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
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
The effect of open porosity of Y2O3ceramic on the apparent contact angle and interaction between molten Ti47 Al alloy and Y2O3ceramic substrates under pure Ar was investigated by using a sessile drop method at 1600 &#...The effect of open porosity of Y2O3ceramic on the apparent contact angle and interaction between molten Ti47 Al alloy and Y2O3ceramic substrates under pure Ar was investigated by using a sessile drop method at 1600 °C. As the open porosity increased from 9.6% to 30.3%, the spreading rate of molten Ti47 Al alloys on Y2O3ceramic substrates reduced from 2.3 to 1.1°/s; meanwhile, the final equilibrium contact angles increased from 55.8° to 63.6°. The microstructure observations revealed that with increasing the open porosity of the Y2O3substrates, the thickness of sand adhesion at the interfaces of the alloy droplets increased from 5.4 to 15.7 lm, and ceramic particles in the alloy matrix increased as well. The increasing contact area between the molten alloy and the substrate played a dominant role in determining the interaction on Ti Al/Y2O3interface.展开更多
Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular mes...Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of B中央人民政府 who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10<sup>th</sup> and 30<sup>th</sup> postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10<sup>th</sup> and 30<sup>th</sup> POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.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 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 examine whether rs2472493 and rs248032 in the ABCA1 gene,rs3785176 in the PMM2 gene,and rs11827818 in the ARHGEF12 gene contribute to primary open angle glaucoma(POAG)in an Iranian population.METHODS:Totally 82...AIM:To examine whether rs2472493 and rs248032 in the ABCA1 gene,rs3785176 in the PMM2 gene,and rs11827818 in the ARHGEF12 gene contribute to primary open angle glaucoma(POAG)in an Iranian population.METHODS:Totally 82 POAG patients and 172 healthy controls were enrolled.The selected gene polymorphisms were analyzed using TaqMan SNP Genotyping Assay using deoxyribonucleic acid(DNA)extracted from blood samples.Allelic and genotypic frequencies were evaluated using the Chi-square test.The association between the genotypes of single nucleotide polymorphisms(SNPs)and POAG was assessed using multiple logistic regression models.The linkage disequilibrium and haplotype block structure were assessed using the Haploview 4.2 software.RESULTS:The results showed a significant association between allele frequencies of rs2472493 in the ABCA1 gene locus and POAG[odds ratio(OR)=1.58,95%confidence intervals(CI)=1.04-2.39,P=0.031].The rs3785176 in the PMM2 gene was also associated with POAG in additive and over dominant genotypes.Moreover,haplotype analysis showed a significant association of two estimated haplotypes of rs2472493/rs2487032 with POAG.The AA haplotype showed a reduction in POAG risk(OR=0.41,95%CI=0.202-0.834,P=0.012),while the GG haplotype was associated with the disease.In addition,this study could not discover any association between genotype and allele frequency of rs248032 in the ABCA1 gene,and rs11827818 in ARHGEF12 gene and POAG.CONCLUSION:rs2472493 in the ABCA1 gene can be considered a genetic susceptibility locus for POAG.The haplotype constructed with ABCA1 gene SNPs(rs2472493/rs2487032)is associated with POAG.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
Pressure-driven reverse osmosis membrane has important application in seawater desalination.Inspired by the structure of aquaporin,we established and studied the mechanism of the structure of multilayer graphene with ...Pressure-driven reverse osmosis membrane has important application in seawater desalination.Inspired by the structure of aquaporin,we established and studied the mechanism of the structure of multilayer graphene with tapered channels as reverse osmosis.The water flux of multilayer graphene with tapered channels was about 20%higher than that of parallel graphene channel.The flow resistance model was established,and the relationship between flow resistance and opening angles was clarified.The relationship between flow resistance and outlet size was also described.By means of molecular dynamics simulation,slip coefficients of multilayer graphene with tapered channel were obtained and verified by the contact angle of water.Results show that the permeability of graphene with tapered channel is about three orders of magnitude higher than that of commercial reverse osmosis membrane and the desalination rate is 100%.Temperature difference between the two sides of the tapered channel will promote the water flux positively.