准分子激光角膜屈光手术后开角型青光眼患者的临床特征

目的：观察具有准分子激光角膜屈光手术（简称准分子术）史的开角型青光眼患者的临床特征。方法：回顾 性病例研究。纳入2005─2018年北京大学第三医院眼科中心就诊、具有准分子术史且随访2年以上的 开角型青光眼患者。记录一般情况以及特殊检查结果,选取每例视野较差的眼或双眼相似者随机1眼 作为研究眼。对视野进展分析采用非参数分析（NPA）法。采用独立样本t检验及秩和检验进行分析。结果： 共纳入33例患者,青光眼确诊均在准分子术后,手术至青光眼确诊间隔（10.3±6.1）年,确诊时年龄 （37.5±10.4）岁,最高眼压<21 mmHg（1 mmHg=0.133 kPa）者27例（82%）;中央角膜厚度为（456±47）μm。 眼底照相显示视网膜神经纤维层缺损18例（55%）,无法辨认的15例（45%）;杯/盘比为0.7±0.1。视 野平均缺损（MD）绝对值小于6的有18例（55%）,6～12有8例（24%）,12以上有7例（21%）。其中随 访2年以上21例,随访时间为（4.5±2.2）年;视野进展13例（62%）,视野进展速度为（0.5±0.6）dB/年。 视野进展组与非进展组治疗后降眼压幅度分别为（28.3±20.7）%和（15.4±11.0）%（t=-1.867,P=0.078）, 屈光回退发生率分别为92%和25%（P=0.003）。21例中屈光回退14例（64%）,屈光回退组中12例 （12/14）视野进展,无回退组中1例视野进展（1/7）（P=0.003）;屈光回退组的视野进展[（0.7±0.7）dB/年] 快于无回退组[（0.1±0.1）dB/年]（t=-2.899,P=0.011）。结论：准分子术后的青光眼患者确诊时大多 处于病情早中期,4/5患者眼压在21 mmHg以下,通过眼底照相能明确视网膜神经纤维层缺损的只 占一半病例。随访中约2/3患者视野恶化,可能与屈光回退有关。     

眼压与全身因素的相关性研究

背景 眼压的异常可导致眼球形态和功能的改变,以往人们对影响眼压因素的研究多集中在眼部因素方面,全身因素对眼压的影响研究较少. 目的 研究中国人群正常眼压分布及其全身的影响因素.方法 采用横断面研究设计.研究对象为广州市干部疗养院健康体检者中自愿参加眼科检查的受试者.按照事先培训的统一标准测量受检者的身高、体质量及血压,利用非接触眼压计测量眼压,由接受统一培训并有经验的专业人员对受检者进行裂隙灯及眼底检查,眼底视盘表现可疑者接受倍频视野检查,通过问卷调查了解受检者眼部手术史,视野异常、任何一侧眼有手术史者排除.用Stata 11.0统计学软件进行数据整理和统计分析.结果 共7763人完成眼压检查,其中男4213人,女3550人;曾行内眼手术或诊断为青光眼者415人剔除本研究,共7348人符合本研究的纳入标准,平均年龄(59.1±10.3)岁.纳入的受检者平均眼压为(15.6±2.8)mmHg(1 mmHg=0.133 kPa),其中男性为(15.6±2.8) mmHg,女性为(15.7±2.8) mmHg,不同性别间眼压的差异有统计学意义(t=2.415,P=0.016).受检者右眼与左眼眼压测量值一致(r=0.830,P＜0.001),故将右眼纳入统计分析.检查显示受检者眼压测量值呈近似正态分布,随年龄的增长眼压逐渐下降;多因素回归分析结果显示,眼压与年龄、性别均呈负相关(P＜0.001),与体质量指数(BMI)、收缩压及舒张压均呈正相关(P＜0.001).结论 在中国人群中年龄、性别、BMI及血压与眼压相关,与以往东亚地区的研究结论一致.     

