]。原发性青光眼是最常见的类型,因其发病机制的不同,可分为原发性闭角型青光眼(primary angle closure glaucoma,PACG)和原发性开角型青光眼(primary open angle glaucoma,POAG)。展开更多
AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized betwee...AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized between July 2024 and January 2025.Clinical data were collected,including medical history,best-corrected visual acuity(BCVA),intraocular pressure(IOP),slit-lamp examination,gonioscopic findings,and fundus examination.Demographic characteristics,etiological factors,and treatment modalities were analyzed.RESULTS:A total of 67 patients(82 eyes)were enrolled,aged 7 to 90y.Males accounted for 54.0%(36/67),and 22.4%(15/67)of patients had bilateral involvement.The predominant etiologies of SG were neovascular glaucoma(NVG;25.4%),traumatic glaucoma(23.9%),uveitic glaucoma(20.9%),and lens-induced glaucoma(14.9%),collectively accounting for 85.1%of all cases.The peak age-specific incidence occurred in the 50-59 years age group(32.8%,22/67),while NVG was prevalent across the 40-79 years age range.IOP of the 82 affected eyes was stratified into five severity tiers:22-29 mm Hg(15 eyes,18.3%),30-39 mm Hg(14 eyes,17.1%),40-49 mm Hg(13 eyes,15.9%),50-59 mm Hg(20 eyes,24.4%),and≥60 mm Hg(20 eyes,24.4%).The overall mean IOP was 45.2±12.3 mm Hg,indicating a significant pathological elevation.Surgical intervention was required in 46.3%of cases,predominantly for NVG,lensinduced glaucoma,and traumatic glaucoma—conditions prone to rapid IOP elevation.The etiologies with the highest surgical intervention rates were malignant glaucoma,pigmentary glaucoma,lens-induced glaucoma,and NVG.In contrast,uveitic glaucoma cases were primarily managed with targeted anti-inflammatory therapy,which effectively controlled IOP in the early disease stages and potentially obviated the need for surgery.CONCLUSION:This study identifies NVG,traumatic glaucoma,uveitic glaucoma,and lens-induced glaucoma as the four leading etiologies of SG in Northwestern China.These findings emphasize the critical need for targeted prevention strategies and evidence-based health education programs among high-risk populations.Implementation of such initiatives will improve early detection,enable ophthalmologists to deliver timely therapeutic interventions,and ultimately reduce preventable vision loss in this region.展开更多
AIM:To evaluate long-term visual field(VF)prediction using K-means clustering in patients with primary open angle glaucoma(POAG).METHODS:Patients who underwent 24-2 VF tests≥10 were included in this study.Using 52 to...AIM:To evaluate long-term visual field(VF)prediction using K-means clustering in patients with primary open angle glaucoma(POAG).METHODS:Patients who underwent 24-2 VF tests≥10 were included in this study.Using 52 total deviation values(TDVs)from the first 10 VF tests of the training dataset,VF points were clustered into several regions using the hierarchical ordered partitioning and collapsing hybrid(HOPACH)and K-means clustering.Based on the clustering results,a linear regression analysis was applied to each clustered region of the testing dataset to predict the TDVs of the 10th VF test.Three to nine VF tests were used to predict the 10th VF test,and the prediction errors(root mean square error,RMSE)of each clustering method and pointwise linear regression(PLR)were compared.RESULTS:The training group consisted of 228 patients(mean age,54.20±14.38y;123 males and 105 females),and the testing group included 81 patients(mean age,54.88±15.22y;43 males and 38 females).All subjects were diagnosed with POAG.Fifty-two VF points were clustered into 11 and nine regions using HOPACH and K-means clustering,respectively.K-means clustering had a lower prediction error than PLR when n=1:3 and 1:4(both P≤0.003).The prediction errors of K-means clustering were lower than those of HOPACH in all sections(n=1:4 to 1:9;all P≤0.011),except for n=1:3(P=0.680).PLR outperformed K-means clustering only when n=1:8 and 1:9(both P≤0.020).CONCLUSION:K-means clustering can predict longterm VF test results more accurately in patients with POAG with limited VF data.展开更多
