Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour inter...Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour intervals for 48 h. Based on the results of the serial lOP measurements, optic disc changed and visual field defected, the patients were diagnosed as primary OAG （ POAG ）, normal tension glaucoma （NTG）, ocular hypertension （ OHT） , or physiologic cup （PC）. Results After the serial lOP measurements, 16. 7% of the suspected OAG patients were diagnosed as POAG, 32. 4% as NTG, 24. 5% as OHT, and 26. 4% as PC. The highest percentages of the POAG group had peak lOP at 8 AM （19. 4% ） and their trough lOP at 10 PM （27. 8% ） ; the NTG group had peak lOP at 12 AM （18. 6% ） and their trough lOP at 12 PM （22. 9% ） ; the OHT group had peak lOP at 4 AM （22. 6% ） and their trough lOP at 10 PM （26. 4% ） ; and the PC group had peak lOP at 4 AM （ 21. 1% ） and their trough lOP at 12 PM （ 21. 1% ）. The percentages of peak lOP outside clinic （ 8 AM - 4 PM） in the POAG, NTG, OHT and PC groups were 55. 6%, 50. 0%, 58. 4% and 45. 7%, respectively. The mean magnitude of variance was 5. 1 - 6. 7 mmHg in those suspected OAG patients. There was a strong positive correlation in lOP between both eyes at each time point of measurement and the variation curves of the right and left eyes had parallel profiles in those suspected OAG patients. Conclusion Serial measurement of lOP is still needed, in order not to miss the peak and the trough lOP readings in suspected OAG patients, which helps in better management of glaucoma.展开更多
AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glauc...AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.展开更多
AIM： To evaluate the use of short-duration transient visual evoked potentials（VEP） and color reflectivity discretization analysis（CORDA） in glaucomatous eyes,eyes suspected of having glaucoma,and healthy eyes.MET...AIM： To evaluate the use of short-duration transient visual evoked potentials（VEP） and color reflectivity discretization analysis（CORDA） in glaucomatous eyes,eyes suspected of having glaucoma,and healthy eyes.METHODS： The study included 136 eyes from 136 subjects： 49 eyes with glaucoma,45 glaucoma suspect eyes,and 42 healthy eyes.Subjects underwent Humphrey visual field（VF） testing,VEP testing,as well as peripapillary retinal nerve fiber layer optical coherence tomography imaging studies with post-acquisition CORDA applied.Statistical analysis was performed using means and ranges,ANOVA,post-hoc comparisons using Turkey＇s adjustment,Fisher＇s Exact test,area under the curve,and Spearman correlation coefficients.RESULTS： Parameters from VEP and CORDA correlated significantly with VF mean deviation（MD）（P〈0.05）.In distinguishing glaucomatous eyes from controls,VEP demonstrated area under the curve（AUC） values of 0.64-0.75 for amplitude and 0.67-0.81 for latency.The CORDA HR1 parameter was highly discriminative for glaucomatous eyes vs controls（AUC=0.94）.CONCLUSION： Significant correlations are found between MD and parameters of short-duration transient VEP and CORDA,diagnostic modalities which warrant further consideration in identifying glaucoma characteristics.展开更多
AIM:To compare the intraocular pressure(IOP)peaks and fluctuations using water drinking tests(WDTs)and mean diurnal IOP among Filipino patients with normal eyes and glaucoma suspectsMETHODS:This prospective study incl...AIM:To compare the intraocular pressure(IOP)peaks and fluctuations using water drinking tests(WDTs)and mean diurnal IOP among Filipino patients with normal eyes and glaucoma suspectsMETHODS:This prospective study included normal and glaucoma suspect patients.Each patient underwent both WDT and mean diurnal examination on separate visits.For mean diurnal examination,IOP was recorded every 2 h for 8 h while in WDT,IOP was recorded prior to WDT,and postWDT at 5,15,30,45,and 60 min.IOP peak was recorded as the highest IOP for both methods,and IOP fluctuation was recorded as highest IOP minus lowest IOP.RESULTS:With the comparison of diagnostic tests,both normal eyes and glaucoma suspect groups,the peak IOP was caught at 15 min.Comparative analysis of both groups also showed that the peak IOP measurements were statistically higher for the WDT compared to mean diurnal IOP(P=0.039,P=0.048 under normal group and P=0.032 and P=0.031 under glaucoma suspect group).Similarly,the WDT had a statistically higher mean IOP fluctuation score than the mean diurnal IOP method in both groups(P=0.003,P=0.011 under normal group;P=0.002 and P=0.005 under glaucoma suspect group).CONCLUSION:This study shows that WDT is a comparable diagnostic exam in predicting IOP fluctuations than mean diurnal measurement.WDT is a promising diagnostic procedure for risk assessment in glaucoma.展开更多
AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current resea...AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.展开更多
Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central n...Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central nervous system,microglia play a dual function in the progression of glaucoma.Under standard physiological states,microglia safeguard the retina by offering neurotrophic support and removing cellular debris.In the pathological progression of glaucoma,microglia become activated and release significant levels of inflammatory factors,resulting in retinal ganglion cell injury,cell death,and impaired neuroregeneration.This review focuses on examining the dual functions of microglia in glaucoma,evaluating their influence on retinal neurodegeneration and repair,and suggesting that modulating microglial activity could serve as a promising therapeutic strategy.Understanding the mechanisms of microglial action in glaucoma is crucial for unveiling the complex pathophysiological processes of the disease and developing new therapeutic strategies.