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 analyze the diagnostic capabilities of peripapillary retinal nerve fiber layer（p RNFL） thickness and segmented inner macular layer（IML） thickness measured by spectraldomain optical coherence tomography fo...AIM： To analyze the diagnostic capabilities of peripapillary retinal nerve fiber layer（p RNFL） thickness and segmented inner macular layer（IML） thickness measured by spectraldomain optical coherence tomography for detection of early glaucoma. METHODS： Fifty-three patients with primary open angle glaucoma（POAG）, 60 patients with normal tension glaucoma（NTG） and 32 normal control subjects were enrolled. Thicknesses of p RNFL, total macular layers（TML）, and the IML, including macular RNFL（m RNFL） and macular ganglion cell layer（m GCL） were assessed. The areas under the receiver operating characteristic curves（AROC） were calculated to compare the diagnostic power of different parameters. RESULTS： There were no differences in the parameters of p RNFL, TML, and IML between POAG and NTG groups. The thicknesses of superior and inferior m GCL showed significant correlation with mean deviation of visual field（R2=0.071, P=0.004; R2=0.08, P=0.002）. The m GCL thickness significantly correlated with the p RNFL thickness in the superior and inferior quadrants（R2=0.156, P〈0.001; R2=0.407, P〈0.001）. The thickness of the inferior-outer sector of macula had greater AROCs than those in the inferior-inner sector of macula. The AROCs for superior（0.894） and inferior（0.879） p RNFL thicknesses were similar with the AROCs for superior（0.839） and inferior m GCL（0.864） thicknesses. Sensitivities at 80% specificity for global p RNFL, inferior-outer m GCL and inferior-outer m RNFL thicknesses were 0.938, 0.867, and 0.725, respectively. CONCLUSION： The diagnostic capability of the m GCL thickness is comparable to that of the p RNFL thickness in patients with early glaucoma. The inferior-outer sector of IML has a better diagnostic capability than the inferiorinner sector of IML for detection of early glaucoma.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 quantify the association between diabetes and glaucoma using Meta-analysis.METHODS：Pub Med and Embase were searched using medical subject headings and key words related to diabetes and glaucoma.The inclusion ...AIM：To quantify the association between diabetes and glaucoma using Meta-analysis.METHODS：Pub Med and Embase were searched using medical subject headings and key words related to diabetes and glaucoma.The inclusion criteria were：1）the study design was a prospective cohort study;2）the exposure of interest was diabetes;3）the outcome of interest was primary open angle glaucoma（POAG）;4）risk ratios（RR）and the corresponding 95%confidence interval（CI）.Data were pooled using fixed effects models to take into account heterogeneity between studies.Seven prospective studies were selected.Diabetes increased the incidence of glaucoma by 36%（OR=1.36,95%CI=1.25-1.50）.There was no evidence of statistical heterogeneity（I2=0,P=0.53）or publication bias（the funnel plot did not identify obvious asymmetry）.RESULTS：Seven prospective cohort studies were incorporated in this Meta-analysis.The pooled RR of the association between POAG and diabetes based on the risk estimates of the seven cohort studies was 1.36（95%CI=1.24-1.50）,with no significant heterogeneity across studies（I2=0;P=0.526）.The sensitivity analysis yielded a range of RRs from 1.34（95%CI=1.22-1.48）to1.40（95%CI=1.18-1.67）.CONCLUSION：Diabetes is associated with a significantly increased risk of glaucoma.展开更多