急性闭角型青光眼高眼压状态下行白内障摘除对角膜内皮细胞的影响

目的：观察急性闭角型青光眼高眼压状态下行白内障摘除联合人工晶状体植入对角膜内皮细胞的 影响。方法：回顾性系列病例研究。选择2018年1月至2021年8月在同济大学附属同济医院眼科就 诊的急性闭角型青光眼发作且药物保守治疗及前房穿刺不能稳定控制眼压患者41例（55眼），眼压 （47.3±4.8）mmHg（1 mmHg=0.133 kPa），同时伴不同程度晶状体混浊。所有患者行白内障摘除联合 人工晶状体植入及房角分离术。术前及术后3个月内行常规眼科检查，并获取角膜内皮相关指标， 包括角膜内皮细胞密度（ECD）、中央角膜厚度（CCT）及变异系数（CV）等。手术前后各指标差值比 较采用配对t检验或Wilcoxon符号秩和检验。结果：术后第1天眼压为（16.7±3.7）mmHg，其中4眼 眼压仍高（[ 24.9±2.2）mmHg]需药物控制，其余患眼眼压在正常范围内；术后3个月眼压为（15.7±3.1） mmHg，与术前相比差异有统计学意义（t=36.48, P<0.001）。术后ECD[（1 023±344）个/mm2]明显 较术前 [（2 062±300）个/mm2]下降（t=-22.75, P<0.001）。术后CV（33.5%±6.8%）明显较术前CV （22.7%±2.6%）增大（t=13.62, P<0.001）。手术前后患眼最佳矫正视力明显改善（Z=-4.94, P<0.001）。 所有患者均未发生术中或术后并发症。结论：急性闭角型青光眼高眼压状态下行白内障摘除联合人 工晶状体植入可快速有效控制眼压，但角膜内皮细胞损伤明显。     

复杂外伤性睫状体离断的临床特征分析

 目的 探讨复杂外伤性睫状体离断的临床特征。设计 回顾性病例系列。研究对象2013年1月至2015年1月北京同仁医院就诊的复杂外伤性睫状体离断患者44例（44眼）。方法 回顾性分析患者的一般情况及临床表现特点。主要指标 性别、年龄、受伤眼别、致伤原因、视力、眼压、睫状体离断范围、眼部合并症等。结果 患者平均年龄（43±14）岁,男性39例（88.6%）,右眼占52.3%。致伤原因中钝挫伤占95.5%,以铁块崩伤、爆竹崩伤和拳击伤为主。就诊时平均视力（2.3±1.1）logMAR,平均眼压（8.0±3.4）mmHg。就诊时表现低眼压者占79.6%,浅前房占31.8%。眼压与睫状体离断范围无相关性（r=-0.09, P=0.56）。平均睫状体离断范围4.8±3.2个钟点,其中16例（37%）离断范围超过180°,3例离断范围 360°。右眼颞上象限,左眼鼻上和颞上象限易发生离断。眼部其他合并症包括晶状体损伤（84.1%）、前房积血（31.8%）、房角后退（18.2%）、虹膜根部离断（34.1%）、玻璃体积血（54.5%）、视网膜脱离（31.8%）等。结论 复杂外伤性睫状体离断常合并眼部多组织损伤尤其是晶状体损伤。对眼球钝挫伤即使无浅前房、低眼压等表现也需警惕睫状体离断的可能。（眼科, 2018, 27： 301-304）     

