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Objective To observe the role of ultrasound biomicroscopy(UBM)in two-year post-operative follow-up for primary open-angle glaucoma patients with modified CO
Subject(s)
Humans , Carbon Dioxide , Follow-Up Studies , Glaucoma, Open-Angle/surgery , Microscopy, Acoustic , Sclera/diagnostic imaging , Treatment OutcomeABSTRACT
This article reports a rare case of bilateral choroidal occlusion that occurred in a 24-year-old woman with antiphospholipid syndrome (APS) associated with systemic lupus erythematosus (SLE). This young lady concurred with aorta ventralis thrombosis and bilateral iliac artery occlusion when presented, and experienced a rapid deterioration of vision. She also has a history of recurrent miscarriage. Corticosteroid, immunosuppression and anticoagulation therapy were administered. Patients with APS associated with SLE are at risk for thrombotic phenomena, which may affect the ocular vessels of all sizes, including choroidal vessel. Our case alerts ophthalmologists and rheumatologists that bilateral choroidal occlusion may indeed be developed in patients with APS associated with SLE, and is a potential cause of visual morbidity.
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<p><b>OBJECTIVE</b>To explore the impact of combination use of prostaglandin analogue and cholinergic agonists on main matrix metalloproteinases (MMPs) synthesized by albino rabbit ciliary muscle.</p><p><b>METHODS</b>Normal adult albino rabbits were divided into the control group, 2% pilocarpine group, 0.004% travoprost group and travoprost plus pilocarpine group. Two rabbits in the control group were executed after treated with normal saline for one day. Two rabbits were separately executed on the 7th, 14th and 24th day of the treatment in each drug treated group. In each subgroup ciliary muscle band of 4 eyes was taken and made into homogenate. The MMPs activities of 10 subgroups were assayed by zymography. Bands' intensity which represents the activity of MMPs was measured by the UltraViolet Illumination system.</p><p><b>RESULTS</b>A bright band of MMP-1/2 was showed on each lane at the position corresponding to the molecular weight of 62 kD in the ciliary smooth muscles electrophoresis. When ion Zn and Ca was displaced by MMPs inhibitor EDTA, this bright band disappeared. Compared with the control group, MMP1/2 activity increased by 4.0%, 4.1% and 14.0% after 7, 14 and 24 days of pilocarpine treatment. Corresponding data was 23.2%, 61.7% and 111.5% in the travoprost group and 49.3%, 68.0% and 88.4% in the travoprost plus pilocarpine group.</p><p><b>CONCLUSIONS</b>Pilocarpine has little effect on activity of MMP1/2. Travoprost can increase activity of MMP1/2 gradually. Activity of MMP1/2 is rapidly increased by pilocarpine combined with travoprost, but shows small change with the prolonged treatment.</p>
Subject(s)
Animals , Rabbits , Ciliary Body , Cloprostenol , Pharmacology , Matrix Metalloproteinase 1 , Matrix Metalloproteinase 2 , Muscle, Smooth , Pilocarpine , Pharmacology , Pilot Projects , TravoprostABSTRACT
Background Myopia is an important risk factor of glaucoma.Investigation of the characteristics of retinal nerve fiber layer thickness (RNFLT) and optical head morphology in myopia patients was helpful for differentiating myopic change and glaucomatous change in myopic eye.Objective This study was to investigate the peripapillary RNFLT and papillary parameters in different degrees of myopic eyes.Methods A 5-year case series study was retrospectively analyzed.Total 168 eyes of 168 myopic patients without visual field defect were recruited and divided into three age matched groups according to spherical equivalent (SE):low myopia group (SE:-0.25 ～-0.75 D) (57 eyes),moderate myopia group (SE:-3.0 ～-5.75 D) (57 eyes) and high myopia group (SE:-6.0～-12.0 D) (54 eyes).The RNFLT was measured with scanning laser polarmetry (GDxVCC) and papillary parameters measured with confocal scanning laser ophthalmoscope (HRT Ⅱ).Intergroup difference of parameters from GDxVCC and HRT Ⅱ were analyzed using one-way analysis of variance and SNK-q test.The correlations between spherical equivalent and RNFLT or papillary parameters was evaluated with multiple linear regression analysis.Results The global average,superior and inferior average,standard deviation,inter-eye symmetry of RNFLT were gradually reduced as the increase of SE with significant differences among the three groups (F=6.193,7.127,3.874,4.098,3.128,P ＜ 0.05).Global average,superior average,standard deviation,inter-eye symmetry of RNFLT were significantly lower in the high myopia group than those in the low myopia group (q =5.334,4.526,4.586,20.679,P＜0.05).An statistically significant reduce in inter-eye symmetry was seen between the high myopia group and the moderate myopia group (q =6.225,P＜0.05) as well as between the moderate myopia group and the low myopia group (q =10.035,P＜0.05).The multiple regression analysis showed that global average,superior average,inferior average,standard deviation,inter-eye symmetry of the R NFLT decreased with the increase of SE (β=0.441,t=6.329,P=0.000;β=0.471,t=6.880,P=0.000;β=0.339,t=4.641,P=0.000;β=0.389,t=5.445,P =0.000 ; β =0.338,t =4.621,P =0.000).Cup volume,linear cup/disk ratio,mean cup depth and maximum cup depth in the high myopia group were significantly lower than those of the moderate myopia groups (q =2.603,P =0.0l 1 ;q =2.105,P =0.037 ; q =2.825,P =0.006 ; q =2.495,P =0.014).Mean cup depth and height variation contour were significantly decreased in the high myopia group compared with the low myopia group (q =2.562,P =0.013 ;q =2.203,P =0.030).Rim area,rim volume,height variation contour were positively correlated with the degree of myopia (β=0.195,t=-2.565,P=0.011 ;β=0.199,t=-2.611,P=0.010;β=0.177,t =-2.311,P=0.022) ; while mean cup depth were negatively correlated with the degree of myopia (β =0.153,t =1.997,P =0.047).Conclusions As the increase of myopia degree,superior and inferior quadrants of RNFLT and cup depth are declined,but rim volume is elevated.Myopia is a confounding factor when RNFL data is interpreted by GDxVCC and papillary parameter by HRT Ⅱ.
