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Somatostatin, also called somatotropin release-inhibiting factor (SRIF), is a kind of neurotransmitter, neuromodulator and neurotrophic factor, which participates in a variety of physiological functions in the central nervous system by activating the five G-protein-coupled receptors (sst 1-sst 5). SRIF and its receptors are extensively expressed and distributed in retina.Activation of SRIF receptors modulates voltage-gated K + and Ca 2+ channels, and regulates multiple intracellular signaling pathways in retinal cells, then influences neurotransmitter release and synaptic transmission, which plays an important role in the regulation of retinal visual information processing.In addition, SRIF and its receptors may provide protective effects against retinal injuries, such as retinal ischemia, excitotoxic injury and diabetic retinopathy.In this article, connected with related previous researches of our team, the distribution of SRIF and its receptor in retina, as well as the role of SRIF and its receptor in the physiological regulation and neuroprotection of retina were reviewed.
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With the accelerated development of aging society, the incidence of glaucoma is increasing in recent years.Glaucoma is a primary cause of irreversible blindness worldwide and affects the visual and life quality of patients, which will bring great burden to the prevention and control of blindness in China. Terminology and Guidelines for Glaucoma formulated by European Glaucoma Society (EGS) is a classic document of Glaucoma guidelines.Recently, EGS released the Terminology and Guidelines for Glaucoma (5th edition), which put forward some updated concepts of diagnosis and therapy of glaucoma, primarily in several renewed key issues and the problems to be avoided in clinical practice.In the document, central corneal thickness is not recommended to correct intraocular pressure during the diagnosis and follow-up of glaucoma, and gonio-imaging devices do not replace gonioscopy in the diagnosis of angle-closure glaucoma, and optical coherence tomogranphy should not be used as the sole indicator in the early evaluation and dynamic monitoring of glaucoma.In addition, some available suggestions about anti-glaucoma drugs and surgeries are recommended for the managements of glaucomatous patients.The updated recommendations in the Terminology and Guidelines for Glaucoma (5th edition) are enunciated in this paper.
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The pathogenesis, diagnosis and management of glaucoma are complex and the population with glaucoma is huge in China now.With the development and popularization of cataract surgery, the visual disability and blindness caused by glaucoma are becoming more and more prominent.With the advantages of the combination of clinical pathway and public health in China, it is necessary to pay close attention to the following focuses of the prevention and control of glaucoma according to China's national conditions.(1)The awareness of glaucoma prevention and control should be strengthened, and the relevant screening technology and the construction of special team should be promoted to achieve the goal of early screening, early diagnosis and early treatment.(2)The diagnosis and treatment guidelines for glaucoma should be further well-established to promote the application of appropriate technologies in glaucoma diagnosis and treatment.In addition, glaucoma should be included in the chronic disease management system to accelerate the establishment and improvement of a three-level medical network system.(3)At the same time, the rehabilitation measurement for the patients with glaucomatous low vision should be reinforced to reduce the glaucomatous blindness rate.(4)The whole-process management for glaucoma patients should be enhanced, and nationwide popular science education should be well implemented.
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The pathogenesis and clinical manifestations of glaucoma in children are quite complex and diverse.Because the visual function of childhood is in a developing stage, even the intraocular pressure is controlled well, the visual function of childhood glaucoma patients is often poor from ametropia and amblyopia.So the prognosis is unsatisfying.New diagnostic classification of childhood glaucoma of the World Glaucoma Association showed that, except for glaucoma associated with acquired conditions and secondary glaucoma following cataract surgery, ocular anterior segment dysplasia in tissue structure and genetic factors are involved in the pathogenesis to different degrees in other classifications of childhood glaucoma.Therefore, it is very important for researchers to actively carry out genetic evaluation for childhood glaucoma.Current research status of molecular genetics in childhood glaucoma is briefly described here to emphasize that the researchers should make full use of available disease resources in China to carry out the study of molecular genetics in the diagnosis and classification of childhood glaucoma, which can provide more evidences for the prevention and treatment of blindness in children and healthy birth policy.
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Objective:To evaluate the clinical application of the SITA faster (SFR) visual field strategy in glaucoma patients.Methods:A diagnostic test was adopted.A total of 72 subjects who visited the Eye and ENT Hospital Affiliated to Fudan University during September 2018 to February 2019 were collected, including 28 normal subjects (56 eyes) and 44 glaucoma patients (86 eyes). The consistency and convenience of visual field tests were evaluated using SITA Standard (SS) and SITA Fast (SF), or SS and SITA Faster (SFR) in normal subjects and glaucoma patients.Test duration, visual field index (VFI), mean deviation (MD) and the number of defect points with probabilities of <5%, <2%, <1%, and <0.5% in the pattern deviation probability plots were recorded, and tested for difference, correlation and consistency.This study followed the Declaration of Helsinki.Written informed consent was obtained from all subjects prior to their entering the study cohort.The study protocol was approved by the Ethics Committee of the Eye and ENT Hospital of Fudan University.Results:For all of the included subjects, the mean test durations of SF and SFR were (64±13)% and (44±10)% compared to that of SS, respectively.MD and VFI evaluated by SS and SF, or by SS and SFR, showed no significant difference in either the normal subjects or the glaucoma patients (all at P>0.05). Across all included subjects, the positive correlation and consistency of MD and VFI were good ( r=0.99, P<0.01). However, for the results of the probability points in the pattern deviation probability blot, there was no difference among normal subjects, but the correlation and consistency were not good.In the deviation probability blot, there was a greater number of defect points of P<0.5% in glaucoma patients evaluated via SS compared to those evaluated by SFR, and the difference was statistically significant ( Z=-2.28, P=0.02). Apart from this, the number of defect points in glaucoma patients showed no difference between SS and SF, or between SS and SFR, and the correlation and consistency were higher in glaucoma patients than those in the normal subjects. Conclusions:Compared with SF and SS, SFR saves more test time.Except for partial variances in the pattern deviation probability blot, the difference between visual field strategies is relatively small and the results are basically consistent.