Schlemm管为基础的青光眼内引流手术术后眼压分布特征

目的：分析以Schlemm管为基础的各类型青光眼内引流手术术后眼压分布特征。方法：回顾性系列病例研究。选取2015年6月至2019年1月于温州医科大学附属眼视光医院行以Schlemm管为基础的青光眼内引流手术（黏小管成形术和穿透性黏小管成形术）的患者资料,入选其中随访时间≥6个月, 且末次随访在未用药情况下眼压≤21 mmHg（1 mmHg=0.133 kPa）患者,分析患者的眼压分布特征。各类型青光眼的眼压比较采用单因素方差分析。结果：共纳入患者204例（236眼）,术前眼压为 （33.4±12.1）mmHg,用药（2.7±1.2）种。术后末次随访时（6个月及以上）眼压为（13.9±3.3）mmHg。 其中眼压分布在5～10 mmHg有37眼（15.7%）,分布在>10～12 mmHg有43眼（18.2%）,分布在 >12～15 mmHg有78眼（33.1%）,分布在>15～18 mmHg有56眼（23.7%）,分布在>18～21 mmHg有 22眼（9.3%）。原发性开角型青光眼（85眼）、原发性闭角型青光眼（30眼）、继发性青光眼（76眼）和先天性青光眼（45眼）的末次随访眼压分别为（13.9±3.2）（14.5±3.0）（14.0±3.3）（13.2±3.7）mmHg, 各类型青光眼总体眼压差异无统计学意义（F=1.011,P=0.289）。对于原发性开角型青光眼,早、中、 晚期青光眼的目标眼压达标率分别为82.4%、81.8%、36.8%。结论：以Schlemm管为基础的青光眼内引流手术术后平均眼压为14 mmHg,80%的早、中期以及1/3的晚期原发性开角型青光眼患者可以达到目标眼压。     

基于爆破音的两种经巩膜睫状体光凝方案治疗难治性青光眼的疗效比较

目的 探讨根据爆破音调节经巩膜二极管激光睫状体光凝能量方案治疗难治性青光眼的疗效。设计 回顾性比较性病例系列。研究对象 难治性青光眼患者62例（62眼）。方法 将患者随机分为爆破音调节能量组（调节组）30例（30眼）,爆破音固定能量组（固定组）32例（32眼）。调节组在经巩膜二极管激光睫状体光凝术术中根据爆破音出现的频率不断调节能量。固定组以首次出现爆破音的能量完成手术。术后随访3个月。主要指标 激光总平均能量、爆破音数量、眼压、视力、用药数量、术后并发症。结果 术前及术后3个月调节组平均眼压分别为（46.1±10.7）mmHg和（15.8±6.9）mmHg;固定组分别为（44.9±12.3）mmHg和（16.7±8.2）mmHg。不使用降眼压药物眼压控制在 21 mmHg以下者,调节组占80.0%,固定组占65.6%（χ2=5.643,P=0.018）。爆破音数量与眼压下降幅度呈中度正相关（调节组r=0.517,P=0.001;固定组r=0.572,P=0.001）。调节组术后1例视力下降;固定组术后2例视力下降,1例持续性低眼压。结论 爆破音调节能量的经巩膜睫状体光凝方案较爆破音固定能量方案对难治性青光眼的的疗效更好。（眼科, 2020, 29： 147-151）     

微导管辅助小梁切开术治疗儿童青光眼的疗效

目的：观察微导管辅助的小梁切开术治疗儿童青光眼的临床效果及术后1 年切开小梁的开放情况。 方法：前瞻性临床研究。纳入2018 年1 月至2019 年12 月于河南省立眼科医院青光眼中心接受微导 管辅助的小梁切开术治疗的4～16 岁儿童青光眼患者21 例（28 眼）。观察记录患者手术前后最佳矫正 视力（BCVA）、眼压、抗青光眼药物使用数量、房角情况、术中及术后并发症。术后随访1 年。采用 配对t检验、Wilcoxon符号秩和检验、Kruskal-Wallis H检验、Spearman秩相关分析等对数据进行分 析。结果：所有患者均完成了微导管辅助的小梁切开术,其中完全切开16 例（22 眼）,次全切开5 例 （6眼）。术前及术后末次随访的BCVA（LogMAR视力）分别为0.80（0.00～2.00）和0.75（0.00～1.60）, 差异无统计学意义（Z=-1.41,P=0.157）。术前及术后末次随访的眼压分别为（30.4±4.8）mmHg （1 mmHg=0.133 kPa）和（14.1±4.5）mmHg,末次随访眼压较术前明显降低（t=14.11,P<0.001）。术 前使用降眼压药物数量中位数为3（1～4）,末次随访时下降至0（0～3）（ Z=-4.35,P<0.001）。末次 随访时切开小梁开放范围中位数为302.5°（70°～360°）。所有患者中15例（21眼）手术完全成功,4例 （5眼）条件成功,2例（2眼）手术失败,这3类患者切开小梁开放范围中位数分别为330°（210°～360°）、 205°（180°～225°）、85°（70°～100°）,差异有统计学意义（χ2=15.20,P=0.001）。切开小梁开放范围 与眼压呈负相关（r=-0.82,P<0.001）。结论：微导管辅助的小梁切开术治疗儿童青光眼具有良好的 临床效果,且术后切开小梁开放范围是影响患者预后的重要因素。     

