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
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 investigate the role of adipokines in primary open angle glaucoma(POAG)by comparing the levels of these molecules in the aqueous humor among POAG patients and cataract patients with or without metabolic disorde...AIM:To investigate the role of adipokines in primary open angle glaucoma(POAG)by comparing the levels of these molecules in the aqueous humor among POAG patients and cataract patients with or without metabolic disorders.METHODS:In this cross-sectional study,aqueous humor samples of 22 eyes of POAG patients(POAG group),24 eyes of cataract patients without metabolic disorders(cataract group),and 24 eyes of cataract patients with metabolic disorders(cataract+metabolic disorders group)were assessed for 15 adipokines by Luminex bead-based multiplex array.The correlation between aqueous humor adipokines and clinical indicators of POAG was analyzed and compared across the groups.RESULTS:The analysis revealed that the levels of adiponectin,leptin,adipsin,retinol-binding protein 4(RBP4),angiopoietin-2,angiopoietin-like protein 4(ANGPTL4),chemokine(C-C motif)ligand 2(CCL2),interleukin-8(IL-8),and interleukin-18(IL-18)in the aqueous humor of the POAG group were significantly higher than those in the cataract group.Additionally,the level of angiopoietin-2 in the POAG group was higher than in the cataract+metabolic disorders group.However,no significant correlation was found between the levels of adipokines in the POAG group and intraocular pressure(IOP),severity of POAG,or the use of glaucoma medications.CONCLUSION:This study demonstrates significant differences in aqueous humor adipokine levels between POAG and cataract patients.The findings suggest that the levels of aqueous humor adipokines may reflect the inflammatory states in POAG and systemic metabolic abnormalities.展开更多
AIM:To evaluate the one-year clinical outcomes of a novel canaloplasty device used in combination with cataract extraction(CE)in patients with mild to severe open angle glaucoma(OAG).METHODS:This study reviewed patien...AIM:To evaluate the one-year clinical outcomes of a novel canaloplasty device used in combination with cataract extraction(CE)in patients with mild to severe open angle glaucoma(OAG).METHODS:This study reviewed patients diagnosed with mild to severe OAG,who underwent canaloplasty with the STREAMLINE®Surgical System combined with CE.The primary outcome was surgical success,defined as achieving≥20%intraocular pressure(IOP)reduction and/or a reduction of≥1 glaucoma medication compared to baseline.Secondary outcomes included mean IOP,average number of glaucoma medications,and best-corrected distance visual acuity(BCDVA).Data was collected preoperatively and at multiple postoperative time points up to one year.RESULTS:A total of 68 eyes of 47 patients were included with mean age was 73.1±7.0y and 60%were females.Surgical success at one year was achieved in 68.8%of eyes,with 67.6%success in mild,80.0%in moderate,and 66.7%in severe OAG cases.IOP was significantly reduced from a baseline of 16.1±0.5 to 14.7±0.4 mm Hg at one year(P=0.0004).The number of medications decreased significantly in all eyes from a baseline of 1.2±0.1 to 0.6±0.1 at one year(P<0.0001).When stratified by glaucoma severity,only the mild group experienced a statistically significant decrease from a baseline of 1.1±0.1 to 0.4±0.1(P<0.0001).BCDVA improved significantly from baseline to one year.No sight-threatening complications were reported.CONCLUSION:Canaloplasty using the STREAMLINE®surgical system combined with CE effectively reduces IOP at one year in mild to severe OAG with minimal complications.IOP lowering efficacy,reduction in IOP lowering medications,and safety in moderate to severe OAG require further study.展开更多
AIM:To explore whether plasma proteins serve as potential therapeutic targets for primary open angle glaucoma(POAG)based on a Mendelian randomization(MR)study.METHODS:Large-scale protein quantitative trait loci(pQTLs)...AIM:To explore whether plasma proteins serve as potential therapeutic targets for primary open angle glaucoma(POAG)based on a Mendelian randomization(MR)study.METHODS:Large-scale protein quantitative trait loci(pQTLs)data from the Icelandic deCODE database and two large POAG Genome-Wide Association Study(GWAS)summary datasets were used in this study.Causal associations between plasma proteins and POAG were identified using summary-data-based MR(SMR)analysis and the heterogeneity in dependent instruments(HEIDI)test.Colocalization analysis was then conducted to assess the genetic associations between these two factors.Phenotype-wide MR analysis was performed to validate protein targets as potential drug targets and to evaluate potential side effects.Finally,protein-protein interactions(PPI)were studied,and the Drug-Gene Interaction Database(DGIDb)was used to identify associations between drugs and the identified proteins.RESULTS:Four proteins(SVEP1,TMEM190,ROBO1,and ENPP5)were identified as potential drug targets in this study.Phenome-wide MR analysis showed that SVEP1,ROBO1,and ENPP5 were not associated with adverse effects,while TMEM190 was linked to nerve root and plexus disorders,as well as subarachnoid hemorrhage.Ticagrelor was suggested as a potential new drug for the treatment of glaucoma by regulating SVEP1.CONCLUSION:Four plasma proteins—SVEP1,TMEM190,ROBO1,and ENPP5—are identified as potential therapeutic targets for POAG through an MR approach.Phenome-wide MR analysis reveals that SVEP1,ROBO1,and ENPP5 are not associated with adverse effects,while TMEM190 is linked to nerve root and plexus disorders,as well as subarachnoid hemorrhage.Ticagrelor is proposed as a potential therapeutic drug for glaucoma by regulating SVEP1.These findings highlight the potential of plasma proteins as drug targets for POAG and provide valuable insights for further research.展开更多