AIM: To assess the inflammatory cytokines expression in aqueous humor in diabetic primary open angle glaucoma(POAG) patients. METHODS: A cross-sectional study on 87 eyes, distributed as following: 26 eyes from diabeti...AIM: To assess the inflammatory cytokines expression in aqueous humor in diabetic primary open angle glaucoma(POAG) patients. METHODS: A cross-sectional study on 87 eyes, distributed as following: 26 eyes from diabetic patients, 16 eyes with POAG and 21 eyes from diabetic POAG patients; healthy controls(24 eyes) were recruited from patients undergoing conventional cataract surgery. A volume of 100 μL of aqueous humor(AH) was collected during phacoemulsification and 21 inflammatory markers were quantified using a Luminex~? cytometric bead assay: IL-1 Ra, IL-1α, IL-1β, IL-5, IL-6, IL-10, IL-17, GM-CSF, IFNγ, CCL2, CCL3, CCL4, CXCL5, CXCL8, bFGF, VEGF, TNFα. Main changes in cytokine profile were analyzed and compared between groups. Data on demographics, duration of glaucoma, intraocular pressure(IOP), number of anti-glaucoma substances were recorded for correlation analysis and prediction models. RESULTS: Significant differences in cytokine expression between groups were detected for CXCL5(P<0.001), CXCL8(P=0.004), IL-1α(P<0.001), IL-2(P<0.001), CCL4(P=0.003), CCL5(P<0.001) and TNFα(P=0.05). Post-hoc analysis identified IL-2(P=0.009) and CXCL5(P<0.001) as "separation markers" between POAG and diabetic POAG eyes. In POAG patients, the "separation markers" could highly predict the TNFα levels F(1, 16)=14.639, P<0.001, whereas in diabetic patients F(1, 24)=4.844, P=0.006 and diabetic POAG patients F(1, 19)=2.358, P=0.05 the level of prediction was inferior.CONCLUSION: Our results reveal an inflammatory model based on increased TNFα levels in POAG eyes.Simultaneous co-stimulatory molecules and additional inflammatory pathways need to be further explored in diabetic POAG cases, since the prediction model could only partially explain the increased TNFα level in this category of patients.展开更多
AIM:To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma(POAG)by optical coherence tomography(OCT)and optical coherence ...AIM:To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma(POAG)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),and to evaluate the diagnostic value of OCT and OCTA.METHODS:Totally 15 patients(23 eyes)with early POAG as observation group and 30 health people(30 eyes)as normal control group were enrolled in this cross-sectional study.OCTA-based superficial macula vessel density,superficial macula perfusion density,superficial optic disc vessel density,superficial optic disc perfusion density and spectral domain OCT(SD-OCT)-based macular area thickness,ganglion cell complex(GCC)thickness and retinal nerve fiber layer(RNFL)thickness were measured in the two groups.Independent t-test and receiver operating characteristic curve were used for analysis.Area under the receiver operating characteristic curves(AUROC)were used to measure the diagnostic utility.RESULTS:Among all the parameters,the optimal diagnostic utility parameter was the superficial vessel density in the macular area(except the center of the macula),and the AUROC reached 0.98.The diagnostic utility of macular area perfusion density(except the center of the macula)was similar to that of superficial vessel density in the macular area,and the AUROC was above 0.97.Followed by the diagnostic utility of vessel density in the optic disc area,the best parameter was the inner ring of the vessel density,and its AUROC reached 0.97.The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area.The best parameter was the central optic disc perfusion density,and its AUROC was 0.95.The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above,the top three parameters were the inferior RNFL thickness(AUROC=0.919),the superior(AUROC=0.919)and the inferior GCC thickness(AUROC=0.9077).CONCLUSION:The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters.OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.展开更多