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BackgroundDry eye is a multi-factorial-induced tear film and ocular surface disorder.Immunoinflammation plays a key role in the pathogenesis of dry eye.As inhibitor of the cyclo-oxygenase pathway,nonsteroidal anti-inflammatory drugs play an anti-inflammatory and anti-hypersensitivity role,and it can be a potential treatment for dry eyes.ObjectiveThis study was to investigate the effectiveness of nonsteroidal anti-inflammatory drugs (0.1％topical pranoprofen) on moderate to severe dry eyes and its mechanism.MethodsThis was a small sample of randomized controlled clinical trial.Thirty right eyes of 30 patients with moderate to severe dry eyes were included in the study according to the diagnosis criteria and randomized into two groups.The patients of the trial group received topical administration of 0.1％ pranoprofen plus 0.1％ sodium hyaluronate,and those of the control group received the topical 0.1％ sodium hyaluronate only.Ocular surface inflammation index scores (OSDI) and ocular surface fluorescine staining (OSS) scores were measured under the slit lamp,and tear film break-up time (BUT),Schirmer Ⅰ test values were evaluated.The expression of human leucocyte antigen-DR (HLA-DR) and CD11b in conjunctiva epithelial cells were detected by impression cytology and flow cytometry (FCM).All the indexes were compared between the two groups before and after treatment.Informed consent was obtained from all patients.ResultsThere were no significant differences in terms of age and gender and their baseline values between the trial group and control group (t=0.412,P=0.684;x2=0.240,P=0.624),and so were all the indexes (P＞0.05).Compared with the control group,the OSDI,OSS scores and cells positive for HLA-DR were lowered but the BUT was delayed in the trial group on day 15 ( t=2.43,P=0.03;t=2.83,P=0.01;t=3.29,P=0.00;t=3.23,P=0.00 ).No significant differences were found in the Schirmer Ⅰ test value and CD11b expression between these two groups (t=0.17,P=0.87;t=0.28,P=0.79).The OSDI,OSS scores and BUT were significantly improved,and the number of cells positive for HLA-DR were reduced 15 days after administration of drugs in comparison with before treatment in the trial group ( t =12.30,10.70,6.10,7.92,P =0.00 ).However,there were no comparable alteration seen in these indexes before and after the usage of drugs in the control group ( P＞0.05).Positive correlations were found in HLADR expression with OSDI and OSS ( r =0.601,P =0.018 ; r =0.586,P =0.022 ) and a negative correlation in HLADR expression with BUT (r=-0.697,P=0.004) on day 15 in the trial group.ConclusionsTopical usage of 0.1％ pranoprofen is beneficial for remitting the ocular signs and symptoms in moderate to severe dry eyes.This study illustrates that topical usage of 0.1％ pranoprofen can down-regulate the expression of inflammatory markers in conjunctival epithelial cells.