动态轮廓眼压计在健康人群中使用情况的初步调查

目的调查动态轮廓眼压计（Dynamic Contour Tonometer,DCT）眼压及眼脉动幅度（Ocular Pulse Amplitude,OPA）在健康人群中使用时测量值范围。方法以DCT测量一组健康人（107例）的双眼眼压和OPA,获得该组人群的DCT眼压和OPA值的范围。结果该组健康人的DCT眼压值范围：右眼（18.02±2.96）mmHg,左眼（17.12±2.94）mmHg;OPA值范围：右眼（2.54±0.91）mmHg,左眼（2.53±0.94）mmHg。配对t检验表明,双眼之间DCT值有显著性统计学差异（t=0.240,P〈0.001）,双眼之间OPA值无显著性差异（t=5.294,P=0.811）。相关分析显示,双眼OPA值的大小与DCT眼压值之间均无显著的相关关系（右眼：r=0.124,P=0.207;左眼：r=0.133,P=0.180）。结论初步获得了DCT眼压和OPA在一健康人群中的范围,为今后的研究提供了依据。     

儿童眼压与近视屈光度的相关性

目的：探讨眼压高低与儿童近视屈光度数的关系。方法：横断面研究。共纳入2017年3─7月在河南 安阳城区开展的“安阳儿童眼病研究”随访的小学六年级学生2 126例，年龄为（12.2±0.4）岁。采用 自动电脑验光仪测量睫状肌麻痹后的屈光度并计算等效球镜度（SE），非接触式眼压计测量眼压（IOP）， 非接触光学测量仪Lenstar LS900获得眼轴长度、角膜厚度、前房深度和晶状体厚度等数据。将受检者 的IOP按照三分位数，分为低[IOP<14 mmHg（1 mmHg=0.133 kPa）]、中（14 mmHg≤IOP≤16 mmHg） 和高水平组（IOP>16 mmHg）。正视组的定义为-0.5 D≤SE≤0.5 D，远视组的定义为SE>0.5 D。近 视组的定义为SE<-0.5 D，其中分为低度近视组（-0.5 D≤SE<-3.0 D）、中度近视组（-6.0 D≤SE< -3.0 D）和高度近视组（SE<-6.0 D）。统一纳入右眼数据进行分析。采用独立样本t检验、单因素方 差分析及线性回归模型分析IOP与屈光度的关系。结果：所有受检者的IOP为（15.06±3.40）mmHg， SE为（-1.36±2.08）D。低、中和高IOP水平组的近视屈光度逐渐增大，差异有统计学意义（F=3.863， P=0.021）。低IOP水平组的SE为（-1.22±1.96）D，明显低于高IOP水平组（[ -1.52±2.22）D]（P=0.021）。 不同屈光不正类别的IOP比较，差异有统计学意义（F=2.695，P=0.029）。远视组的IOP最低 [（14.77±3.31）mmHg]，高度近视组的IOP最高[（16.32±3.55）mmHg]，2组的IOP相差1.55 mmHg （P=0.047）。以IOP为因变量，校正相关因素后的线性回归模型中，显示较高的IOP与较高的近视程 度明显相关（β=-0.168，P=0.013）。结论：较高的眼压与较高的近视程度明显相关，眼压在儿童青少 年近视发展过程中可能发挥作用，但因果关系仍需进一步研究。     

