Central visual function and inner retinal structure in primary open-angle glaucoma / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

To investigate associations between central visual function and inner retinal structure in primary open-angle glaucoma (POAG). This study enrolled 78 POAG patients and 58 healthy controls. POAG was classified into early glaucoma and moderate to advanced glaucoma. The following tests were performed on all participants: isolated-check visual evoked potential (icVEP) testing, 24-2 standard automated perimetry (SAP), and Cirrus optical coherence tomography (OCT) examinations. Signal-to-noise ratio (SNR) measures obtained from icVEP responses to isolated checks presented at four depths of modulation (DOMs; 8%, 14%, 22%, and 32%) were explored. Mean macular sensitivity (mMS) was assessed by calculating the mean sensitivities of central 12 SAP points. Ganglion cell layer+ inner plexiform layer thickness (GCL+IPLT) and peripapillary retinal nerve fiber layer thickness (pRNFLT) were measured by OCT scanning. For each group of subjects, linear relationships among the following measures were analyzed: SNR, mMS, GCL+IPLT, and pRNFLT. SNR, mMS, GCL+IPLT, and pRNFLT were all more significantly decreased in glaucoma than in controls (P<0.001). A significant positive association was found between SNR at 14% DOM and GCL+IPLT at the inferior sector in early glaucoma (r=0.465, P=0.004). In moderate to advanced glaucoma, significant correlations were found between SNR at 32% DOM and mean GCL+IPLT (r=0.364, P=0.023), superior GCL+IPLT (r=0.358, P=0.025), and mean pRNFLT (r=0.396, P=0.025). In addition, in moderate to advanced glaucoma, there were significant correlations between mMS and all relevant measures of retinal thickness (r=0.330-0.663, P< 0.010). In early glaucoma, significant correlations were found between mean mMS and minimum GCL+IPLT (r=0.373, P=0.023), and between inferior mMS and superior GCL+IPLT (r=0.470, P=0.003). Linear models provided a good explanation for the relationship between SNR and inner retinal thickness (IRT), whereas nonlinear models better explained the relationship between mMS and IRT. In early glaucoma, both SNR and mMS were related moderately and significantly to IRT, whereas in moderate to advanced glaucoma, mMS was more strongly correlated with IRT than SNR.

Ocular Trauma in a Rural Population of North China: The Handan Eye Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the prevalence of ocular trauma and the proportion of blindness and visual impairment due to trauma in a rural population in northern China.</p><p><b>METHODS</b>The Handan Eye Study is a population-based cross-sectional study that surveyed 6830 Chinese people aged 30+ years from 13 randomly selected villages in Yongnian County, city of Handan, Hebei Province, in July, 2006. All participants underwent a standardized interview and extensive examinations. A structured questionnaire was used to collect information on ocular trauma.</p><p><b>RESULTS</b>Of the 5837 participants who filled out the questionnaire, 124 subjects [2.1%; 95% confidence interval (CI), 1.8%-2.5%] reported a history of ocular trauma in either eye, including 19 (0.3%) persons reporting trauma in both eyes. Men were more likely to have an eye injury than women [odds ratio (OR), 3.3; 2.2-4.9]. In multiple logistic regression models, ocular trauma was significantly more frequent among normotensive participants when compared with hypertensive participants (hypertensive vs. normotensive: OR, 0.6; 0.4-0.9) and among participants who had a history of falls (OR, 2.4; 1.2-4.8). The proportion of unilateral visual impairment and unilateral blindness due to trauma were 10.5% (13 subjects) and 21.0% (26 subjects), respectively.</p><p><b>CONCLUSION</b>Our study reports the prevalence of severe ocular trauma among adults in rural China, revealing a high proportion of blindness and visual impairment due to trauma. These findings suggest the need for educational strategies to increase eye health awareness in this rural population with focus on providing at least appropriate first aid care to reduce blindness due to trauma.</p>

Long-term intraocular pressure fluctuation of primary angle closure disease following laser peripheral iridotomy/iridoplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies indicated that short-term and long-term intraocular pressure (IOP) fluctuations in primary open angle glaucoma patients might lead to glaucomatous progression. However, seldom study has evaluated the long-term fluctuation of IOP in primary chronic angle closure diseases. The objective of this study was to investigate the long-term IOP fluctuation of primary angle closure diseases and its associations following laser peripheral iridotomy (LPI) with or without laser peripheral iridoplasty.</p><p><b>METHODS</b>A total of 158 patients with primary angle closure suspect (PACS, n = 21), primary angle closure (PAC, n = 81) and primary angle closure glaucoma (PACG, n = 55) had been treated by LPI with or without laser peripheral iridoplasty and followed up for more than 12 months. IOP was measured with Goldman applanation tonometer. Multivariate linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of long-term IOP fluctuation (maximum IOP minus minimum IOP) with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline vertical cup/disc ratio (VCDR), baseline mean deviation (MD), need for IOP-lowering medications.</p><p><b>RESULTS</b>IOP fluctuation during follow-up in PACS, PAC and PACG groups were (4.83 ± 2.90), (5.67 ± 3.35), and (9.40 ± 7.14) mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP (r = 0.356, P < 0.001), PAS (r = 0.374, P < 0.001). IOP fluctuation was higher in patients with higher baseline IOP (0.18 mmHg per unit increase, 95%CI: 0.05 - 0.31 mmHg).</p><p><b>CONCLUSIONS</b>Long-term IOP fluctuation in PACG group was larger than that in PACS or PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation.</p>