The introduction of selective laser trabeculoplasty (SLT) provided a new choice for the reduction of intraocular pressure (IOP) in eyes with open angle glaucoma (OAG) and ocular hypertension (OHT). SLT was demonstrate...The introduction of selective laser trabeculoplasty (SLT) provided a new choice for the reduction of intraocular pressure (IOP) in eyes with open angle glaucoma (OAG) and ocular hypertension (OHT). SLT was demonstrated equally as effective as topical medical therapy and argon laser trabeculoplasty (ALT) to lower IOP. It is a potentially repeatable procedure because of the lack of coagulation damage to the trabecular meshwork (TM) and also effect in patients with previously failed ALT. SLT can be used to treat patients with OAG, pseudoexfoliation glaucoma, pigmentary glaucoma, normal-tension glaucoma, OHT, juvenile glaucoma, pseudophakic and aphakic glaucoma. Furthermore, SLT can be considered as a primary treatment option in patients who cannot tolerate or are noncompliant with medications, while not interfering with the success of future surgery. Its safety profiles include mild and transient inflammation, ocular pain and a small risk of moderate IOP elevations after the procedure. SLT is a safe and effective means of IOP reduction in eyes with OAG and OHT.展开更多
AIM:To find a new concept to show whether or not apoptosis of retinal ganglion cells(RGCs)canbe determined in the histology of acute hyperglycemia in the role of expressed Brn3b gene related to nitric oxide(NO),caspas...AIM:To find a new concept to show whether or not apoptosis of retinal ganglion cells(RGCs)canbe determined in the histology of acute hyperglycemia in the role of expressed Brn3b gene related to nitric oxide(NO),caspase-3,nuclear factor kappa-B(NF-κB),and tumor necrosis factor-α(TNF-α)as an early predictor of primary open angle glaucoma(POAG)eyes and their associations.METHODS:Experimental in vivo study was carried out using adult male,white Sprague-Dawley rats aged≥2 mo,weighing 150-200 g.The animals were divided into two groups,one group receiving intraperitoneal injection of streptozotociz 50 mg/kg in 0.01 mol/L citricbuffer and p H 4.5 and a comparison made with the control group.Retinal tissue was divided into two parts(both experimental and control groups respectively):a)right retina for immunohistochemistry(IHC;caspase-3 and TNF-α);b)left retina was divided into two parts for the purpose of real-time polymerase chain reaction(PCR)test(RNA extraction for Brn3b gene expression analysis)and ELISA test(NO and NF-κB).RESULTS:The experimental group showed a decrease in Brn3b gene expression compared to the control group(1.3-fold lower in 2nd month;1.1-fold lower in 4th month and 2.5-fold lower in 6th month).However,there was a decrease of NO,caspase-3,and an increase of NF-κB and TNF-αquantity.CONCLUSION:The expression of m RNA Brn3b gene is inversely proportional to apoptosis in RGCs.The quantity of NO,caspase-3,NF-κB and TNF-αis influential in expression of Brn3b in RGCs caused by hyperglycemia in diabetic rats.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 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support of the‘‘National Science&Technology Pillar Program of China’’project of PR China(No.2013BAB11B04)the National Natural Science Foundation of China(Grant No.51404017)the State Key Laboratory of Refractories and Metallurgy,Wuhan University of Science and Technolog
文摘The effect of open porosity of Y2O3ceramic on the apparent contact angle and interaction between molten Ti47 Al alloy and Y2O3ceramic substrates under pure Ar was investigated by using a sessile drop method at 1600 °C. As the open porosity increased from 9.6% to 30.3%, the spreading rate of molten Ti47 Al alloys on Y2O3ceramic substrates reduced from 2.3 to 1.1°/s; meanwhile, the final equilibrium contact angles increased from 55.8° to 63.6°. The microstructure observations revealed that with increasing the open porosity of the Y2O3substrates, the thickness of sand adhesion at the interfaces of the alloy droplets increased from 5.4 to 15.7 lm, and ceramic particles in the alloy matrix increased as well. The increasing contact area between the molten alloy and the substrate played a dominant role in determining the interaction on Ti Al/Y2O3interface.
文摘Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of B中央人民政府 who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10<sup>th</sup> and 30<sup>th</sup> postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10<sup>th</sup> and 30<sup>th</sup> POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.
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 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 the Noor Ophthalmology Research Center and Shahroud University of Medical Sciences(No.9449)Shahroud University of Medical Sciences(No.9449)Shahroud Eye Cohort Study is supported by the Noor Ophthalmology Research Center and Shahroud University of Medical Sciences(No.8737).