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 identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on diseas...AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on disease progression status.Tear samples were collected for proteomic analysis.Dataindependent acquisition(DIA)mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression.Additionally,differentially expressed proteins(DEPs)were evaluated using mediating effect models and receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 19 patients(20 eyes)with NTG participated in this study,including 10 patients(4 males and 6 females;10 eyes)in the progression group with mean age of 67.70±9.03y and 10 patients(4 males and 6 females;10 eyes)in the non-progression group with mean age of 68.60±7.58y.A total of 158 significantly differentially expressed proteins were detected.UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis.Gene Ontology(GO)enrichment analysis revealed functional clusters related to cellular processes.Weighted gene coexpression network analysis(WGCNA)indicated that the core proteins were primarily involved in the neurodegenerationmultiple diseases pathway and cellular processes.Mediating effect analysis identified PRDX4(L)as a potential protein biomarker.ROC curve analysis showed that GNAI1 had the largest area under the curve(AUC=0.889).CONCLUSION:This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients,including PRDX4(L).PRDX4(L)plays a key role in oxidative stress.展开更多
AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions fo...AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies.METHODS:A systematic search was conducted in the Web of Science Core Collection(WoSCC)database to retrieve relevant literature published from January 1,2000,to August 31,2025(data accessed on September 12,2025).Multiple data visualization tools were employed to conduct in-depth analyses of the included publications,covering aspects such as publication quantity and quality,evolutionary trends of research hotspots,keyword cooccurrence networks,and collaborative patterns among countries/regions,institutions,and authors.RESULTS:A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC.The analysis showed that the USA had the highest research output in this field(29.04%,n=982),followed by China(18.40%,n=622)and UK(6.01%,n=203).Based on citation frequency and burst intensity,the USA also ranked as the most influential country.Baudouin C and Sun X were identified as the most productive authors,while Journal of Glaucoma and Investigative Ophthalmology&Visual Science were the journals with the highest number of published relevant articles.Additionally,keyword analysis revealed that“neuroinflammation”,“retinal ganglion cells(RGCs)”,“pathophysiology”,and“traditional Chinese medicine”are emerging research hotspots in the field of immuneinflammatory responses in glaucoma.CONCLUSION:This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation,indicating that this field has received extensive scientific attention with a steady upward trend in research activity.Furthermore,it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.展开更多
AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and ...AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.展开更多
Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activat...Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activated microglia mediates the crosstalk between Müller cells and microglia and impacts RGC injury in a chronic ocular hypertension(COH)glaucoma model.In COH retinas,elevated TNF-αinduced the activation of Müller cells and microglia,and recruited microglia to the ganglion cell layer.Co-culture with Müller cells enhanced TNF-α-induced microglial activation,migration,and proliferation.Both in vivo and in vitro experiments confirmed that chemokine C-C motif ligand 2(CCL2),primarily released from Müller cells,mediated the TNF-α-induced effects on microglia in COH retinas.Knockdown of CCL2 attenuated RGC damage and vision loss.Our results demonstrate that TNF-αreleased from microglia induces the secretion of CCL2 from Müller cells,thus inducing microglial activation and migration,exacerbating retinal neuroinflammation and RGC injury in glaucoma.展开更多
Glaucoma is characterized by chronic progressive optic nerve damage and retinal ganglion cell death.Although extensive research has been conducted on neuroprotection for retinal ganglion cells,there is still no treatm...Glaucoma is characterized by chronic progressive optic nerve damage and retinal ganglion cell death.Although extensive research has been conducted on neuroprotection for retinal ganglion cells,there is still no treatment for clinical use.Recent evidence shows that extracellular vesicles isolated from a variety of stem cells are efficacious in retinal ganglion cell neuroprotection.In this study,we tested the novel extracellular vesicle source of the retinal progenitor R-28 cell line in vitro and in vivo.We isolated and characterized extracellular vesicles from R-28 cells and tested their therapeutic efficacy in terms of retinal ganglion cell survival in vitro and in an in vivo glaucoma model,measuring retinal ganglion cell survival and preservation of their axons.Additionally,we tested extracellular vesicles for their neuroprotective capacity in retinal ganglion cells differentiated from human embryonic stem cells.Finally,we investigated miRNA changes in retinal ganglion cells with R-28 extracellular vesicle treatment,and predicted possible pathways that may be modulated.R-28 extracellular vesicles improved retinal ganglion cell survival but failed to preserve axons significantly.Moreover,the results also illustrated the neuroprotection of R-28 extracellular vesicles on human retinal ganglion cells.Finally,we also showed changes in hsa-miRNA-4443,hsa-miRNA-216a-5p,hsa-let-7e-5p,hsa-miRNA-374b-5p,hsa-miRNA-331-3p,and hsa-miRNA-421 expressions,which may have neuroprotective potential on retinal ganglion cell degeneration.This study will pave the way for miRNA and extracellular vesicle-based neuroprotective therapies for glaucoma.展开更多
AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:...AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:Totally 716 eyes of 716 patients with primary open angle glaucoma(POAG)with at least 5 reliable 24-2 test results and 2y of follow-up were selected.The functional GEE model was used to detect perimetric progression in the training dataset(501 eyes).In the testing dataset(215 eyes),progression was evaluated the functional GEE model,mean deviation(MD)and visual field index(VFI)rates of change,Advanced Glaucoma Intervention Study(AGIS)and Collaborative Initial Glaucoma Treatment Study(CIGTS)scores,and pointwise linear regression(PLR).RESULTS:The proposed method showed the highest proportion of eyes detected as progression(54.4%),followed by the VFI rate(34.4%),PLR(23.3%),and MD rate(21.4%).The CIGTS and AGIS scores had a lower proportion of eyes detected as progression(7.9%and 5.1%,respectively).The time to detection of progression was significantly shorter for the proposed method than that of other algorithms(adjusted P≤0.019).The VFI rate displayed moderate pairwise agreement with the proposed method(k=0.47).CONCLUSION:The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.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
Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of n...Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of neurodegenerative diseases with glaucoma being highly prevalent.Glaucoma is characterized by the progressive dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve.It is the leading cause of irreversible vision loss and affects an estimated 80 million people.The mammalian central nervous system is non-regenerative and,once lost or injured,retinal ganglion cells cannot regenerate an axon into the optic nerve under basal conditions.Thus,strategies that provide neuroprotection to stressed,dysfunctional,or dying retinal ganglion cells are likely to be of high therapeutic and translational value.Advancing age,genetics,and elevated intraocular pressure are all major risk factors for glaucoma,however,all clinically available glaucoma treatments focus on intraocular pressure management and do not directly address the neurodegenerative component of glaucoma.展开更多
Dear Editor,We reported a Chinese family carrying a novel Crumbs homologue 1(CRB1)variant(c.1737_1755del).Consanguineous marriage resulted in a homozygous mutation,leading to the onset of Leber congenital amaurosis(LC...Dear Editor,We reported a Chinese family carrying a novel Crumbs homologue 1(CRB1)variant(c.1737_1755del).Consanguineous marriage resulted in a homozygous mutation,leading to the onset of Leber congenital amaurosis(LCA)in their offspring.展开更多
AIM:To explore the mechanical indices used for differential diagnosis and to investigate the relationship between ocular biomechanics and glaucoma severity within each group.METHODS:This cross-sectional study included...AIM:To explore the mechanical indices used for differential diagnosis and to investigate the relationship between ocular biomechanics and glaucoma severity within each group.METHODS:This cross-sectional study included 185 eyes from 185 subjects:62 normal controls,91 hightension glaucoma(HTG),and 32 normal-tension glaucoma(NTG)patients.All participants underwent a comprehensive ophthalmic examination that involved ocular biomechanical measurements.Glaucoma severity was assessed using visual field index(VFI),mean deviation(MD),pattern standard deviation(PSD)and retinal nerve fiber layer(RNFL)thickness.Multivariable models were used to compare fifteen biomechanical parameters among the three groups adjusting for age,gender,intraocular pressure(IOP),central corneal thickness(CCT),and axial length(AL).The generalized linear model was utilized for multifactor comparison.RESULTS:Significant differences in first applanation time(AT1),highest concavity time(HC time),stress strain index(SSI),and HC deflection were found among the three groups(P<0.05).AT1 was significantly higher in the HTG group compared to controls(P<0.05),and SSI was higher in HTG than NTG(P<0.05).HC deflection in the HTG group was significantly smaller than in NTG(P<0.05).Furthermore,AT1 levels were observed to be significantly higher in primary open angle glaucoma(POAG)patients compared to controls(P<0.05).Receiver operating charactristic(ROC)analysis showed HC deflection had an area under the curve(AUC)of 0.802 between HTG and NTG.A negatively significant correlation was observed between SSI and VFI in POAG patients.CONCLUSION:Biomechanical analysis reveals that corneas in POAG patients are stiffer than normal controls,with increased corneal stiffness correlating with more severe glaucomatous damage.Interestingly,stiffer corneas in NTG patients appeares protective.In addition,HC deflection may be useful for differentiating HTG and NTG.展开更多
AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 ...AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023.These participants then completed a general information questionnaire and the Decision Conflict Scale.Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.RESULTS:The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01,with 99.1%of these individuals reporting experiencing decisional conflict.Multiple linear regression analysis revealed that females(P=0.002)and patients with a shorter duration of the disease(P=0.006)had higher levels of decisional conflict.Additionally,patients diagnosed during medical visits(P=0.049),those who refused LPI treatment(P=0.032),and individuals facing significant economic burdens related to medical expenses(P=0.005)exhibited higher levels of decisional conflict.Furthermore,patients who preferred to make medical decisions independently(P=0.023)and those who favored involving family members in decisionmaking(P=0.005)experienced increased levels of decisional conflict.CONCLUSION:Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict.Healthcare professionals should thoroughly assess a range of factors that influence this conflict,including gender,duration of disease,method of diagnosis acquisition,LPI treatment,economic burden of medical expenses,and patient preferences regarding medical decision-making.By considering these variables,tailored decision support can be developed to address individual patient needs,ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.展开更多
AIM:To evaluate the efficacy and safety of microcatheterassisted 360-degree trabeculotomy combined with trabeculectomy(MATT-Trab)for treating refractory glaucoma.METHODS:Patients with refractory glaucoma who underwent...AIM:To evaluate the efficacy and safety of microcatheterassisted 360-degree trabeculotomy combined with trabeculectomy(MATT-Trab)for treating refractory glaucoma.METHODS:Patients with refractory glaucoma who underwent MATT-Trab were retrospectively examined.Efficacy indicators for research statistics included the intraocular pressure(IOP)level,degree of decrease,changes in medication dosage,and success rate.Safety indicators included the best-corrected visual acuity and incidence of complications.RESULTS:This study comprised 31 patients,including 11 males and 20 females,with ages ranging from 8mo to 67y(mean age:29.40±22.10y).The average postoperative IOP at 1d,1wk,1mo,3mo,6mo,1y,and the last followup was significantly lower than the average preoperative IOP(31.33±9.24 mm Hg,P<0.05).The average number of postoperative medications at 1y was 0.48±1.51,which was significantly reduced compared to that used preoperatively(3.77±0.99,P=0.00).The absolute and qualified success rates were 45.16% and 83.87%,respectively.Visual acuity exhibited no statistically significant difference between the postoperative and preoperative follow-up time points,except for the first day after surgery.The most common postoperative complications were anterior chamber hemorrhage(25 cases,86.21%)and high IOP(10 cases,34.48%).CONCLUSION:Our results indicate that MATT-Trab is effective and safe for treating refractory glaucoma.展开更多
AIM:To assess the effect of the coronavirus disease 2019(COVID-19)pandemic on the wait times and severity of surgical glaucoma cases in a single tertiary referral center in Quebec,Canada.METHODS:Preoperative severity ...AIM:To assess the effect of the coronavirus disease 2019(COVID-19)pandemic on the wait times and severity of surgical glaucoma cases in a single tertiary referral center in Quebec,Canada.METHODS:Preoperative severity data included mean visual field(VF)deficit,intraocular pressure(IOP),the number of topical glaucoma medication classes,and preoperative best corrected visual acuity(BCVA).The times from referral to procedure(referral time)and from listing date to procedure(waitlisting time)were calculated.RESULTS:This retrospective cohort study involved 181 eyes of patients undergoing glaucoma surgery from March 1 to June 30,2019(pre-pandemic period),and 201 eyes in the same timeframe in 2021(pandemic period)at Saint-Sacrement Hospital in Quebec City.There was no significant difference in the severity data of surgical glaucoma across both periods(VF deficit:P=0.48;IOP:P=0.14;BCVA:P=0.24;topical medication classes:P=0.27).The number of patients referred with oral glaucoma medication increased slightly from 45 to 70 in 2019 and 2021 respectively(P=0.08).Delay data were also comparable.Mean referral time was 122±120d in 2019 versus 144±136d in 2021(P=0.09),whereas waitlisting time before the pandemic was 43±44.5 versus 39±41.8d in 2021(P=0.13).CONCLUSION:Despite North America’s strictest pandemic restrictions,limited negative impact is observed on waitlisting delays and the severity of glaucoma cases presenting at our center.A larger subset of patients is treated with oral medications indicating a possible increase in advanced glaucoma.展开更多
文摘Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour intervals for 48 h. Based on the results of the serial lOP measurements, optic disc changed and visual field defected, the patients were diagnosed as primary OAG （ POAG ）, normal tension glaucoma （NTG）, ocular hypertension （ OHT） , or physiologic cup （PC）. Results After the serial lOP measurements, 16. 7% of the suspected OAG patients were diagnosed as POAG, 32. 4% as NTG, 24. 5% as OHT, and 26. 4% as PC. The highest percentages of the POAG group had peak lOP at 8 AM （19. 4% ） and their trough lOP at 10 PM （27. 8% ） ; the NTG group had peak lOP at 12 AM （18. 6% ） and their trough lOP at 12 PM （22. 9% ） ; the OHT group had peak lOP at 4 AM （22. 6% ） and their trough lOP at 10 PM （26. 4% ） ; and the PC group had peak lOP at 4 AM （ 21. 1% ） and their trough lOP at 12 PM （ 21. 1% ）. The percentages of peak lOP outside clinic （ 8 AM - 4 PM） in the POAG, NTG, OHT and PC groups were 55. 6%, 50. 0%, 58. 4% and 45. 7%, respectively. The mean magnitude of variance was 5. 1 - 6. 7 mmHg in those suspected OAG patients. There was a strong positive correlation in lOP between both eyes at each time point of measurement and the variation curves of the right and left eyes had parallel profiles in those suspected OAG patients. Conclusion Serial measurement of lOP is still needed, in order not to miss the peak and the trough lOP readings in suspected OAG patients, which helps in better management of glaucoma.
