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>

Vision function and quality of life outcomes after low vision rehabilitation in patients with age-related macular degeneration at a tertiary eye care center

To report vision function [VF] and quality of life [QOL] outcomes after low vision rehabilitation in patients with age-related macular degeneration [AMD]. A questionnaire developed and validated to assess VF and QOL in cataract patients in south India was administered to 50 patients with AMD before and after providing low vision care between October 1, 1997, and May 31, 2003. The outcome measures included overall changes in VF and QOL after low vision rehabilitation. Rasch analysis was performed on pre and post rehabilitation responses to the QOL and VF instruments using Winsteps package. Visual function: The items that were most difficult were reading, writing, needlework, sorting stones from food grains, recognizing faces and light adaptation. Difficulties with these functions reduced significantly after rehabilitation. Quality of Life: The items that were most difficult were banking, using public transport, and psychological well-being. Following rehabilitation the visual functioning for banking, daily living skills, and ease of dialing the telephone increased significantly though the visual functioning/satisfaction for the item related to mobility and psychological well-being either remained the same or worsened. The average perceived visual functioning and QOL improved significantly after rehabilitation [p<0.001]. The improvement in visual function [reading, writing, and recognizing faces] and improvement in quality of life [banking, daily living skills, and dialing the telephone] following rehabilitation point to the advantage of low vision rehabilitation in patients with age-related macular degeneration