文摘AIM:To examine whether rs2472493 and rs248032 in the ABCA1 gene,rs3785176 in the PMM2 gene,and rs11827818 in the ARHGEF12 gene contribute to primary open angle glaucoma(POAG)in an Iranian population.METHODS:Totally 82 POAG patients and 172 healthy controls were enrolled.The selected gene polymorphisms were analyzed using TaqMan SNP Genotyping Assay using deoxyribonucleic acid(DNA)extracted from blood samples.Allelic and genotypic frequencies were evaluated using the Chi-square test.The association between the genotypes of single nucleotide polymorphisms(SNPs)and POAG was assessed using multiple logistic regression models.The linkage disequilibrium and haplotype block structure were assessed using the Haploview 4.2 software.RESULTS:The results showed a significant association between allele frequencies of rs2472493 in the ABCA1 gene locus and POAG[odds ratio(OR)=1.58,95%confidence intervals(CI)=1.04-2.39,P=0.031].The rs3785176 in the PMM2 gene was also associated with POAG in additive and over dominant genotypes.Moreover,haplotype analysis showed a significant association of two estimated haplotypes of rs2472493/rs2487032 with POAG.The AA haplotype showed a reduction in POAG risk(OR=0.41,95%CI=0.202-0.834,P=0.012),while the GG haplotype was associated with the disease.In addition,this study could not discover any association between genotype and allele frequency of rs248032 in the ABCA1 gene,and rs11827818 in ARHGEF12 gene and POAG.CONCLUSION:rs2472493 in the ABCA1 gene can be considered a genetic susceptibility locus for POAG.The haplotype constructed with ABCA1 gene SNPs(rs2472493/rs2487032)is associated with POAG.
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.
基金the National Natural Science Foundation of China(No.51706157)Applied Basic Research Foundation of Guangdong Hong Kong-Macao Greater Bay Area(No.2020B1515120011)。
文摘Pressure-driven reverse osmosis membrane has important application in seawater desalination.Inspired by the structure of aquaporin,we established and studied the mechanism of the structure of multilayer graphene with tapered channels as reverse osmosis.The water flux of multilayer graphene with tapered channels was about 20%higher than that of parallel graphene channel.The flow resistance model was established,and the relationship between flow resistance and opening angles was clarified.The relationship between flow resistance and outlet size was also described.By means of molecular dynamics simulation,slip coefficients of multilayer graphene with tapered channel were obtained and verified by the contact angle of water.Results show that the permeability of graphene with tapered channel is about three orders of magnitude higher than that of commercial reverse osmosis membrane and the desalination rate is 100%.Temperature difference between the two sides of the tapered channel will promote the water flux positively.
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 grants CMRPG8E1251 from Chang Gung Memorial Hospital,Taiwan
文摘AIM： To analyze the diagnostic capabilities of peripapillary retinal nerve fiber layer（p RNFL） thickness and segmented inner macular layer（IML） thickness measured by spectraldomain optical coherence tomography for detection of early glaucoma. METHODS： Fifty-three patients with primary open angle glaucoma（POAG）, 60 patients with normal tension glaucoma（NTG） and 32 normal control subjects were enrolled. Thicknesses of p RNFL, total macular layers（TML）, and the IML, including macular RNFL（m RNFL） and macular ganglion cell layer（m GCL） were assessed. The areas under the receiver operating characteristic curves（AROC） were calculated to compare the diagnostic power of different parameters. RESULTS： There were no differences in the parameters of p RNFL, TML, and IML between POAG and NTG groups. The thicknesses of superior and inferior m GCL showed significant correlation with mean deviation of visual field（R2=0.071, P=0.004; R2=0.08, P=0.002）. The m GCL thickness significantly correlated with the p RNFL thickness in the superior and inferior quadrants（R2=0.156, P〈0.001; R2=0.407, P〈0.001）. The thickness of the inferior-outer sector of macula had greater AROCs than those in the inferior-inner sector of macula. The AROCs for superior（0.894） and inferior（0.879） p RNFL thicknesses were similar with the AROCs for superior（0.839） and inferior m GCL（0.864） thicknesses. Sensitivities at 80% specificity for global p RNFL, inferior-outer m GCL and inferior-outer m RNFL thicknesses were 0.938, 0.867, and 0.725, respectively. CONCLUSION： The diagnostic capability of the m GCL thickness is comparable to that of the p RNFL thickness in patients with early glaucoma. The inferior-outer sector of IML has a better diagnostic capability than the inferiorinner sector of IML for detection of early glaucoma.