文摘AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.
文摘AIM： To evaluate the use of short-duration transient visual evoked potentials（VEP） and color reflectivity discretization analysis（CORDA） in glaucomatous eyes,eyes suspected of having glaucoma,and healthy eyes.METHODS： The study included 136 eyes from 136 subjects： 49 eyes with glaucoma,45 glaucoma suspect eyes,and 42 healthy eyes.Subjects underwent Humphrey visual field（VF） testing,VEP testing,as well as peripapillary retinal nerve fiber layer optical coherence tomography imaging studies with post-acquisition CORDA applied.Statistical analysis was performed using means and ranges,ANOVA,post-hoc comparisons using Turkey＇s adjustment,Fisher＇s Exact test,area under the curve,and Spearman correlation coefficients.RESULTS： Parameters from VEP and CORDA correlated significantly with VF mean deviation（MD）（P〈0.05）.In distinguishing glaucomatous eyes from controls,VEP demonstrated area under the curve（AUC） values of 0.64-0.75 for amplitude and 0.67-0.81 for latency.The CORDA HR1 parameter was highly discriminative for glaucomatous eyes vs controls（AUC=0.94）.CONCLUSION： Significant correlations are found between MD and parameters of short-duration transient VEP and CORDA,diagnostic modalities which warrant further consideration in identifying glaucoma characteristics.
文摘AIM:To compare the intraocular pressure(IOP)peaks and fluctuations using water drinking tests(WDTs)and mean diurnal IOP among Filipino patients with normal eyes and glaucoma suspectsMETHODS:This prospective study included normal and glaucoma suspect patients.Each patient underwent both WDT and mean diurnal examination on separate visits.For mean diurnal examination,IOP was recorded every 2 h for 8 h while in WDT,IOP was recorded prior to WDT,and postWDT at 5,15,30,45,and 60 min.IOP peak was recorded as the highest IOP for both methods,and IOP fluctuation was recorded as highest IOP minus lowest IOP.RESULTS:With the comparison of diagnostic tests,both normal eyes and glaucoma suspect groups,the peak IOP was caught at 15 min.Comparative analysis of both groups also showed that the peak IOP measurements were statistically higher for the WDT compared to mean diurnal IOP(P=0.039,P=0.048 under normal group and P=0.032 and P=0.031 under glaucoma suspect group).Similarly,the WDT had a statistically higher mean IOP fluctuation score than the mean diurnal IOP method in both groups(P=0.003,P=0.011 under normal group;P=0.002 and P=0.005 under glaucoma suspect group).CONCLUSION:This study shows that WDT is a comparable diagnostic exam in predicting IOP fluctuations than mean diurnal measurement.WDT is a promising diagnostic procedure for risk assessment in glaucoma.
基金Suppotred by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-3-004A-2).
文摘AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.
基金supported by the Deutsche Forschungsgemeinschaft(DFG)with grants PR1569/1-1 and PR 1569/1-3(to VP).
文摘Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central nervous system,microglia play a dual function in the progression of glaucoma.Under standard physiological states,microglia safeguard the retina by offering neurotrophic support and removing cellular debris.In the pathological progression of glaucoma,microglia become activated and release significant levels of inflammatory factors,resulting in retinal ganglion cell injury,cell death,and impaired neuroregeneration.This review focuses on examining the dual functions of microglia in glaucoma,evaluating their influence on retinal neurodegeneration and repair,and suggesting that modulating microglial activity could serve as a promising therapeutic strategy.Understanding the mechanisms of microglial action in glaucoma is crucial for unveiling the complex pathophysiological processes of the disease and developing new therapeutic strategies.
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 Eye Hospital of Wenzhou Medical University(No.KYQD20220304)The Fifth Batch of Provincial Ten Thousand Personnel Program Outstanding Talents Funding(No.474092204)+1 种基金Innovative Talents and Teams(2024)-The Fifth Batch of Funding Funds for Scientific and Technological Innovation Leading Talents Under the Provincial Ten Thousand Personnel Program(No.4240924003G)The Key R&D Program of Zhejiang(No.2022C03112).