AIM:To report the one-year surgical outcome Kahook Dual Blade goniotomy combined with phacoemulsification(KDB-Phaco)in Chinese patients with primary open angle glaucoma(POAG).METHODS:This is a retrospective study incl...AIM:To report the one-year surgical outcome Kahook Dual Blade goniotomy combined with phacoemulsification(KDB-Phaco)in Chinese patients with primary open angle glaucoma(POAG).METHODS:This is a retrospective study included 43 eyes of 28 Chinese POAG patients with cataract who accepted KDB-Phaco and followed-up for 12mo.Intraocular pressure(IOP),glaucoma medications and surgical complications were recorded.Success 1 and success 2 was defined as 5-21 mm Hg and 5-18 mm Hg,and success plus was determined if additional criteria of IOP reduction≥20%from baseline was reached.A corrected IOP by adding 3 mm Hg for each medication was used to do correlation test.Cox’s proportional hazards regression model was used to test the hazard ratio for factors associated with surgical success.RESULTS:After a 12-month follow up,the IOP decreased from 28.1±6.3 to 13.8±3.0 mm Hg(47.92%reduction,P<0.001),and the medications used decreased from 2.0(1.0)to 0.0(0.0)(95%reduction,P<0.001).The mean IOP of all postoperative visits were lower than preoperative IOP(all P<0.001),so as the number of glaucoma medications(all P<0.001).Complete success 1 and qualified success 1 were 87.80%and 100.00%respectively.The complete success 1 plus and qualified success 1 plus were 85.37%and 97.56%,respectively.Totally 82.93%and 90.24%of patients got complete success 2 and qualified success 2 while 80.49%and 87.80%of patients satisfied complete success 2 plus and qualified success 2 plus.Age(r=-0.511,P=0.001)and visual acuity(VA;r=-0.321,P=0.041)were negatively correlated with postoperative corrected IOP at 12mo,while anterior chamber depth(r=0.432,P=0.005),mean deviation(r=0.617,P<0.001)and visual field index(r=0.524,P<0.001)were positively correlated with it.Preoperative VA(OR=33.092,P=0.004)and MD(OR=1.481,P=0.018)were hazard factors associated with failure based on qualified success as 18 mm Hg.The main complications of KDB were hyphema(9.30%),IOP spike(11.63%)and peripheral anterior synechia(6.98%).CONCLUSION:KDB goniotomy is a safe and effective in the treatment for Chinese POAG patients.Preoperative VA and mean deviation may predict the surgical success.展开更多
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 serie...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 and12mo 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 meanΔIOP（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.展开更多
Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in ...Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in population based prevalence studies worldwide. Elevated intraocular pressure is a well-known major risk factor for POAG. In addition, there is growing evidence that other risk factors like age, gender, race, refractive error, heredity and systemic factors may play a role in glaucoma pathogenesis. Many studies found that high myopia has been associated with POAG, however, direct and convincing evidences are still lacking. The aim of this review is to summarize the evidences implicating high myopia as a risk factor in the pathogenesis of POAG.展开更多
AIM： To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open angle glaucoma （POAG） patients. METHODS： This was a multicenter, retrospective, observatio...AIM： To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open angle glaucoma （POAG） patients. METHODS： This was a multicenter, retrospective, observational study and included POAG patients with or without visually-significant cataracts. The Chinese patients were enrolled from three glaucoma centers and a group of comparable Japanese POAG patients was analyzed from our international Trabectome database. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome was intraocular pressure （IOP） reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2y. Success was defined as： 1） IOP≤21 mm Hg and at least 20% IOP reduction from baseline after 3mo at any two consecutive visits; 2） no additional glaucoma surgery required. RESULTS： A total of 42 Chinese POAG patients from three glaucoma centers were enrolled. Twelve patients underwent Trabectome surgery combined with phacoemulsification and intraocular lens implantation while the remainder underwent Trabectome surgery alone. Thirteen patients had a history of failed glaucoma surgery and were considered as complicated cases. In China data, the mean preoperative IOP was 21.4±1.23 mm Hg. The Trabectome lowered IOP to 17.9±1.8 mm Hg at 2y （P=0.05）. The number of glaucoma medications also decreased significantly from a baseline of 2.0±0.9 to 1.1±0.8 at 2y post-surgery （P=0.04）. The overall 2-year success rate was 78%, with patients undergoing combined surgery having a higher success rate compared with those undergoing Trabectome surgery alone （100% vs 76%）. In Japan data, the mean preoperative IOP was 20.8±7.7 mm Hg. The Trabectome lowered IOP to 12.20±2.0 mm Hg at 2y. The number of glaucoma medications also decreased significantly from a baseline of 2.1±0.9 to 3.4±0.6 at 2y post-surgery. In all patients, no major complications were seen. CONCLUSION： Surgery with the Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.展开更多
AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients wit...AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm's canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It's a safe procedure with less complications over 10 y in Chinese individuals with OAG.展开更多
BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully c...BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully corrected with improved super-elastic Ti-Ni alloy wire(ISW).CASE SUMMARY A 19 years old male came to our clinic with a chief complaint of anterior open bite and crossbite and not able to chew food well.Clinical examination revealed an angle class III malocclusion with anterior open bite,crossbite and spaced arch.Ra-diographic and clinical examination showed a skeletal class III pattern.We used ISW to level the upper and lower arch and to correct the anterior open bite and crossbite.Intermaxillary elastics were also used to achieve a better interdigitation.Finally,adequate overbite,overjet and a desirable occlusion were achieved.The active treatment time took 2 years and 2 months.CONCLUSION In a case of class III angular malocclusion with open bite and crossbite in the ante-rior teeth,ideal results were achieved using the ISW technique and the patient was satisfied with the outcome.展开更多
