ABSTRACT
<p><b>BACKGROUND</b>The existing classifications for evaluating glaucoma filtering blebs rely mostly on external bleb characteristics and the postoperative control of intraocular pressure (IOP). Internal bleb structures are not carefully observed. This study aimed to analyze and compare glaucoma filtering bleb morphology using slit-lamp-adapted optical coherence tomography (SL-OCT) and ultrasound biomicroscopy (UBM), and to classify blebs according to results and intraocular pressure.</p><p><b>METHODS</b>We followed 29 eyes of 21 male patients and 40 eyes of 32 female patients who underwent glaucoma filtering surgery in Sixth People's Hospital of Shanghai, between 2002 and 2006. The blebs were imaged using SL-OCT and UBM and classified according to the intrableb morphology and control of IOP after surgery. A Fisher's exact test was used to compare the sensitivity for predicting a functioning bleb differed significantly between SL-OCT and UBM. A Fisher's exact test was also used for morphological analysis of the trabeculectomy blebs based on SL-OCT.</p><p><b>RESULTS</b>In the 69 eyes, there were 45 (65.2%) functioning blebs and 24 (34.8%) non-functioning blebs. We classified the blebs into four categories on the basis of SL-OCT images: diffuse, cystic, encapsulated and flat. Diffuse and cystic blebs were typically functional, whereas the other two types were always non-functional. The sensitivity of SL-OCT for predicting a functioning bleb was 92.7% (38/41 eyes) and specificity of predicting a non-functioning bleb was 83.3% (20/24 eyes). By contrast, sensitivity of UBM was 66.7% (30/45 eyes) and specificity was 75.0% (18/24 eyes). The sensitivity for predicting a functioning bleb differed significantly between the two techniques (P = 0.003).</p><p><b>CONCLUSIONS</b>SL-OCT provides high-axial-resolution images of anterior segment structures. The non-contact approach of SL-OCT enables visualization of intrableb structures at any time after surgery. SL-OCT has greater sensitivity and specificity than UBM in evaluating filtering bleb function. The morphological classification supported the assessment of bleb function and could provide objective data for evaluating the outcome of antiglaucoma surgery or the need for a second procedure.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Blister , Pathology , Conjunctiva , Pathology , Glaucoma , General Surgery , Intraocular Pressure , Microscopy, Acoustic , Methods , Reproducibility of Results , Tomography, Optical Coherence , Methods , Trabeculectomy , MethodsABSTRACT
<p><b>BACKGROUND</b>Glaucoma is mainly characterized by the loss of retinal ganglion cells. Ciliary neurotrophic factor (CNTF) is believed to stimulate the regeneration of axons of retinal ganglion cells. The objective of our study was to detect the expression of CNTF in the retina of a rat glaucoma model with increased intraocular pressure (IOP).</p><p><b>METHODS</b>The rat glaucoma model was set up by electrocoagulating at least three episcleral and limbal veins. The location and the expression level of CNTF were detected at 1, 3, 7, 14, and 28 days post-surgery by immunohistochemistry, semiquantitative reverse-transcription polymerase chain reaction (RT-PCR), and Western blot analysis.</p><p><b>RESULTS</b>The rat glaucoma model with chronic, moderately elevated IOP was successfully produced. A minimum expression of CNTF was found in the ganglion cell layer of the retinas of the control group, and temporally increased expression and intensity of CNTF were found in the experimental retinas.</p><p><b>CONCLUSION</b>The expression of endogenous CNTF in the rat retina was found altered after the induction of ocular hypertension.</p>
Subject(s)
Animals , Male , Rats , Ciliary Neurotrophic Factor , Genetics , Densitometry , Immunoblotting , Immunohistochemistry , Ocular Hypertension , Metabolism , Pathology , Rats, Sprague-Dawley , Retina , Metabolism , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Objective To explore the correlative factors and management of secondary high intraocular pressure(IOP) after vitreoretinal surgery for proliferative diabetic retinopathy(PDR). Methods The data of 51 patients(54 eyes) with PDR after vitreoretinal surgery were collected.The incidence of secondary high IOP was obtained,and the correlative factors leading to high IOP were analysed.Besides,the therapeutic effects of management were observed. Results Twenty-six patients(26 eyes) experienced postoperative high IOP,with the incidence of 48.15%(26/54).It was revealed that the preoperative retinal detachment,the combined performance of crystal phacoemulsification,the practice of intraocular tamponade and the postoperative posterioruveitis were related to the occurrence of high IOP(P
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0.05),but all were lower than those of the control group(P