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Background It has been clarified that topical administration of cholinomimetic drug or prostaglandin analogus can effectively low intraoeular pressure (IOP) in primary angle-closure glaueoma and angleopen glaucoma,respectively.The two eyedrops are often combined clinically to treat glaueomatous eye.But their effect mechanism on ciliary muscle is different.It is neeessarv to prove the clinical efficacy of combination of these two drugs.Objective This study attempted to compare hypotensive effect of individual and combinative use of 2％piloearpine and 0.004％ travoprost in normal rabbit eyes.Methods Thirty normal albino rabbits were randomly divided into three parallel groups.Lateral eye of each rabbit was appointed as the experimental eye and the fellow eye was used as control eye.2％ Pilocarpine eyedrop was instilled three times daily and 0.004％ travoprost eyedrops was used once per night in the pilocarpine and travoprost group.These two drugs were combined in the combination group.The normal saline solution was used in the control eyes IOP was measured bilaterally with Perkins application tonometer at 8:00 am on the day before and 1,2,4,8,14,24 days after the administration of eyedrops.The use of the animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The IOP was significantly lower on 1 day after use of eyedrops than baseline IOP in the experimental eyes in the pilocarpine group,travoprost group and combination group,but no obvious change in IOP before and after use of eyedrops in the control eyes.There was no significant difference in the baseline IOP in both experimental eyes and control eyes,however,signifieant differences were seen in various time points after administration of eyedrops between experimental eyes and control eyes(P＜0.05).Compared with baseline IOP,IOP declined by 17.5％-22.0％ in pilocarpine group,23.8％-26.4％ travoprost group,27.6％-32.0％ in the combination group.For normal eye,piloearpine+travoprost showed a more power lowing IOP effect.Conclusions Hypotensive effect of combinative use of 2％ pilcoarpine and 0.004％ travoprost is strongest in comparison with individual use of pilocarpine or travoprost,but less than the statistical sum of individual use of these two drugs in a 24-day duration in normal eye of albino rabbit.
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<p><b>OBJECTIVE</b>To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation (TSCP) in a midterm observation.</p><p><b>METHODS</b>Fifty-four consecutive patients (54 eyes) with refractory glaucoma were enrolled and underwent TSCP (power of 1.5-2.0 W, exposure time of 2 seconds and 20-50 applications). Patients were regularly followed up for 12 months. Intraocular pressure (IOP) was measured before TSCP treatment and at each follow-up visit. Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP. The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit. Difference of age between the sensitive and insensitive groups was evaluated with independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test. The success rate of different types of glaucoma to TSCP was calculated.</p><p><b>RESULTS</b>A total of 32 patients were sensitive to TSCP (sensitive group) and 22 patients were insensitive to TSCP (insensitive group). The success rates of female (77.8%, 14/18) and cases being over 50 years (71.4%, 20/28) were higher than those of male (50.0%, 18/36) and ones being under 50 years (46.2%, 12/26) (all P>0.05). The age of the sensitive and insensitive groups was 56.0+/-15.5 and 46.4+/-15.4 years, respectively (P=0.029). The age (P=0.029) and gender distribution (P=0.046) of the two groups had significant difference. The success rate of neovascular glaucoma, primary angle-closure glaucoma, primary open angle glaucoma, traumatic glaucoma, uveitic glaucoma, and secondary glaucoma after silicone oil injection to TSCP was 57.1%, 100.0%, 50.0%, 20.0%, 81.8%, and 0%, respectively.</p><p><b>CONCLUSION</b>Age, gender, and type of glaucoma appear to be associated with effect of TSCP on IOP control.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Age Factors , Follow-Up Studies , Glaucoma , General Surgery , Intraocular Pressure , Physiology , Laser Coagulation , Lasers, Semiconductor , Prognosis , Sex Factors , Treatment OutcomeABSTRACT
Background Goldmann applanation tonometry (GAT) is a gold standard of intraocular pressure measurement.But its utilization iS limited because of its complexity and high requirement of cooperation.iCare rebound tonometer (iCare RBT) is a new type of applanation tonometry,and its accuracy and safety in clinical application need to be evaluated.Objective Present study was to investigate the reproducibility and tolerability of iCare RBT and its measurement agreement with GAT over a wide intraocular pressure (IOP) range. Methods The IOP were measured in bilateral eyes of 36 glaucoma and glaucoma suspect patients by 2 examinees with iCare RBT at the 1-minute interval to assess the interobserver reproducibility.Then the IOP of both eyes from 56 Subjeets and other 52 subjects were separately measured twice for each by two operators with iCare RBT for the evaluation of intraobserver reproducibility.Finally.IOP of 182 eyes of 92 glaucoma and glaucoma suspect patients was obtained by examiner 2 with RBT first and examiner 1 with GAT subsequently at a 2.minute interval in a masked fashion to perform an agreement evaluation of two readings by using Bland-Ahman method.The tolerance of subjects to iCare RBT measurement were surveyed.Oral informed consent was obtained prior to the IOP measurement. Results Concerning the iCare RBT readings.interobserver correlation coefficients were 0.937 in the right eye and 0.887 in the left eye.Intraobserver correlation coefficients of examiner 1 were 0.986 in the left eyes and 0.969 in the fight eyes.And those of examiner 2 were 0.990 and 0.979.Mcan values of iCare RBT readings and GAT were(18.74±8.36)mmHg and(19.33±8.20)mmHg and the mean difference values(iCare-GAT)was(-0.59 4±2.60)mmHg with the 95%confidence interval of -5.80-4.60 mmHg.The correlation coefficient between two modalities of IOP measurement WaS 0.95 1.No severe pain and discomfort were complained in all the subjects during or after measurement of iCare RBT. Conclusion iCare RBT has good interobserver and intraobserver reproducibility and good tolerance.It was proved that this is a good correlation between iCare RBT readings and GAT readings.