●AIM:To systematically review and Meta-analyze studies of managing open angle glaucoma(OAG)with gonioscopyassisted transluminal trabeculotomy(GATT)and to evaluate its effectiveness and safety.●METHODS:Eligible studi...●AIM:To systematically review and Meta-analyze studies of managing open angle glaucoma(OAG)with gonioscopyassisted transluminal trabeculotomy(GATT)and to evaluate its effectiveness and safety.●METHODS:Eligible studies were retrieved and screened from five main electronic databases.Mean difference(MD)was hired to show the pooled effectiveness of intraocular pressure(IOP)and medication decrease achieved by GATT.In addition,combined surgical success and reoperation rates were calculated,and complications were also summarized.●RESULTS:Ten studies were included for systematic review,but one study was not pooled for Meta-analysis due to the repeated data.The combined IOP decrease after GATT was 9.81 mm Hg(95%CI:7.98-11.63 mm Hg)which showed significant reduction from the baselines(Z=10.52,P<0.0001).Similarly,the number of medications after GATT also decreased distinctly compared with that of medication before the surgery(Z=9.09,P<0.0001),and the pooled medication decrease was 1.68(95%CI:1.31-2.04).In addition,the combined surgical success rate was 85%,while the pooled reoperation rate was 20%.Sightthreatening complications occurred scarcely,whereas the pooled occurrence rate of hyphemia was as high as 36.0%.●CONCLUSION:GATT could effectively lower IOP and decrease medications for patients with OAG.Moreover,the procedure appears to be a safe and promising treatment for OAG due to its minimally-invasive and conjunctiva-sparing nature.展开更多
AIM: To compare the safety and efficacy of subconjunctival injection with conbercept and 5-fluorouracil(5-FU) for open angle glaucoma(OAG) patients after filtration surgery. METHODS: As a prospective randomized interv...AIM: To compare the safety and efficacy of subconjunctival injection with conbercept and 5-fluorouracil(5-FU) for open angle glaucoma(OAG) patients after filtration surgery. METHODS: As a prospective randomized interventional trial, 36 eyes from 36 patients after OAG surgery were collected and divided randomly into conbercept and 5-FU groups. All patients were subconjunctivally injected with either conbercept(0.2 mL) or 5-FU(0.2 mL) on the 5th day post-operatively. The intraocular pressure(IOP), number of medications used, type of conjunctival bleb, and complications were recorded and analyzed pre-operatively and 1d, 1wk, 1, 3 and 6mo post-injection. RESULTS: There were significant differences in IOP between the conbercept and 5-FU groups 1mo(conbercept group: 12.17±1.04 mm Hg; 5-FU group: 13.50±2.33 mm Hg, t=2.214, P=0.037), 3mo(conbercept group: 13.00±1.88 mm Hg; 5-FU group: 14.50±2.28 mm Hg, t=2.153, P=0.039), and 6mo post-injection(conbercept group: 13.28±2.95 mm Hg; 5-FU group: 15.22±2.49 mm Hg, t=2.140, P=0.040); however, in the number of medications, a prominent difference was not shown between groups on post-injection 6mo(t=1.312, P=0.200). Moreover, there was mild vascularity observed in the conbecept group than the 5-FU group 1d(3a, 3b, 3c: t=8.497, 6.693, 4.515, P=0.000), 1wk(3a, 3b, 3c: t=3.431, 6.408, 3.984, P=0.002, 0.000, 0.000), and 1mo post-injection(3a, 3b, 3c: t=2.466, 2.466, 2.503, P=0.019, 0.019, 0.017). Simultaneously, differences from other indicators between the two groups were not demonstrated. Also, there was a lower probability of corneal epithelial stripping in the conbercept group than the 5-FU group(χ2=4.500, P=0.034). CONCLUSION: Subconjunctival injection of conbercept has a safe, effective, and tolerable profile for open angle glaucoma patients with distinct conjunctival congestion after filtration surgery.展开更多
AIM： To evaluate the advantage of canaloplasty compared to trabeculectomy for patients with open angle glaucoma.METHODS： Potentially relevant studies were systematically searched using various databases from incepti...AIM： To evaluate the advantage of canaloplasty compared to trabeculectomy for patients with open angle glaucoma.METHODS： Potentially relevant studies were systematically searched using various databases from inception until December 2015. The outcome analyses performed automatically using Revman 5.3 included intraocular pressure reduction （IOPR）, postoperative success rate, anti-glaucoma medications reduction and the incidence of adverse events.RESULTS： We included four qualified studies incorporating a total of 215 eyes for quantitative synthesis. The weighted mean difference （WMD） of IOPR between canaloplasty and trabeculectomy from baseline to 12mo was -2.33 （95%CI： -4.00, -0.66）. There was not significant improvement in the complete or qualified success rate （OR： 0.58, 95%CI： 0.26, 1.31; OR： 0.50, 95%CI： 0.10, 2.44, respectively）. Similarly, no statistically significance was observed in anti-glaucoma mediations reduction （WMD： -0.54, 95%CI： -1.18, 0.09）. Sensitivity analysis of the primary outcome estimate confirmed the stability of the Meta-analysis result.CONCLUSION： Trabeculectomy seems to be more effective in lowering IOP up to 12mo when comparing with canaloplasty. Canaloplasty does not seem to be inferior to trabeculectomy considering the postoperative success rate or the number of postoperative anti-glaucoma medications. Meanwhile, it has an advantage of less bleb related complications.展开更多
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 ...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 -70℃.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/m L 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.展开更多
This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED （1966 to 2009）, Embase （1980 to 2009） an...This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED （1966 to 2009）, Embase （1980 to 2009） and CMB-disk （1979 to 2009） for the randomized clinical trials （RCT） concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration＇s RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure （IOP） between non-penetrating trabecular surgery and trabeculectomy （Z=6.05 P0.00001）. There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures （Z=4.92, P0.00001）. Difference in the success rate was also found between the two surgeries （Z=3.82, P=0.0001）. It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.展开更多