文摘AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on disease progression status.Tear samples were collected for proteomic analysis.Dataindependent acquisition(DIA)mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression.Additionally,differentially expressed proteins(DEPs)were evaluated using mediating effect models and receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 19 patients(20 eyes)with NTG participated in this study,including 10 patients(4 males and 6 females;10 eyes)in the progression group with mean age of 67.70±9.03y and 10 patients(4 males and 6 females;10 eyes)in the non-progression group with mean age of 68.60±7.58y.A total of 158 significantly differentially expressed proteins were detected.UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis.Gene Ontology(GO)enrichment analysis revealed functional clusters related to cellular processes.Weighted gene coexpression network analysis(WGCNA)indicated that the core proteins were primarily involved in the neurodegenerationmultiple diseases pathway and cellular processes.Mediating effect analysis identified PRDX4(L)as a potential protein biomarker.ROC curve analysis showed that GNAI1 had the largest area under the curve(AUC=0.889).CONCLUSION:This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients,including PRDX4(L).PRDX4(L)plays a key role in oxidative stress.
基金Supported by the National Natural Science Foundation of China(No.82074500)Beijing Natural Science Foundation(No.7252273)+2 种基金CACMS Innovation Fund(No.CI2021A02605)Administration of Traditional Chinese Medicine of Zhejiang Province(No.2024ZR029)Science and Technology Program of Wenzhou City(No.Y2023210).
文摘AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies.METHODS:A systematic search was conducted in the Web of Science Core Collection(WoSCC)database to retrieve relevant literature published from January 1,2000,to August 31,2025(data accessed on September 12,2025).Multiple data visualization tools were employed to conduct in-depth analyses of the included publications,covering aspects such as publication quantity and quality,evolutionary trends of research hotspots,keyword cooccurrence networks,and collaborative patterns among countries/regions,institutions,and authors.RESULTS:A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC.The analysis showed that the USA had the highest research output in this field(29.04%,n=982),followed by China(18.40%,n=622)and UK(6.01%,n=203).Based on citation frequency and burst intensity,the USA also ranked as the most influential country.Baudouin C and Sun X were identified as the most productive authors,while Journal of Glaucoma and Investigative Ophthalmology&Visual Science were the journals with the highest number of published relevant articles.Additionally,keyword analysis revealed that“neuroinflammation”,“retinal ganglion cells(RGCs)”,“pathophysiology”,and“traditional Chinese medicine”are emerging research hotspots in the field of immuneinflammatory responses in glaucoma.CONCLUSION:This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation,indicating that this field has received extensive scientific attention with a steady upward trend in research activity.Furthermore,it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112).
文摘AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.
基金supported by the National Natural Science Foundation of China(32471057,32271043,82301215,and 82171047)the Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)ZJLab,the Shanghai Center for Brain Science and Brain-Inspired Technology.
文摘Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activated microglia mediates the crosstalk between Müller cells and microglia and impacts RGC injury in a chronic ocular hypertension(COH)glaucoma model.In COH retinas,elevated TNF-αinduced the activation of Müller cells and microglia,and recruited microglia to the ganglion cell layer.Co-culture with Müller cells enhanced TNF-α-induced microglial activation,migration,and proliferation.Both in vivo and in vitro experiments confirmed that chemokine C-C motif ligand 2(CCL2),primarily released from Müller cells,mediated the TNF-α-induced effects on microglia in COH retinas.Knockdown of CCL2 attenuated RGC damage and vision loss.Our results demonstrate that TNF-αreleased from microglia induces the secretion of CCL2 from Müller cells,thus inducing microglial activation and migration,exacerbating retinal neuroinflammation and RGC injury in glaucoma.
基金supported by a Ph.D.scholarship from the YLSY program of the Republic of Turkiye,Ministry of National Educationfunded by Fight for Sight UK,grant reference#5183/5184。
文摘Glaucoma is characterized by chronic progressive optic nerve damage and retinal ganglion cell death.Although extensive research has been conducted on neuroprotection for retinal ganglion cells,there is still no treatment for clinical use.Recent evidence shows that extracellular vesicles isolated from a variety of stem cells are efficacious in retinal ganglion cell neuroprotection.In this study,we tested the novel extracellular vesicle source of the retinal progenitor R-28 cell line in vitro and in vivo.We isolated and characterized extracellular vesicles from R-28 cells and tested their therapeutic efficacy in terms of retinal ganglion cell survival in vitro and in an in vivo glaucoma model,measuring retinal ganglion cell survival and preservation of their axons.Additionally,we tested extracellular vesicles for their neuroprotective capacity in retinal ganglion cells differentiated from human embryonic stem cells.Finally,we investigated miRNA changes in retinal ganglion cells with R-28 extracellular vesicle treatment,and predicted possible pathways that may be modulated.R-28 extracellular vesicles improved retinal ganglion cell survival but failed to preserve axons significantly.Moreover,the results also illustrated the neuroprotection of R-28 extracellular vesicles on human retinal ganglion cells.Finally,we also showed changes in hsa-miRNA-4443,hsa-miRNA-216a-5p,hsa-let-7e-5p,hsa-miRNA-374b-5p,hsa-miRNA-331-3p,and hsa-miRNA-421 expressions,which may have neuroprotective potential on retinal ganglion cell degeneration.This study will pave the way for miRNA and extracellular vesicle-based neuroprotective therapies for glaucoma.