Assessment of vision-related quality of life in Chinese glaucoma patients by utility analysis / 中华实验眼科杂志

BackgroundThe influence of glaucoma on the quality of life in patients is of increasing concern for ophthalmologists in recent years. However,some studies demonstrated that different types of questionnaires about quality of life have various disadvantages. Therefore, to accurately and fully assess the influencing factors of quality of life in glaucoma patients is very important. ObjectiveThe present study was to survey the self-reported visionrelated quality of life(QOL) in glaucoma patients by means of utility analysis and to tentatively analyze its influencing factors. Methods Patients with glaucoma were recruited from a single tertiary ophthalmic department. Standard face-to-face interviews were conducted. Utility values of linear rating scale ( RS ) and time trade-off ( TTO ) were calculated to evaluate the self-reported vision-related QOL of the patients. The correlations of the utility values with the patients' general and ophthalmologic characteristics were also analyzed. This survey was approved by the Ethic Committee of Beijing Tongren Hospital. Oral informed consent was obtained from the subjects before the study.ResultsA cross-sectional study was designed. A total of 86 glaucoma patients were enrolled in this study with 62 male and 24 female, with a mean age of 44. 67 years old. The mean utility values measured by RS and TTO were 0. 62± 0. 19 and 0. 77 ± 0. 12, respectively, and no evidential correlation was found between these two values ( r =0. 074, P=0. 499 ). The RS value was associated with daily visual acuity,mean deviation(MD) of visual field and the history of trabeculectomy. Neither daily visual acuity nor MD showed a significant correlation with the TTO value. Age, work status and educational background contributed to higher utility value for the TTO method. After adjusting for age, work status and educational level,patients with visual acuity in the worse-seeing eye better than 0. 3 showed a higher TTO value than those with less than 0. 3. Conclusions Utility analysis possesses the advantages of convenience and sensitivity. RS utility value is easily affected by the Objective visual status and surgery history in glaucomatous patients,which reflects the subjective assessment of patients'visual quality. However, TTO value is primarily associated with age,work status and education level rather than visual function in glaucoma patients,which is therefore subjective assessment of the disease-related quality of life. These Results indicate that visual function impairment is not a determining factor for the QOL of glaucoma patients.

The correlation between the structural parameters provided by the Heidelberg retina tomography (HRT) and laser diagnostics glaucoma scanning system (GDx) in primary open angle glaucoma / 眼科

Objective To investigate the correlation between the structural parameters provided by the Heidelberg retina tomogra- phy (HRT) and the structural parameters provided by laser diagnostics glaucoma scanning system (GDx), to discuss whether the correla- tion between them be used to make a more accurate diagnosis. Design Case control study. Participants Thirty-two patients (49 eyes) with primary open angle glaucoma and 15 patients only with abnormal GDx results. Methods The patients underwent examination with HRT, GDx. The relations between the topographic parameters of GDx Ecc and HRT were analysed by linear regression. F test was used to analyse whether there was a spatial correspondence between the GDx Ecc and HRT I]. Maim Outcome Measures The topographic parameters generated by GDx Ecc and HRTⅡ. Results In glaucoma group, among the topographic parameters generated by GDx Ecc and HRTⅡ. The correlation between NFI and rim area was significant (r=-0.68,P=-0.000). The spatial correspondence between GDx Ecc and HRTⅡwas also significant. In control group, NFI and rim area also had the significant correlation among the parameters of optic nerve head and retinal nerve fiber layer (r=-0.79, P=0.001). But there was no spatial correspondence between the GDx Ecc and HRTⅡ. Conclusions There is a spatial correspondence between GDx and HRT, but this correspondence doesn't existence in patients only with abnormal GDx result. This difference can be used to make a more accurate diagnosis.

Comparison of early optic nerve damage between primary open angle glaucoma and primary angle-closure glaucoma / 眼科

Objective To compare the difference of early optic nerve damage and visual field defect between primary open angle glaucoma(POAG)and primary angle-closure glaucoma(PACG).Design Prospective case series.Participants 30 eyes of 23 patients with early POAG and 30 eyes of 22 patients with early PACG were recruited.Methods Routine ophthalmologic exams,visual field (Humphrey Field Analysis 24-2),scanning laser polarimetry GDx ECC(Full Exam)were performed.Different types of RNFLD and GDx ECC parameters were compared between the two groups through X square-test and independent samples t-test,respectively.Both the intra-group globe visual indices and retinal sensitivity loss of each illumination target were compared with independent samples t-test. Main Outcome Measure GDx ECC parameters,types of RNFLD,visual indices and retinal sensitivity loss of each illumination target. Results Significant differences in all GDx ECC parameters of the two groups were found except Superior Average and Symmetry.In GDx ECC reports,diffuse RNFLD in POAG and PACG were 40% and 10%,respectively(P＜0.05),while localized RNFLD were 53% and 63%,respectively.The differences of PSD and CPSD between groups were significant.More localized retinal sensitivity loss in the superiotemporal visual field in PACG were found.Conclusion The diffuse RNFL damage of early POAG is more than that of PACG. Differences between POAG and PACG in retinal sensitivity loss of the superiotemporal visual field are found,which are consistent with the RNFL damages.The pattern of RNFL damage and the visual field defects are different both functionally and structurally,which may give insight into the different etiologies of POAG and PACG.