AIM:To evaluate intraocular pressure(IOP)-lowering effect and ocular tolerability of brimonidine/timolol,dorzolamide/timolol and latanoprost/timolol fixed combination therapies in the management of primary open angle ...AIM:To evaluate intraocular pressure(IOP)-lowering effect and ocular tolerability of brimonidine/timolol,dorzolamide/timolol and latanoprost/timolol fixed combination therapies in the management of primary open angle glaucoma.· METHODS:Each drug was administered for two months, after which a circadian tonometric curve was recorded using a Goldmann applanation tonometer.Ocular discomfort(conjunctival hyperemia, burning or stinging, foreign body sensation, itching, ocular pain) of each eye was assessed by the subject on a standardized ocular discomfort scale.RESULTS:Among the three study groups, there were no significant differences in the mean baseline IOP measurements, mean 2ndmo IOP measurements, and mean(%) change of IOPs from baseline. Among the three study groups, there were no significant differences in the mean IOP measurements obtained at circadian tonometric curves at baseline and at two months controls. In sum brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies showed similar effects on IOP levels.· CONCLUSION:Brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies showed similar lowering efficaties on IOP levels whereas there was no any difference between each other.展开更多
AIM:To assess the effects of the fixed combination of0.005% latanoprost and 0.5% timolol(FCLT) vs their individual components for primary open angle glaucoma(POAG) and ocular hypertension(OHT).· METHODS:After sea...AIM:To assess the effects of the fixed combination of0.005% latanoprost and 0.5% timolol(FCLT) vs their individual components for primary open angle glaucoma(POAG) and ocular hypertension(OHT).· METHODS:After searched PubMed, EMBASE, the Cochrane Library and SCI, all randomized controlled clinical trials(RCTs) and cross-over studies were included. The control groups were the monotherapy or the concomitant therapy of latanoprost and timolol. The outcomes were visual field defect, optic atrophy, mean intraocular pressure(IOP) and IOP fluctuation. The analysis was carried out in RevMan version 5.1 software.RESULTS:Thepost-interventionmeanIOPofFCLTwas significantly lower compared to timolol [mean difference(MD)-2.92, 95%CI-3.28 to-2.55, P 【0.00001] and latanoprost(MD-1.11, 95%CI-1.51 to-0.72, P 【0.00001). The postintervention IOP fluctuation was also significantly lower compared to timolol(MD-0.88, 95%CI-1.23 to-0.53, P 【0. 00001) and latanoprost( MD- 0. 63, 95 % CI- 1. 04to-0.22, P =0.002). The mean IOP was higher in FCLT morning dose group than the one in unfixed combination of 0.005% latanoprost and 0.5% timolol(UFCLT)(MD1.10, 95% CI 0.81 to 1.39, P 【0.00001). Otherwise, there was no difference between FCLT evening dose group and UFCLT(MD 0.34, 95% CI-0.01 to 0.69, P =0.06).There was no statistical difference for the incidence ofvisual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.visual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.展开更多
AIM: To investigate the efficacy of low-energy selective laser trabeculoplasty(SLT) on the treatment of primary open angle glaucoma(POAG) patients.METHODS: Outpatients with POAG who underwent 360-degree SLT using an i...AIM: To investigate the efficacy of low-energy selective laser trabeculoplasty(SLT) on the treatment of primary open angle glaucoma(POAG) patients.METHODS: Outpatients with POAG who underwent 360-degree SLT using an initial energy of 0.3 mJ(total energy of 30-40 mJ) were reviewed retrospectively from September 2011 to January 2018.RESULTS: Eight-six eyes of 44 POAG patients underwent 360-degree SLT using initial energy of 0.3 mJ and were followed up regularly. The total energy used was 32.5±2.5 mJ(23-40 mJ, 105±6 spots). The average pretreatment intraocular pressure(IOP) was 19.8±3.9 mm Hg. At 1, 3, 6 mo, 1, and 2 y, the post-SLT IOPs(mm Hg) were 16.9±3.3, 16.5±3.3, 17.1±3.4, 16.6±3.5, 16.5±2.8, which were significantly lower than that before treatment(P<0.001). The patients in the SLT success group were found to be younger than those in the SLT failure group. After SLT, 59 eyes that maintained pretreatment medications were defined as the drug retention group. The pre-SLT IOP was 20.1±3.7 mm Hg.At 1, 3, 6 mo, 1, and 2 y, the post-SLT IOPs(mm Hg) were 17.3±3.6, 16.6±3.5, 17.2±3.6, 16.9±3.8 and 16.5±2.9, respectively. Twenty-seven eyes that required reduced drugs were defined as the drug reduction group. The pre-SLT IOP was 19.2±4.4 mm Hg. At 1, 3, 6 mo, 1, and 2 y, the post-SLT IOPs(mm Hg) were 16.1±2.6, 16.5±3.1, 16.8±2.9, 16.0±2.6 and 16.3±2.4, respectively. Compared with the pretreatment IOPs, the post-SLT IOPs were significantly lower in drug retention group and drug reduction group. The patients in the drug reduction group were found to be younger than those in the drug retention group.CONCLUSION: Low-energy SLT is safe and effective for POAG patients during a 2-year follow-up. Younger POAG patients may obtain better results after low-energy SLT treatment.展开更多
AIM: To evaluate the efficiency and safety of micropulse laser trabeculoplasty(MLT) for primary open angle glaucoma(POAG) patients. METHODS: Retrospective study. POAG patients undergoing MLT in Peking University Third...AIM: To evaluate the efficiency and safety of micropulse laser trabeculoplasty(MLT) for primary open angle glaucoma(POAG) patients. METHODS: Retrospective study. POAG patients undergoing MLT in Peking University Third Hospital from June 2016 to November 2017. Seventy-two eyes of 72 POAG patients were enrolled. Only one eye of each patient was treated by MLT. The intraocular pressure(IOP) before MLT and at 1 d, 1, 4, 12 and 24 wk and glaucoma medication before and after treatment were compared.RESULTS: The IOP was 20.6±5.9 mm Hg before MLT and 20.8±6.8 mm Hg at 2 h after MTL. The IOP at 1 d, 1, 4, 12 and 24 wk was 17.9±4.4, 18.0±4.3, 17.5±3.4, 17.0±2.7, and 16.5±2.9 mm Hg, respectively. The IOP before and after MLT demonstrated a statistically significant difference by ANOVA analyses(F=5.797, P<0.001). Least significant difference t-tests showed there was no statistically significant difference between pre-MLT IOP within 2 h after MLT(P=0.207). The statistically significant difference was confirmed between the pre-MLT IOP at 1 d, 1, 4, 12 and 24 wk after MLT(P=0.006, 0.009, 0.001, <0.001, <0.001, respectively). The number of glaucoma medications before MLT was 1.7±1.4 and 1.5±1.4 24 wk after MLT with a significantly statistical difference(t=2.219, P=0.031)CONCLUSION: MLT is effective and safe for POAG patients. No patient experienced IOP spikes after MLT. The IOP 6 mo after treatment decreased significantly with less glaucoma medication.展开更多
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 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 National Key R&D Program of China(No.2023YFC2506100)the Changping Key Research Project of the Beijing Natural Science Foundation Program(No.L234016).