小梁切除术后早期视神经形态学变化的图像配比研究

目的 探讨成年人小梁切除术后早期的视神经形态学变化特征。设计 回顾性病例系列。研究对象 2010年6月至2011年10月北京市眼科研究所实施复合式小梁切除术、平均年龄（47.5±18.5）岁的青光眼患者57例57眼。方法 通过“同仁眼科电子病历系统”检索由本文第一作者在上述时间连续实施的复合式小梁切除术、术后眼压控制在正常范围、手术前及手术后6个月内进行眼底数码照相的青光眼患者。采用计算机图像处理软件的图像配准法闪烁比较同一患者手术前、后的眼底像,对视神经及后极部眼底形态进行定性分析。主要指标 手术前、后眼底像显示的视神经形态学改变。结果 57眼中,术后视杯缩小者43眼（75.4%）,视杯明显缩小者30眼（52.6%）。视杯缩小者与视杯无变化者平均年龄分别为（43.7±18.7）岁、（59.7±13.6）岁（t=-3.0,P=0.009）。视杯缩小者中慢性青光眼占95.3%（41眼）。术后视盘血管位置变化（主要是鼻侧血管向心性移位）者43眼（75.4%）,其与术后视杯缩小呈显著相关性（r=0.775,P=0.000）。视盘及其周围视网膜血管直径变化者29眼（50.9%）。出现黄斑区视网膜水肿者13眼（22.8%）。结论 成年人青光眼患者小梁切除术后早期随着眼压的降低出现视杯缩小及相应的视盘血管位置与直径变化较为普遍,这种变化在年轻患者更为突出。（眼科,2012,21：34-38）     

Refractive errors,intraocular pressure,and glaucoma in a white population

OBJECTIVE: To examine the relation of refractive errors to glaucoma and intraocular pressure (IOP) in a defined white population. DESIGN: Population-based cross-sectional and follow-up study. PARTICIPANTS: Persons aged 43 to 86 years living in Beaver Dam, Wisconsin (n = 4926). METHODS: All participants received a standardized assessment of refraction, IOP, and glaucoma at baseline (1988-1990), with IOP remeasured 5 years later (1993-1995). Refraction was defined at baseline as follows: myopia as spherical equivalent of -1.00 diopters (D) or less, emmetropia as -0.75 to +0.75 D, and hyperopia as +1.00 D or more. MAIN OUTCOME MEASURES: Relation of baseline refraction to prevalent glaucoma (defined from IOP, optic disc, and visual field criteria) and incident ocular hypertension (defined as IOP more than 21 mmHg at the 5-year examination in eyes with IOP of 21 mmHg or less at baseline). RESULTS: A myopic refraction was correlated with increasing IOP at baseline (P < 0.001). After controlling for age and gender, persons with myopia were 60% more likely to have prevalent glaucoma than those with emmetropia (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1, 2.3). In contrast, controlling for age, gender, and baseline IOP, persons with hyperopia were 40% more likely to have incident ocular hypertension than those who were emmetropic at baseline (OR, 1.4; 95% CI, 1.0, 2.0). Myopia was not related to incident ocular hypertension. CONCLUSIONS: In these population-based data, there was a cross-sectional association of myopia with higher IOP and prevalent glaucoma. Similar associations have been found in previous studies. Hyperopia may be associated with 5-year risk of ocular hypertension, a finding that needs further investigation.     

Prevalence of suspected glaucoma in Haiti: a pilot study

ObjectiveGather epidemiological data pertaining to the prevalence of suspected glaucoma in rural and urban areas of Haiti.DesignCross-sectional pilot study.ParticipantsHaitians of African ancestry.MethodsWe conducted a cross-sectional study on 211 Haitians of African ancestry (76 males and 135 females) aged 40 years and over. The mean age was 54.6 ± 10.9 years. The data were collected in glaucoma screening clinics at health fairs held in urban Port-au-Prince (57 people) and three rural regions (154 people) during a two-week medical mission to Haiti in November 2014. An ophthalmic exam with intraocular pressure measurement (with Tonopen) and dilated fundus exam were conducted.ResultsThe average C/D was 0.41 ± 0.18. The prevalence of suspected glaucoma, defined as C/D ≥ 0.7, asymmetry of ≥0.2 or significant rim notching, was 14.2%. The average IOP was 18.4 ± 5.4. Ocular hypertension (IOP ≥ 24mmHg) was found in 19.0% of participants.ConclusionsThe prevalence of ocular hypertension and glaucoma based on suspect optic nerves in our sample population was high, indicating a strong need for access to ophthalmologic care in the Haitian population.     