基金Supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(No.HR20C0026)the National Research Foundation of Korea(NRF)(No.RS-2023-00247504)the Patient-Centered Clinical Research Coordinating Center,funded by the Ministry of Health&Welfare,Republic of Korea(No.HC19C0276).
文摘AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:Totally 716 eyes of 716 patients with primary open angle glaucoma(POAG)with at least 5 reliable 24-2 test results and 2y of follow-up were selected.The functional GEE model was used to detect perimetric progression in the training dataset(501 eyes).In the testing dataset(215 eyes),progression was evaluated the functional GEE model,mean deviation(MD)and visual field index(VFI)rates of change,Advanced Glaucoma Intervention Study(AGIS)and Collaborative Initial Glaucoma Treatment Study(CIGTS)scores,and pointwise linear regression(PLR).RESULTS:The proposed method showed the highest proportion of eyes detected as progression(54.4%),followed by the VFI rate(34.4%),PLR(23.3%),and MD rate(21.4%).The CIGTS and AGIS scores had a lower proportion of eyes detected as progression(7.9%and 5.1%,respectively).The time to detection of progression was significantly shorter for the proposed method than that of other algorithms(adjusted P≤0.019).The VFI rate displayed moderate pairwise agreement with the proposed method(k=0.47).CONCLUSION:The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.
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.
基金supported by St.Erik Eye Hospital philanthropic donations,Vetenskapsrådet 2022-00799(to PAW).
文摘Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of neurodegenerative diseases with glaucoma being highly prevalent.Glaucoma is characterized by the progressive dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve.It is the leading cause of irreversible vision loss and affects an estimated 80 million people.The mammalian central nervous system is non-regenerative and,once lost or injured,retinal ganglion cells cannot regenerate an axon into the optic nerve under basal conditions.Thus,strategies that provide neuroprotection to stressed,dysfunctional,or dying retinal ganglion cells are likely to be of high therapeutic and translational value.Advancing age,genetics,and elevated intraocular pressure are all major risk factors for glaucoma,however,all clinically available glaucoma treatments focus on intraocular pressure management and do not directly address the neurodegenerative component of glaucoma.
基金Supported by the National Natural Science Foundation of China(No.81970804)Natural Science Foundation of Hunan Province(No.2021JJ30949).
文摘Dear Editor,We reported a Chinese family carrying a novel Crumbs homologue 1(CRB1)variant(c.1737_1755del).Consanguineous marriage resulted in a homozygous mutation,leading to the onset of Leber congenital amaurosis(LCA)in their offspring.
基金Supported by the Science&Technology Department of Sichuan Province(China)Funding Project(No.2021YFS0221,No.2023YFS0179)1.3.5 Project for Disciplines of ExcellenceWest China Hospital,Sichuan University(No.2022HXFH032,ZYJC21058,2021-023,2022-014).
文摘AIM:To explore the mechanical indices used for differential diagnosis and to investigate the relationship between ocular biomechanics and glaucoma severity within each group.METHODS:This cross-sectional study included 185 eyes from 185 subjects:62 normal controls,91 hightension glaucoma(HTG),and 32 normal-tension glaucoma(NTG)patients.All participants underwent a comprehensive ophthalmic examination that involved ocular biomechanical measurements.Glaucoma severity was assessed using visual field index(VFI),mean deviation(MD),pattern standard deviation(PSD)and retinal nerve fiber layer(RNFL)thickness.Multivariable models were used to compare fifteen biomechanical parameters among the three groups adjusting for age,gender,intraocular pressure(IOP),central corneal thickness(CCT),and axial length(AL).The generalized linear model was utilized for multifactor comparison.RESULTS:Significant differences in first applanation time(AT1),highest concavity time(HC time),stress strain index(SSI),and HC deflection were found among the three groups(P<0.05).AT1 was significantly higher in the HTG group compared to controls(P<0.05),and SSI was higher in HTG than NTG(P<0.05).HC deflection in the HTG group was significantly smaller than in NTG(P<0.05).Furthermore,AT1 levels were observed to be significantly higher in primary open angle glaucoma(POAG)patients compared to controls(P<0.05).Receiver operating charactristic(ROC)analysis showed HC deflection had an area under the curve(AUC)of 0.802 between HTG and NTG.A negatively significant correlation was observed between SSI and VFI in POAG patients.CONCLUSION:Biomechanical analysis reveals that corneas in POAG patients are stiffer than normal controls,with increased corneal stiffness correlating with more severe glaucomatous damage.Interestingly,stiffer corneas in NTG patients appeares protective.In addition,HC deflection may be useful for differentiating HTG and NTG.