文摘AIM:To investigate the role of adipokines in primary open angle glaucoma(POAG)by comparing the levels of these molecules in the aqueous humor among POAG patients and cataract patients with or without metabolic disorders.METHODS:In this cross-sectional study,aqueous humor samples of 22 eyes of POAG patients(POAG group),24 eyes of cataract patients without metabolic disorders(cataract group),and 24 eyes of cataract patients with metabolic disorders(cataract+metabolic disorders group)were assessed for 15 adipokines by Luminex bead-based multiplex array.The correlation between aqueous humor adipokines and clinical indicators of POAG was analyzed and compared across the groups.RESULTS:The analysis revealed that the levels of adiponectin,leptin,adipsin,retinol-binding protein 4(RBP4),angiopoietin-2,angiopoietin-like protein 4(ANGPTL4),chemokine(C-C motif)ligand 2(CCL2),interleukin-8(IL-8),and interleukin-18(IL-18)in the aqueous humor of the POAG group were significantly higher than those in the cataract group.Additionally,the level of angiopoietin-2 in the POAG group was higher than in the cataract+metabolic disorders group.However,no significant correlation was found between the levels of adipokines in the POAG group and intraocular pressure(IOP),severity of POAG,or the use of glaucoma medications.CONCLUSION:This study demonstrates significant differences in aqueous humor adipokine levels between POAG and cataract patients.The findings suggest that the levels of aqueous humor adipokines may reflect the inflammatory states in POAG and systemic metabolic abnormalities.
文摘AIM:To evaluate the one-year clinical outcomes of a novel canaloplasty device used in combination with cataract extraction(CE)in patients with mild to severe open angle glaucoma(OAG).METHODS:This study reviewed patients diagnosed with mild to severe OAG,who underwent canaloplasty with the STREAMLINE®Surgical System combined with CE.The primary outcome was surgical success,defined as achieving≥20%intraocular pressure(IOP)reduction and/or a reduction of≥1 glaucoma medication compared to baseline.Secondary outcomes included mean IOP,average number of glaucoma medications,and best-corrected distance visual acuity(BCDVA).Data was collected preoperatively and at multiple postoperative time points up to one year.RESULTS:A total of 68 eyes of 47 patients were included with mean age was 73.1±7.0y and 60%were females.Surgical success at one year was achieved in 68.8%of eyes,with 67.6%success in mild,80.0%in moderate,and 66.7%in severe OAG cases.IOP was significantly reduced from a baseline of 16.1±0.5 to 14.7±0.4 mm Hg at one year(P=0.0004).The number of medications decreased significantly in all eyes from a baseline of 1.2±0.1 to 0.6±0.1 at one year(P<0.0001).When stratified by glaucoma severity,only the mild group experienced a statistically significant decrease from a baseline of 1.1±0.1 to 0.4±0.1(P<0.0001).BCDVA improved significantly from baseline to one year.No sight-threatening complications were reported.CONCLUSION:Canaloplasty using the STREAMLINE®surgical system combined with CE effectively reduces IOP at one year in mild to severe OAG with minimal complications.IOP lowering efficacy,reduction in IOP lowering medications,and safety in moderate to severe OAG require further study.
基金Supported by the National Natural Science Foundation of China(No.81770920)Open Project of State Key Laboratory of Ophthalmology(No.303060202400383).
文摘AIM:To explore whether plasma proteins serve as potential therapeutic targets for primary open angle glaucoma(POAG)based on a Mendelian randomization(MR)study.METHODS:Large-scale protein quantitative trait loci(pQTLs)data from the Icelandic deCODE database and two large POAG Genome-Wide Association Study(GWAS)summary datasets were used in this study.Causal associations between plasma proteins and POAG were identified using summary-data-based MR(SMR)analysis and the heterogeneity in dependent instruments(HEIDI)test.Colocalization analysis was then conducted to assess the genetic associations between these two factors.Phenotype-wide MR analysis was performed to validate protein targets as potential drug targets and to evaluate potential side effects.Finally,protein-protein interactions(PPI)were studied,and the Drug-Gene Interaction Database(DGIDb)was used to identify associations between drugs and the identified proteins.RESULTS:Four proteins(SVEP1,TMEM190,ROBO1,and ENPP5)were identified as potential drug targets in this study.Phenome-wide MR analysis showed that SVEP1,ROBO1,and ENPP5 were not associated with adverse effects,while TMEM190 was linked to nerve root and plexus disorders,as well as subarachnoid hemorrhage.Ticagrelor was suggested as a potential new drug for the treatment of glaucoma by regulating SVEP1.CONCLUSION:Four plasma proteins—SVEP1,TMEM190,ROBO1,and ENPP5—are identified as potential therapeutic targets for POAG through an MR approach.Phenome-wide MR analysis reveals that SVEP1,ROBO1,and ENPP5 are not associated with adverse effects,while TMEM190 is linked to nerve root and plexus disorders,as well as subarachnoid hemorrhage.Ticagrelor is proposed as a potential therapeutic drug for glaucoma by regulating SVEP1.These findings highlight the potential of plasma proteins as drug targets for POAG and provide valuable insights for further research.