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.
基金Supported by the Plan of Wenzhou Science and Technology(No.Y20160439)
文摘AIM：To quantify the association between diabetes and glaucoma using Meta-analysis.METHODS：Pub Med and Embase were searched using medical subject headings and key words related to diabetes and glaucoma.The inclusion criteria were：1）the study design was a prospective cohort study;2）the exposure of interest was diabetes;3）the outcome of interest was primary open angle glaucoma（POAG）;4）risk ratios（RR）and the corresponding 95%confidence interval（CI）.Data were pooled using fixed effects models to take into account heterogeneity between studies.Seven prospective studies were selected.Diabetes increased the incidence of glaucoma by 36%（OR=1.36,95%CI=1.25-1.50）.There was no evidence of statistical heterogeneity（I2=0,P=0.53）or publication bias（the funnel plot did not identify obvious asymmetry）.RESULTS：Seven prospective cohort studies were incorporated in this Meta-analysis.The pooled RR of the association between POAG and diabetes based on the risk estimates of the seven cohort studies was 1.36（95%CI=1.24-1.50）,with no significant heterogeneity across studies（I2=0;P=0.526）.The sensitivity analysis yielded a range of RRs from 1.34（95%CI=1.22-1.48）to1.40（95%CI=1.18-1.67）.CONCLUSION：Diabetes is associated with a significantly increased risk of glaucoma.
文摘AIM: To assess the inflammatory cytokines expression in aqueous humor in diabetic primary open angle glaucoma(POAG) patients. METHODS: A cross-sectional study on 87 eyes, distributed as following: 26 eyes from diabetic patients, 16 eyes with POAG and 21 eyes from diabetic POAG patients; healthy controls(24 eyes) were recruited from patients undergoing conventional cataract surgery. A volume of 100 μL of aqueous humor(AH) was collected during phacoemulsification and 21 inflammatory markers were quantified using a Luminex~? cytometric bead assay: IL-1 Ra, IL-1α, IL-1β, IL-5, IL-6, IL-10, IL-17, GM-CSF, IFNγ, CCL2, CCL3, CCL4, CXCL5, CXCL8, bFGF, VEGF, TNFα. Main changes in cytokine profile were analyzed and compared between groups. Data on demographics, duration of glaucoma, intraocular pressure(IOP), number of anti-glaucoma substances were recorded for correlation analysis and prediction models. RESULTS: Significant differences in cytokine expression between groups were detected for CXCL5(P<0.001), CXCL8(P=0.004), IL-1α(P<0.001), IL-2(P<0.001), CCL4(P=0.003), CCL5(P<0.001) and TNFα(P=0.05). Post-hoc analysis identified IL-2(P=0.009) and CXCL5(P<0.001) as "separation markers" between POAG and diabetic POAG eyes. In POAG patients, the "separation markers" could highly predict the TNFα levels F(1, 16)=14.639, P<0.001, whereas in diabetic patients F(1, 24)=4.844, P=0.006 and diabetic POAG patients F(1, 19)=2.358, P=0.05 the level of prediction was inferior.CONCLUSION: Our results reveal an inflammatory model based on increased TNFα levels in POAG eyes.Simultaneous co-stimulatory molecules and additional inflammatory pathways need to be further explored in diabetic POAG cases, since the prediction model could only partially explain the increased TNFα level in this category of patients.