恒河猴慢性高眼压模型视乳头和视神经纤维损伤模式

目的 观察恒河猴慢性高眼压模型与开角型青光眼患者的视乳头和视神经纤维损伤模式是否一致。方法 实验研究。采用眼科多波长激光仪光凝恒河猴（12眼）的小梁网以破坏小梁网功能使眼压升高,建立恒河猴慢性高眼压模型。术前和术后每周行眼压、眼底照相、视乳头参数和视神经纤维层厚度检测。结果 建模的12眼术前眼压为（16.08±2.02）mmHg,中央角膜厚度为（489.17±17.82）μm,眼轴为（20.32±0.84）mm。12只用于诱导建模的恒河猴眼,经3～4次激光光凝,11眼被成功诱导。27周平均眼压为（30.32±14.59）mmHg,眼压波动幅度为（8.19±7.45）mmHg。光学相关断层扫描成像显示整个盘沿面积从（1.67±0.44）mm2减小到（0.43±0.34）mm2。平均视神经纤维从（97.92±6.79）μm减少到（64.46±17.44）μm。结论 恒河猴慢性高眼压性模型模拟了人类高眼压/开角型青光眼发病机制和过程,在视杯对高眼压的反应、视杯可逆性缩小、视神经纤维损伤现象等方面一致,是开展高眼压性视乳头和视神经纤维层损伤研究理想的动物模型。     

Comparison of dynamic contour tonometry with Goldmann applanation tonometry in glaucoma practice

Purpose: To compare intraocular pressure (IOP) readings taken using dynamic contour tonometry (DCT) with IOP readings taken with Goldmann applanation tonometry (GAT) in eyes with glaucoma or ocular hypertension. Methods: The present study included 100 eyes in 100 patients with glaucoma or ocular hypertension. After pachymetry DCT and GAT were performed. Intraocular pressures as measured with DCT and GAT were compared with one another and with central corneal thickness (CCT). Results: Mean DCT IOP measurements (20.1 ± 4.3 mmHg) were significantly (p < 0.001) higher than GAT IOP values (17.9 ± 4.7 mmHg). The mean difference between DCT and GAT measurements was 2.1 mmHg (range ? 3.4 to 9.7 mmHg). The difference followed a normal distribution. Measurements made with DCT and GAT correlated significantly with one another (Spearman’s rho = 0.761, p < 0.001). Neither GAT nor DCT measurements showed a significant correlation with CCT (537 ± 39 μm, range 458–656 μm). Multivariate regression analysis has shown that the difference between DCT and GAT is influenced significantly by ocular pulse amplitude (r = ? 0.334, p = 0.001) and it is not influenced by CCT (r = ? 0.106, p = 0.292). Conclusions: In eyes with glaucoma or ocular hypertension, DCT facilitates suitable and reliable IOP measurements which are in good concordance with GAT readings. Variation in CCT cannot by itself explain the differences in measurements taken with DCT and GAT in a number of eyes.     