基金Supported by the National Natural Science Foundation of China Youth Science Foundation Project(No.82201176)Zhejiang Provincial Medical&Health Science Technology Program(No.2023KY153).
文摘AIM:To report the one-year surgical outcome Kahook Dual Blade goniotomy combined with phacoemulsification(KDB-Phaco)in Chinese patients with primary open angle glaucoma(POAG).METHODS:This is a retrospective study included 43 eyes of 28 Chinese POAG patients with cataract who accepted KDB-Phaco and followed-up for 12mo.Intraocular pressure(IOP),glaucoma medications and surgical complications were recorded.Success 1 and success 2 was defined as 5-21 mm Hg and 5-18 mm Hg,and success plus was determined if additional criteria of IOP reduction≥20%from baseline was reached.A corrected IOP by adding 3 mm Hg for each medication was used to do correlation test.Cox’s proportional hazards regression model was used to test the hazard ratio for factors associated with surgical success.RESULTS:After a 12-month follow up,the IOP decreased from 28.1±6.3 to 13.8±3.0 mm Hg(47.92%reduction,P<0.001),and the medications used decreased from 2.0(1.0)to 0.0(0.0)(95%reduction,P<0.001).The mean IOP of all postoperative visits were lower than preoperative IOP(all P<0.001),so as the number of glaucoma medications(all P<0.001).Complete success 1 and qualified success 1 were 87.80%and 100.00%respectively.The complete success 1 plus and qualified success 1 plus were 85.37%and 97.56%,respectively.Totally 82.93%and 90.24%of patients got complete success 2 and qualified success 2 while 80.49%and 87.80%of patients satisfied complete success 2 plus and qualified success 2 plus.Age(r=-0.511,P=0.001)and visual acuity(VA;r=-0.321,P=0.041)were negatively correlated with postoperative corrected IOP at 12mo,while anterior chamber depth(r=0.432,P=0.005),mean deviation(r=0.617,P<0.001)and visual field index(r=0.524,P<0.001)were positively correlated with it.Preoperative VA(OR=33.092,P=0.004)and MD(OR=1.481,P=0.018)were hazard factors associated with failure based on qualified success as 18 mm Hg.The main complications of KDB were hyphema(9.30%),IOP spike(11.63%)and peripheral anterior synechia(6.98%).CONCLUSION:KDB goniotomy is a safe and effective in the treatment for Chinese POAG patients.Preoperative VA and mean deviation may predict the surgical success.
文摘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 and12mo 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 meanΔIOP（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.
文摘Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in population based prevalence studies worldwide. Elevated intraocular pressure is a well-known major risk factor for POAG. In addition, there is growing evidence that other risk factors like age, gender, race, refractive error, heredity and systemic factors may play a role in glaucoma pathogenesis. Many studies found that high myopia has been associated with POAG, however, direct and convincing evidences are still lacking. The aim of this review is to summarize the evidences implicating high myopia as a risk factor in the pathogenesis of POAG.
基金Supported by the National Natural Science Foundation of China(No.81670851)
文摘AIM： To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open angle glaucoma （POAG） patients. METHODS： This was a multicenter, retrospective, observational study and included POAG patients with or without visually-significant cataracts. The Chinese patients were enrolled from three glaucoma centers and a group of comparable Japanese POAG patients was analyzed from our international Trabectome database. The patients received Trabectome or a combined surgery with phacoemulsification and intraocular lens implantation. The primary outcome was intraocular pressure （IOP） reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2y. Success was defined as： 1） IOP≤21 mm Hg and at least 20% IOP reduction from baseline after 3mo at any two consecutive visits; 2） no additional glaucoma surgery required. RESULTS： A total of 42 Chinese POAG patients from three glaucoma centers were enrolled. Twelve patients underwent Trabectome surgery combined with phacoemulsification and intraocular lens implantation while the remainder underwent Trabectome surgery alone. Thirteen patients had a history of failed glaucoma surgery and were considered as complicated cases. In China data, the mean preoperative IOP was 21.4±1.23 mm Hg. The Trabectome lowered IOP to 17.9±1.8 mm Hg at 2y （P=0.05）. The number of glaucoma medications also decreased significantly from a baseline of 2.0±0.9 to 1.1±0.8 at 2y post-surgery （P=0.04）. The overall 2-year success rate was 78%, with patients undergoing combined surgery having a higher success rate compared with those undergoing Trabectome surgery alone （100% vs 76%）. In Japan data, the mean preoperative IOP was 20.8±7.7 mm Hg. The Trabectome lowered IOP to 12.20±2.0 mm Hg at 2y. The number of glaucoma medications also decreased significantly from a baseline of 2.1±0.9 to 3.4±0.6 at 2y post-surgery. In all patients, no major complications were seen. CONCLUSION： Surgery with the Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.
文摘AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm's canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It's a safe procedure with less complications over 10 y in Chinese individuals with OAG.
文摘BACKGROUND Orthodontic treatment for open bite and crossbite cases is always challenging.In this paper,we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully corrected with improved super-elastic Ti-Ni alloy wire(ISW).CASE SUMMARY A 19 years old male came to our clinic with a chief complaint of anterior open bite and crossbite and not able to chew food well.Clinical examination revealed an angle class III malocclusion with anterior open bite,crossbite and spaced arch.Ra-diographic and clinical examination showed a skeletal class III pattern.We used ISW to level the upper and lower arch and to correct the anterior open bite and crossbite.Intermaxillary elastics were also used to achieve a better interdigitation.Finally,adequate overbite,overjet and a desirable occlusion were achieved.The active treatment time took 2 years and 2 months.CONCLUSION In a case of class III angular malocclusion with open bite and crossbite in the ante-rior teeth,ideal results were achieved using the ISW technique and the patient was satisfied with the outcome.