AIM:To study the relationships between amplitude of low-frequency fluctuations(ALFF)changes and clinical ophthalmic parameters in patients with primary open angle glaucoma(POAG)and analyze the diagnostic value of ALFF...AIM:To study the relationships between amplitude of low-frequency fluctuations(ALFF)changes and clinical ophthalmic parameters in patients with primary open angle glaucoma(POAG)and analyze the diagnostic value of ALFF.METHODS:Twenty-four POAG patients and 24 healthy controls(HCs)underwent resting-state functional magnetic resonance imaging(rs-fMRI).Nonparametric rank-sum tests were used to compare the ALFF values in the slow-4 and slow-5 bands,and Spearman or Pearson correlation analysis was used to assess the correlation between ALFF changes and clinical ophthalmic parameters in POAG patients.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic performance of the ALFF.RESULTS:There were 16 males in POAG patients(median age 48y)and 12 males in HCs(median age 39y).Compared with HCs,POAG patients presented increased or decreased ALFF values in different brain regions,and similar changes were observed in mild POAG patients.The ALFF values were correlated with retinal nerve fiber layer(RNFL)thickness,inner limiting membrane-retinal pigment epithelium thickness changes and the degree of visual field defects.Analysis of the diagnostic value of the ALFF via ROC curves revealed that the right medial frontal gyrus[area under the curve(AUC)=0.9063]and superior frontal gyrus(AUC=0.9097)had better diagnostic value than did the optic disc area(AUC=0.8019),visual field index(VFI%,AUC=0.8988)and macular parameters.CONCLUSION:POAG patients present altered cortical function that is significantly correlated with the optic nerve and retinal thickness and had good diagnostic value,which may reflect the underlying neuropathological mechanism of POAG.展开更多
文摘青光眼是一种由于眼内压(intraocular pressure,IOP)升高致使视神经萎缩和视野缺损的疾病,是全球范围内主要致盲性眼病之一,也是中重度视力损害(moderate and severe vision impairment,MSVI)的第四大致盲原因[1]。原发性青光眼是最常见的类型,因其发病机制的不同,可分为原发性闭角型青光眼(primary angle closure glaucoma,PACG)和原发性开角型青光眼(primary open angle glaucoma,POAG)。
基金Supported by the National Natural Science Foundation of China(No.82070964,No.82571210)Shaanxi Science Fund for Distinguished Young Scholars(No.2022JC-60)+3 种基金the International Scientific and Technological Cooperation Projects(No.2024GH-YBXM-20)the Open Research Funds of the State Key Laboratory of Ophthalmology(No.83000-32030002)Education Department of Shaanxi Provincial Government for Youth Innovation Team Research Program Project(No.23JP151,No.23JP150)General Projects of Hospital-level Research Topics in the Second Affiliated Hospital of Xi’an Medical University(No.22KY0111).
文摘AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized between July 2024 and January 2025.Clinical data were collected,including medical history,best-corrected visual acuity(BCVA),intraocular pressure(IOP),slit-lamp examination,gonioscopic findings,and fundus examination.Demographic characteristics,etiological factors,and treatment modalities were analyzed.RESULTS:A total of 67 patients(82 eyes)were enrolled,aged 7 to 90y.Males accounted for 54.0%(36/67),and 22.4%(15/67)of patients had bilateral involvement.The predominant etiologies of SG were neovascular glaucoma(NVG;25.4%),traumatic glaucoma(23.9%),uveitic glaucoma(20.9%),and lens-induced glaucoma(14.9%),collectively accounting for 85.1%of all cases.The peak age-specific incidence occurred in the 50-59 years age group(32.8%,22/67),while NVG was prevalent across the 40-79 years age range.IOP of the 82 affected eyes was stratified into five severity tiers:22-29 mm Hg(15 eyes,18.3%),30-39 mm Hg(14 eyes,17.1%),40-49 mm Hg(13 eyes,15.9%),50-59 mm Hg(20 eyes,24.4%),and≥60 mm Hg(20 eyes,24.4%).The overall mean IOP was 45.2±12.3 mm Hg,indicating a significant pathological elevation.Surgical intervention was required in 46.3%of cases,predominantly for NVG,lensinduced glaucoma,and traumatic glaucoma—conditions prone to rapid IOP elevation.The etiologies with the highest surgical intervention rates were malignant glaucoma,pigmentary glaucoma,lens-induced glaucoma,and NVG.In contrast,uveitic glaucoma cases were primarily managed with targeted anti-inflammatory therapy,which effectively controlled IOP in the early disease stages and potentially obviated the need for surgery.CONCLUSION:This study identifies NVG,traumatic glaucoma,uveitic glaucoma,and lens-induced glaucoma as the four leading etiologies of SG in Northwestern China.These findings emphasize the critical need for targeted prevention strategies and evidence-based health education programs among high-risk populations.Implementation of such initiatives will improve early detection,enable ophthalmologists to deliver timely therapeutic interventions,and ultimately reduce preventable vision loss in this region.