他氟前列素对原发性开角型青光眼和高眼压症患者24小时眼压的影响

目的：通过测量24 h眼压评估他氟前列素对原发性开角型青光眼（POAG）和高眼压症（OHT）患者的 临床疗效。方法：系列病例研究。收集2018年1月至2019年3月在沈阳爱尔眼视光医院初次诊断的 POAG和OHT患者22例（43眼）,由医师对所有患者进行Icare HOME眼压计操作培训及认证,认证合 格后使用Goldmann压平眼压计（GAT）测量眼压3次,然后由患者使用Icare HOME眼压计自我监测 用药前24 h眼压,之后每天2100给予他氟前列素点眼1次,1个月后患者自我监测用药后24 h眼压。 采用单因素方差分析和Bland-Altman分析比较医师使用GAT和患者使用Icare HOME眼压计测量眼 压的一致性。采用配对t检验分析患者使用他氟前列素治疗前后各个时间点的眼压值、24 h眼压均值、 峰值、谷值和波动值的变化。结果：医师使用GAT和患者使用Icare HOME眼压计测量眼压的平均值 分别为（18.2±3.7）mmHg（1 mmHg=0.133 kPa）和（17.4±4.2）mmHg,差异无统计学意义（F=0.837, P=0.363）。Bland-Altman分析证明医师使用GAT和患者使用Icare HOME眼压计测量眼压具有良好 的一致性。使用他氟前列素治疗1个月后,所有评估时间点的眼压均降低（均P<0.05）,不同时间点 眼压降低的范围为1.8～5.5 mmHg。用药前24 h眼压均值、峰值、谷值、波动值分别为（19.4±5.0）、 （25.0±5.8）、（14.1±4.5）、（10.9±3.8）mmHg,用药后分别降低至（15.6±4.2）、（20.4±4.5）、（11.3±3.6）、 （9.2±2.9）mmHg,差异均有统计学意义（t=9.450、9.636、5.939、3.137,均P<0.05）。结论：对于初 次诊断的POAG和OHT患者,他氟前列素可明显降低24 h中所有评估时间点的眼压。     

The effect of substituting latanoprost 0.005% for unoprostone 0.12%

PURPOSE: To evaluate the effect of substituting latanoprost(LAT) 0.005% for unoprostone(UNO) 0.12% after a trial of unilateral treatment. METHODS: We treated 30 patients with primary open-angle glaucoma(n = 8), ocular hypertension (n = 1), or normal-tension glaucoma(n = 21) with UNO for 4 weeks in one eye and then substituted LAT for UNO. Four weeks later we measured the intraocular pressure(IOP) in the ipsilateral eye. RESULTS: The mean baseline IOP level was 18.6 +/- 3.8(mean +/- standard deviation) mmHg. The mean IOP levels(reduction rates) after UNO and LAT therapy were 16.7 +/- 3.1 mmHg (16.6%) and 14.1 +/- 3.2 mmHg (28.9%), respectively(p < 0.001). All patients who responded to UNO also responded to LAT; however, 55% of those who did not respond to UNO responded to LAT. CONCLUSIONS: If LAT is substituted for UNO, it can be predicted that 63.3% of the patients will respond.     

Intraocular pressure and prevalence of glaucoma in elderly people in Finland: a population-based study

The distribution of intraocular pressure (IOP) and the prevalence of glaucoma and their correlates were studied in a population-based study of inhabitants aged 70 years or older of three communities in the county of Oulu, Finland. 500 of the 560 eligible subjects (89%) were examined. IOP was measured using applanation tonometry. The diagnosis of glaucoma (or suspected glaucoma) was based on previous history and/or characteristic optic disc changes assessed first by ophthalmoscopy and later by photographic evaluation.No correlation existed between IOP level and age, but IOP was higher in women than in men. Glaucoma occurred in 12% of the participants (60 of 500 persons). In 42 of the 60 persons (8% of the participants) glaucoma had been diagnosed before this survey: non-exfoliative open-angle glaucoma in 15 persons (3.0%), bilateral or unilateral exfoliative open-angle glaucoma in 19 persons (3.8%), and congestive glaucoma in 8 persons (1.6%). In another 18 persons (4% of the participants) new open-angle glaucoma was detected, one third of these were exfoliative. In addition, 6% of the study population had suspected glaucomatous disc changes. In all new glaucoma cases and in all suspected cases the IOP was lower than 25 mmHg. Ocular hypertension (>25 mmHg) without disc changes was found in 2%.     