文摘●AIM:To systematically review and Meta-analyze studies of managing open angle glaucoma(OAG)with gonioscopyassisted transluminal trabeculotomy(GATT)and to evaluate its effectiveness and safety.●METHODS:Eligible studies were retrieved and screened from five main electronic databases.Mean difference(MD)was hired to show the pooled effectiveness of intraocular pressure(IOP)and medication decrease achieved by GATT.In addition,combined surgical success and reoperation rates were calculated,and complications were also summarized.●RESULTS:Ten studies were included for systematic review,but one study was not pooled for Meta-analysis due to the repeated data.The combined IOP decrease after GATT was 9.81 mm Hg(95%CI:7.98-11.63 mm Hg)which showed significant reduction from the baselines(Z=10.52,P<0.0001).Similarly,the number of medications after GATT also decreased distinctly compared with that of medication before the surgery(Z=9.09,P<0.0001),and the pooled medication decrease was 1.68(95%CI:1.31-2.04).In addition,the combined surgical success rate was 85%,while the pooled reoperation rate was 20%.Sightthreatening complications occurred scarcely,whereas the pooled occurrence rate of hyphemia was as high as 36.0%.●CONCLUSION:GATT could effectively lower IOP and decrease medications for patients with OAG.Moreover,the procedure appears to be a safe and promising treatment for OAG due to its minimally-invasive and conjunctiva-sparing nature.
文摘AIM: To compare the safety and efficacy of subconjunctival injection with conbercept and 5-fluorouracil(5-FU) for open angle glaucoma(OAG) patients after filtration surgery. METHODS: As a prospective randomized interventional trial, 36 eyes from 36 patients after OAG surgery were collected and divided randomly into conbercept and 5-FU groups. All patients were subconjunctivally injected with either conbercept(0.2 mL) or 5-FU(0.2 mL) on the 5th day post-operatively. The intraocular pressure(IOP), number of medications used, type of conjunctival bleb, and complications were recorded and analyzed pre-operatively and 1d, 1wk, 1, 3 and 6mo post-injection. RESULTS: There were significant differences in IOP between the conbercept and 5-FU groups 1mo(conbercept group: 12.17±1.04 mm Hg; 5-FU group: 13.50±2.33 mm Hg, t=2.214, P=0.037), 3mo(conbercept group: 13.00±1.88 mm Hg; 5-FU group: 14.50±2.28 mm Hg, t=2.153, P=0.039), and 6mo post-injection(conbercept group: 13.28±2.95 mm Hg; 5-FU group: 15.22±2.49 mm Hg, t=2.140, P=0.040); however, in the number of medications, a prominent difference was not shown between groups on post-injection 6mo(t=1.312, P=0.200). Moreover, there was mild vascularity observed in the conbecept group than the 5-FU group 1d(3a, 3b, 3c: t=8.497, 6.693, 4.515, P=0.000), 1wk(3a, 3b, 3c: t=3.431, 6.408, 3.984, P=0.002, 0.000, 0.000), and 1mo post-injection(3a, 3b, 3c: t=2.466, 2.466, 2.503, P=0.019, 0.019, 0.017). Simultaneously, differences from other indicators between the two groups were not demonstrated. Also, there was a lower probability of corneal epithelial stripping in the conbercept group than the 5-FU group(χ2=4.500, P=0.034). CONCLUSION: Subconjunctival injection of conbercept has a safe, effective, and tolerable profile for open angle glaucoma patients with distinct conjunctival congestion after filtration surgery.
文摘AIM： To evaluate the advantage of canaloplasty compared to trabeculectomy for patients with open angle glaucoma.METHODS： Potentially relevant studies were systematically searched using various databases from inception until December 2015. The outcome analyses performed automatically using Revman 5.3 included intraocular pressure reduction （IOPR）, postoperative success rate, anti-glaucoma medications reduction and the incidence of adverse events.RESULTS： We included four qualified studies incorporating a total of 215 eyes for quantitative synthesis. The weighted mean difference （WMD） of IOPR between canaloplasty and trabeculectomy from baseline to 12mo was -2.33 （95%CI： -4.00, -0.66）. There was not significant improvement in the complete or qualified success rate （OR： 0.58, 95%CI： 0.26, 1.31; OR： 0.50, 95%CI： 0.10, 2.44, respectively）. Similarly, no statistically significance was observed in anti-glaucoma mediations reduction （WMD： -0.54, 95%CI： -1.18, 0.09）. Sensitivity analysis of the primary outcome estimate confirmed the stability of the Meta-analysis result.CONCLUSION： Trabeculectomy seems to be more effective in lowering IOP up to 12mo when comparing with canaloplasty. Canaloplasty does not seem to be inferior to trabeculectomy considering the postoperative success rate or the number of postoperative anti-glaucoma medications. Meanwhile, it has an advantage of less bleb related complications.
基金Supported by the Ankara Ophthalmology Society,a branch of the Turkish Society of Ophthalmology
文摘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 -70℃.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/m L 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.
文摘This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED （1966 to 2009）, Embase （1980 to 2009） and CMB-disk （1979 to 2009） for the randomized clinical trials （RCT） concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration＇s RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure （IOP） between non-penetrating trabecular surgery and trabeculectomy （Z=6.05 P0.00001）. There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures （Z=4.92, P0.00001）. Difference in the success rate was also found between the two surgeries （Z=3.82, P=0.0001）. It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.
文摘AIM:To evaluate intraocular pressure(IOP)-lowering effect and ocular tolerability of brimonidine/timolol,dorzolamide/timolol and latanoprost/timolol fixed combination therapies in the management of primary open angle glaucoma.· METHODS:Each drug was administered for two months, after which a circadian tonometric curve was recorded using a Goldmann applanation tonometer.Ocular discomfort(conjunctival hyperemia, burning or stinging, foreign body sensation, itching, ocular pain) of each eye was assessed by the subject on a standardized ocular discomfort scale.RESULTS:Among the three study groups, there were no significant differences in the mean baseline IOP measurements, mean 2ndmo IOP measurements, and mean(%) change of IOPs from baseline. Among the three study groups, there were no significant differences in the mean IOP measurements obtained at circadian tonometric curves at baseline and at two months controls. In sum brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies showed similar effects on IOP levels.· CONCLUSION:Brimonidine/timolol, dorzolamide/timolol and latanoprost/timolol fixed combination therapies showed similar lowering efficaties on IOP levels whereas there was no any difference between each other.