基金Supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),the Ministry of Health&Welfare,Republic of Korea(No.RS-2020-KH088726)the Patient-Centered Clinical Research Coordinating Center(PACEN),the Ministry of Health and Welfare,Republic of Korea(No.HC19C0276)the National Research Foundation of Korea(NRF),the Korea Government(MSIT)(No.RS-2023-00247504).
文摘AIM:To evaluate long-term visual field(VF)prediction using K-means clustering in patients with primary open angle glaucoma(POAG).METHODS:Patients who underwent 24-2 VF tests≥10 were included in this study.Using 52 total deviation values(TDVs)from the first 10 VF tests of the training dataset,VF points were clustered into several regions using the hierarchical ordered partitioning and collapsing hybrid(HOPACH)and K-means clustering.Based on the clustering results,a linear regression analysis was applied to each clustered region of the testing dataset to predict the TDVs of the 10th VF test.Three to nine VF tests were used to predict the 10th VF test,and the prediction errors(root mean square error,RMSE)of each clustering method and pointwise linear regression(PLR)were compared.RESULTS:The training group consisted of 228 patients(mean age,54.20±14.38y;123 males and 105 females),and the testing group included 81 patients(mean age,54.88±15.22y;43 males and 38 females).All subjects were diagnosed with POAG.Fifty-two VF points were clustered into 11 and nine regions using HOPACH and K-means clustering,respectively.K-means clustering had a lower prediction error than PLR when n=1:3 and 1:4(both P≤0.003).The prediction errors of K-means clustering were lower than those of HOPACH in all sections(n=1:4 to 1:9;all P≤0.011),except for n=1:3(P=0.680).PLR outperformed K-means clustering only when n=1:8 and 1:9(both P≤0.020).CONCLUSION:K-means clustering can predict longterm VF test results more accurately in patients with POAG with limited VF data.
基金Supported by National Natural Science Foundation of China(No.82260203).
文摘AIM:To study the relationships between amplitude of low-frequency fluctuations(ALFF)changes and clinical ophthalmic parameters in patients with primary open angle glaucoma(POAG)and analyze the diagnostic value of ALFF.METHODS:Twenty-four POAG patients and 24 healthy controls(HCs)underwent resting-state functional magnetic resonance imaging(rs-fMRI).Nonparametric rank-sum tests were used to compare the ALFF values in the slow-4 and slow-5 bands,and Spearman or Pearson correlation analysis was used to assess the correlation between ALFF changes and clinical ophthalmic parameters in POAG patients.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic performance of the ALFF.RESULTS:There were 16 males in POAG patients(median age 48y)and 12 males in HCs(median age 39y).Compared with HCs,POAG patients presented increased or decreased ALFF values in different brain regions,and similar changes were observed in mild POAG patients.The ALFF values were correlated with retinal nerve fiber layer(RNFL)thickness,inner limiting membrane-retinal pigment epithelium thickness changes and the degree of visual field defects.Analysis of the diagnostic value of the ALFF via ROC curves revealed that the right medial frontal gyrus[area under the curve(AUC)=0.9063]and superior frontal gyrus(AUC=0.9097)had better diagnostic value than did the optic disc area(AUC=0.8019),visual field index(VFI%,AUC=0.8988)and macular parameters.CONCLUSION:POAG patients present altered cortical function that is significantly correlated with the optic nerve and retinal thickness and had good diagnostic value,which may reflect the underlying neuropathological mechanism of POAG.