基金Supported by Key Research and Development(R&D)Projects of Shanxi Province(No.201803D31095)。
文摘AIM:To observe and characterize imaging features of macular and optic disc areas in less than 60-year-old patients with early primary open angle glaucoma(POAG)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),and to evaluate the diagnostic value of OCT and OCTA.METHODS:Totally 15 patients(23 eyes)with early POAG as observation group and 30 health people(30 eyes)as normal control group were enrolled in this cross-sectional study.OCTA-based superficial macula vessel density,superficial macula perfusion density,superficial optic disc vessel density,superficial optic disc perfusion density and spectral domain OCT(SD-OCT)-based macular area thickness,ganglion cell complex(GCC)thickness and retinal nerve fiber layer(RNFL)thickness were measured in the two groups.Independent t-test and receiver operating characteristic curve were used for analysis.Area under the receiver operating characteristic curves(AUROC)were used to measure the diagnostic utility.RESULTS:Among all the parameters,the optimal diagnostic utility parameter was the superficial vessel density in the macular area(except the center of the macula),and the AUROC reached 0.98.The diagnostic utility of macular area perfusion density(except the center of the macula)was similar to that of superficial vessel density in the macular area,and the AUROC was above 0.97.Followed by the diagnostic utility of vessel density in the optic disc area,the best parameter was the inner ring of the vessel density,and its AUROC reached 0.97.The diagnostic utility of perfusion density in the optic disc area was slightly lower than that of vessel density in the optic disc area.The best parameter was the central optic disc perfusion density,and its AUROC was 0.95.The SD-OCT-based diagnostic utility parameters were generally lower than that mentioned above,the top three parameters were the inferior RNFL thickness(AUROC=0.919),the superior(AUROC=0.919)and the inferior GCC thickness(AUROC=0.9077).CONCLUSION:The OCT-based diagnostic utility parameters are generally lower than the OCTA-based diagnostic utility parameters.OCTA has an important clinical application value in diagnosis and evaluation for less than 60-year-old patients with early POAG.
基金Research Fund from Health Department of Hunan Province, China (No. B2009004)Research Fund from Department of finance of Hunan Province, China (No.2008-115)
文摘The introduction of selective laser trabeculoplasty (SLT) provided a new choice for the reduction of intraocular pressure (IOP) in eyes with open angle glaucoma (OAG) and ocular hypertension (OHT). SLT was demonstrated equally as effective as topical medical therapy and argon laser trabeculoplasty (ALT) to lower IOP. It is a potentially repeatable procedure because of the lack of coagulation damage to the trabecular meshwork (TM) and also effect in patients with previously failed ALT. SLT can be used to treat patients with OAG, pseudoexfoliation glaucoma, pigmentary glaucoma, normal-tension glaucoma, OHT, juvenile glaucoma, pseudophakic and aphakic glaucoma. Furthermore, SLT can be considered as a primary treatment option in patients who cannot tolerate or are noncompliant with medications, while not interfering with the success of future surgery. Its safety profiles include mild and transient inflammation, ocular pain and a small risk of moderate IOP elevations after the procedure. SLT is a safe and effective means of IOP reduction in eyes with OAG and OHT.
文摘AIM:To find a new concept to show whether or not apoptosis of retinal ganglion cells(RGCs)canbe determined in the histology of acute hyperglycemia in the role of expressed Brn3b gene related to nitric oxide(NO),caspase-3,nuclear factor kappa-B(NF-κB),and tumor necrosis factor-α(TNF-α)as an early predictor of primary open angle glaucoma(POAG)eyes and their associations.METHODS:Experimental in vivo study was carried out using adult male,white Sprague-Dawley rats aged≥2 mo,weighing 150-200 g.The animals were divided into two groups,one group receiving intraperitoneal injection of streptozotociz 50 mg/kg in 0.01 mol/L citricbuffer and p H 4.5 and a comparison made with the control group.Retinal tissue was divided into two parts(both experimental and control groups respectively):a)right retina for immunohistochemistry(IHC;caspase-3 and TNF-α);b)left retina was divided into two parts for the purpose of real-time polymerase chain reaction(PCR)test(RNA extraction for Brn3b gene expression analysis)and ELISA test(NO and NF-κB).RESULTS:The experimental group showed a decrease in Brn3b gene expression compared to the control group(1.3-fold lower in 2nd month;1.1-fold lower in 4th month and 2.5-fold lower in 6th month).However,there was a decrease of NO,caspase-3,and an increase of NF-κB and TNF-αquantity.CONCLUSION:The expression of m RNA Brn3b gene is inversely proportional to apoptosis in RGCs.The quantity of NO,caspase-3,NF-κB and TNF-αis influential in expression of Brn3b in RGCs caused by hyperglycemia in diabetic rats.