Intraocular pressure abnormalities associated with central and hemicentral retinal vein occlusion

OBJECTIVE: To evaluate the prevalence of ocular hypertension (OHT) and glaucoma in patients with central retinal vein occlusion (CRVO) and hemi-CRVO (HCRVO) and of the fall in intraocular pressure (IOP) secondary to CRVO/HCRVO. DESIGN: Nonrandomized comparative case series. PARTICIPANTS AND METHODS: We investigated 674 consecutive patients who were initially seen with unilateral CRVO (n = 548) and HCRVO (n = 126) at their onset, with a normal fellow eye. The fellow uninvolved eye in each patient acted as a control. Central retinal vein occlusion and HCRVO were categorized into nonischemic and ischemic. At all visits, patients had a detailed ocular history, as well as a thorough bilateral ocular evaluation, including IOP recording with a Goldmann applanation tonometer; when the diagnosis of OHT or glaucoma was initially uncertain, the 24-hour diurnal IOP was recorded. The observed prevalence rates of OHT and glaucoma among patients with CRVO and HCRVO were compared with those in the general population. MAIN OUTCOME MEASURES: The prevalence of OHT and glaucoma, and of ocular hypotension secondary to CRVO/HCRVO. RESULTS: The overall prevalence of glaucoma was 9.9% and of OHT 16.2%. The prevalence of glaucoma/OHT was found to be significantly (P<0.0001) higher in patients with CRVO and HCRVO than in the general population. There was no significant difference in the proportion of patients with glaucoma/OHT among the various types of CRVO/HCRVO (P = 0.156). Forty-eight percent of all patients had lower IOP (>/==" BORDER="0">2 mmHg) in the CRVO/HCRVO eye than in the fellow (uninvolved) eye at their initial evaluation. The prevalence of ocular hypotension was significantly (P<0.0001) higher in patients with glaucoma/OHT not on ocular hypotensive therapy than in patients without glaucoma. Among the patients without glaucoma, the prevalence of ocular hypotension differed significantly among the various types of CRVO/HCRVO (P = 0.007). CONCLUSIONS: Central retinal vein occlusion and HCRVO have a significant association with glaucoma and OHT and with a subsequent fall in IOP in the involved eye. Few patients with CRVO/HCRVO have high IOP in the involved eye, although many of them do have it in the fellow uninvolved eye. It is important to exclude glaucoma/OHT in the fellow eye of any patient with CRVO/HCRVO; if present, elevated IOP should be treated to reduce the risk of that eye developing (1) CRVO/HCRVO and (2) glaucomatous damage. There may be no benefit to prescribing IOP-lowering drops for involved eyes whose IOP is already normal.     

饮水试验对正常年轻人眼压、眼轴及脉络膜厚度的短期影响

目的 研究饮水试验对正常年轻人眼压、眼轴及脉络膜的影响。设计 队列研究。研究对象 平均年龄27.75岁的正常年轻人28例。方法 受试者禁食水2小时后,5分钟内饮水20 ml/Kg,在饮水后10、15、30、60分钟用Goldmann压平式眼压计测量眼压、A超测量眼轴、EDI-OCT测量脉络膜厚度。每例受试者分析一眼的测量数据。主要指标 眼压、脉络膜厚度、眼轴、前房深度、晶状体厚度、玻璃体腔深度。结果 眼压在饮水前与饮水后10、15、30、60分钟分别为（14.51±2.60）mmHg、（17.59±2.44）mmHg、（17.19±2.78）mmHg、（15.46±2.45）mmHg (P<0.001)。与饮水前相比,饮水后30分钟前房变浅（P=0.04）,60分钟眼轴缩短（P=0.02）,玻璃体腔深度缩短（P=0.04）。脉络膜厚度饮水前（330.79±84.81）μm,饮水后10、15、30、60分钟分别为（340.00±91.97）、（336.57±92.93）、（334.86±85.63）、（338.43±96.86）μm（P=0.935）。结论 饮水试验可引起正常人一定程度的眼压升高、眼轴变短、前房深度变浅、玻璃体腔深度变短,而对晶状体厚度和脉络膜厚度无明显影响。（眼科, 2017, 26： 26-29）