文摘AIM:To assess the effects of the fixed combination of0.005% latanoprost and 0.5% timolol(FCLT) vs their individual components for primary open angle glaucoma(POAG) and ocular hypertension(OHT).· METHODS:After searched PubMed, EMBASE, the Cochrane Library and SCI, all randomized controlled clinical trials(RCTs) and cross-over studies were included. The control groups were the monotherapy or the concomitant therapy of latanoprost and timolol. The outcomes were visual field defect, optic atrophy, mean intraocular pressure(IOP) and IOP fluctuation. The analysis was carried out in RevMan version 5.1 software.RESULTS:Thepost-interventionmeanIOPofFCLTwas significantly lower compared to timolol [mean difference(MD)-2.92, 95%CI-3.28 to-2.55, P 【0.00001] and latanoprost(MD-1.11, 95%CI-1.51 to-0.72, P 【0.00001). The postintervention IOP fluctuation was also significantly lower compared to timolol(MD-0.88, 95%CI-1.23 to-0.53, P 【0. 00001) and latanoprost( MD- 0. 63, 95 % CI- 1. 04to-0.22, P =0.002). The mean IOP was higher in FCLT morning dose group than the one in unfixed combination of 0.005% latanoprost and 0.5% timolol(UFCLT)(MD1.10, 95% CI 0.81 to 1.39, P 【0.00001). Otherwise, there was no difference between FCLT evening dose group and UFCLT(MD 0.34, 95% CI-0.01 to 0.69, P =0.06).There was no statistical difference for the incidence ofvisual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.visual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.
基金Supported by National Nature Science Fundation(No.81670845)Research Foundation of Shanghai Science and Technology Committee(No.14411960600)The Science and Technology Commission of Shanghai(No.17DZ2260100)
文摘AIM: To investigate the efficacy of low-energy selective laser trabeculoplasty(SLT) on the treatment of primary open angle glaucoma(POAG) patients.METHODS: Outpatients with POAG who underwent 360-degree SLT using an initial energy of 0.3 mJ(total energy of 30-40 mJ) were reviewed retrospectively from September 2011 to January 2018.RESULTS: Eight-six eyes of 44 POAG patients underwent 360-degree SLT using initial energy of 0.3 mJ and were followed up regularly. The total energy used was 32.5±2.5 mJ(23-40 mJ, 105±6 spots). The average pretreatment intraocular pressure(IOP) was 19.8±3.9 mm Hg. At 1, 3, 6 mo, 1, and 2 y, the post-SLT IOPs(mm Hg) were 16.9±3.3, 16.5±3.3, 17.1±3.4, 16.6±3.5, 16.5±2.8, which were significantly lower than that before treatment(P<0.001). The patients in the SLT success group were found to be younger than those in the SLT failure group. After SLT, 59 eyes that maintained pretreatment medications were defined as the drug retention group. The pre-SLT IOP was 20.1±3.7 mm Hg.At 1, 3, 6 mo, 1, and 2 y, the post-SLT IOPs(mm Hg) were 17.3±3.6, 16.6±3.5, 17.2±3.6, 16.9±3.8 and 16.5±2.9, respectively. Twenty-seven eyes that required reduced drugs were defined as the drug reduction group. The pre-SLT IOP was 19.2±4.4 mm Hg. At 1, 3, 6 mo, 1, and 2 y, the post-SLT IOPs(mm Hg) were 16.1±2.6, 16.5±3.1, 16.8±2.9, 16.0±2.6 and 16.3±2.4, respectively. Compared with the pretreatment IOPs, the post-SLT IOPs were significantly lower in drug retention group and drug reduction group. The patients in the drug reduction group were found to be younger than those in the drug retention group.CONCLUSION: Low-energy SLT is safe and effective for POAG patients during a 2-year follow-up. Younger POAG patients may obtain better results after low-energy SLT treatment.
基金Supported by National Natural Science Foundation of China(No.81670851)
文摘AIM: To evaluate the efficiency and safety of micropulse laser trabeculoplasty(MLT) for primary open angle glaucoma(POAG) patients. METHODS: Retrospective study. POAG patients undergoing MLT in Peking University Third Hospital from June 2016 to November 2017. Seventy-two eyes of 72 POAG patients were enrolled. Only one eye of each patient was treated by MLT. The intraocular pressure(IOP) before MLT and at 1 d, 1, 4, 12 and 24 wk and glaucoma medication before and after treatment were compared.RESULTS: The IOP was 20.6±5.9 mm Hg before MLT and 20.8±6.8 mm Hg at 2 h after MTL. The IOP at 1 d, 1, 4, 12 and 24 wk was 17.9±4.4, 18.0±4.3, 17.5±3.4, 17.0±2.7, and 16.5±2.9 mm Hg, respectively. The IOP before and after MLT demonstrated a statistically significant difference by ANOVA analyses(F=5.797, P<0.001). Least significant difference t-tests showed there was no statistically significant difference between pre-MLT IOP within 2 h after MLT(P=0.207). The statistically significant difference was confirmed between the pre-MLT IOP at 1 d, 1, 4, 12 and 24 wk after MLT(P=0.006, 0.009, 0.001, <0.001, <0.001, respectively). The number of glaucoma medications before MLT was 1.7±1.4 and 1.5±1.4 24 wk after MLT with a significantly statistical difference(t=2.219, P=0.031)CONCLUSION: MLT is effective and safe for POAG patients. No patient experienced IOP spikes after MLT. The IOP 6 mo after treatment decreased significantly with less glaucoma medication.