基金Supported by Basic Scientific Research Projects of Wenzhou(No.Y20220155).
文摘AIM:To investigate decisional conflict among patients diagnosed with primary angle-closure suspect(PACS)or primary angle-closure(PAC)who are considering laser peripheral iridotomy(LPI)treatment.METHODS:A total of 111 individuals diagnosed with PACS or PAC were selected through convenient sampling from March 2023 to December 2023.These participants then completed a general information questionnaire and the Decision Conflict Scale.Data analysis was performed using multiple linear regression to reveal factors influencing decisional conflict.RESULTS:The mean Decisional Conflict Score among patients with PACS or PAC was 48.58±10.01,with 99.1%of these individuals reporting experiencing decisional conflict.Multiple linear regression analysis revealed that females(P=0.002)and patients with a shorter duration of the disease(P=0.006)had higher levels of decisional conflict.Additionally,patients diagnosed during medical visits(P=0.049),those who refused LPI treatment(P=0.032),and individuals facing significant economic burdens related to medical expenses(P=0.005)exhibited higher levels of decisional conflict.Furthermore,patients who preferred to make medical decisions independently(P=0.023)and those who favored involving family members in decisionmaking(P=0.005)experienced increased levels of decisional conflict.CONCLUSION:Patients with PACS or PAC who undergo LPI treatment often encounter significant decisional conflict.Healthcare professionals should thoroughly assess a range of factors that influence this conflict,including gender,duration of disease,method of diagnosis acquisition,LPI treatment,economic burden of medical expenses,and patient preferences regarding medical decision-making.By considering these variables,tailored decision support can be developed to address individual patient needs,ultimately reducing decisional conflict and optimizing the quality of decisions made regarding treatment options.
文摘AIM:To evaluate the efficacy and safety of microcatheterassisted 360-degree trabeculotomy combined with trabeculectomy(MATT-Trab)for treating refractory glaucoma.METHODS:Patients with refractory glaucoma who underwent MATT-Trab were retrospectively examined.Efficacy indicators for research statistics included the intraocular pressure(IOP)level,degree of decrease,changes in medication dosage,and success rate.Safety indicators included the best-corrected visual acuity and incidence of complications.RESULTS:This study comprised 31 patients,including 11 males and 20 females,with ages ranging from 8mo to 67y(mean age:29.40±22.10y).The average postoperative IOP at 1d,1wk,1mo,3mo,6mo,1y,and the last followup was significantly lower than the average preoperative IOP(31.33±9.24 mm Hg,P<0.05).The average number of postoperative medications at 1y was 0.48±1.51,which was significantly reduced compared to that used preoperatively(3.77±0.99,P=0.00).The absolute and qualified success rates were 45.16% and 83.87%,respectively.Visual acuity exhibited no statistically significant difference between the postoperative and preoperative follow-up time points,except for the first day after surgery.The most common postoperative complications were anterior chamber hemorrhage(25 cases,86.21%)and high IOP(10 cases,34.48%).CONCLUSION:Our results indicate that MATT-Trab is effective and safe for treating refractory glaucoma.
文摘AIM:To assess the effect of the coronavirus disease 2019(COVID-19)pandemic on the wait times and severity of surgical glaucoma cases in a single tertiary referral center in Quebec,Canada.METHODS:Preoperative severity data included mean visual field(VF)deficit,intraocular pressure(IOP),the number of topical glaucoma medication classes,and preoperative best corrected visual acuity(BCVA).The times from referral to procedure(referral time)and from listing date to procedure(waitlisting time)were calculated.RESULTS:This retrospective cohort study involved 181 eyes of patients undergoing glaucoma surgery from March 1 to June 30,2019(pre-pandemic period),and 201 eyes in the same timeframe in 2021(pandemic period)at Saint-Sacrement Hospital in Quebec City.There was no significant difference in the severity data of surgical glaucoma across both periods(VF deficit:P=0.48;IOP:P=0.14;BCVA:P=0.24;topical medication classes:P=0.27).The number of patients referred with oral glaucoma medication increased slightly from 45 to 70 in 2019 and 2021 respectively(P=0.08).Delay data were also comparable.Mean referral time was 122±120d in 2019 versus 144±136d in 2021(P=0.09),whereas waitlisting time before the pandemic was 43±44.5 versus 39±41.8d in 2021(P=0.13).CONCLUSION:Despite North America’s strictest pandemic restrictions,limited negative impact is observed on waitlisting delays and the severity of glaucoma cases presenting at our center.A larger subset of patients is treated with oral medications indicating a possible increase in advanced glaucoma.