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Objective To explore the rare nonsynonymous variants of ABCA1 gene in primary open angle glaucoma (POAG).Methods A prospective cohort study was carried out.Three hundred and ninety-eight POAG patients and 198 healthy controls matched in age and gender were recruited from March 2017 to March 2018 in Eye and Ear Nose Throat (ENT) Hospital of Fudan University.The periphery blood of 2-5 ml from all the subjects was collected for extraction of DNA,and rare variant analysis of the ABCA1 gene was conducted by whole exome sequencing (WES) data of these subjects.The study protocol was approved by Ethic Committee of Eye and Ear Nose Throat Hospital of Fudan University and Sichuan Provincial People's Hospital (No.2016-32-1,and written informed consent was obtained from each subject prior to entering the study cohort.Results A total of 21 rare nonsynonymous variants (minor allele frequency MAF＜0.O1) were detected in the coding regions of ABCA1 gene in 27 subjects of the 398 POAG,with the detection rate of 6.8％.Among them,c.4310C＞A (p.Thr1437Asn),c.3772G＞T(p.Asp1258Tyr),c.775A＞G (p.Lys259Glu) and c.1507_1508insGAGGT (p.Glu503GlyfsX7) were four novel variants.In the 198 healthy controls,five rare nonsynonymous variants were detected in the ABCA1 gene from five subjects respectively,with the detection rate of 2.5％,the detection rate of nonsynonymous in POAG group was higher than that in healthy control group,showing a significant difference (x2=4.72,P =0.03,OR =2.81).Conclusions Rare nonsynonymous variants in ABCA1 is associated with the pathogenesis of POAG.These variants can enrich the variation spectrum of ABCA1.
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Objective To investigate the ultrastructural changes of mitochondria and dynamic changes of mitochondrial dynamics related genes in chronic ocular hypertension rat models.Methods Forty Sprague-Dawley (SD) rats were randomized into normal control group,modeling 3 day-group,modeling 7 day-group and modeling 14 day-group.Glaucoma models were induced by translimbal laser photocoagulation of trabecular meshwork in rats.The number of survival retinal ganglion cells was evaluated by retrogradely labeling of FluoroGold.The morphological change of mitochondria in optical nerve was observed under the transmission microscope.The dynamic changes of mitochondrial dynamic-related gene expression in the retina in gene and protein levels were detected by real-time fluorescence quantitative PCR and Western blot assay,respectively.The experiment complied ARVO Statement for the Use of Animals in Ophthalmic and Vision Research and approved by the Animal Experimentation Ethics Committee of the Eye and ENT Hospital of Fudan University.Results The intraocular pressure was significantly higher in the modeling 3-day group,modeling 7-day group and modeling 14-day group than that in the normal control group (all at P＜0.01).Compared with the normal control group,the immunoreactivity of glial fibrillary acidic protein (GFAP) was increased in the Müller cells in all modeling retinas,and the relative expressing levels of GFAP protein were significantly mcreased in all modeling groups (F =91.47,17.58,both at P＜0.01).Compared to the normal control group,the number of mitochondria was increased,and the mitochondrial health degree in the optic nerve and the nearest neighbor distance between adjacent mitochondria were decreased in the modeling 3-day group and 14-day group (all at P＜0.05).The expression levels of dynamics-related protein 1 (Drp1),parkin protein,PINK1,KIF5B and Miro1 mRNA in the retina were significantly elevated in the modeling 3-day group (all at P＜0.05).In addition,the expression levels of optineurin,parkin and OPA1 proteins were higher in the modeling 3-,7-and 14-day groups than those in the normal control group (all at P＜0.05).Conclusions Dysfunction of mitochondria and changes of mitochondrial dynamics exist in RGCs of glaucomatous rats,including increased mitochondrial fission and fusion as well as the activation of mitophagy pathway,which probably are the mechanism of RGC damage in glaucoma.
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Reducing intraocular pressure is the only proven effective treatment of glaucoma.Drug therapy,laser and open surgery are the mainstay clinical tools to achieve this goal and surgical treatment has always been one of the most important method.In recent years,a variety of new methods of glaucoma surgeries were employed in clinical practice,which gave glaucoma surgeons more options.Minimally invasive glaucoma surgery (MIGS) is undoubtedly a topic of intense interest.In addition to new surgical procedures,many glaucoma treatment concepts have been updated.The role of lens extraction in the treatment of angle-closure glaucoma is another hot debate recently.For some classic glaucoma surgery,such as the well-known ciliary body destructive surgery used to treat for absolute glaucoma,has been found useful for early or mid-term glaucoma patients.It suggests that we need to reconsider these classic surgeries.Finally,Chinese ophthalmologists are facing special challenges of our own.Without the aid of mitomycin C (MMC),how to achieve good effects of filtering surgery is a conundrum for everyone.With the abovementioned numerous questions,how to choose a reasonable glaucoma surgery method has become the concern of glaucoma specialists.This article will discuss the development of glaucoma surgery as well as special issues in glaucoma surgery in China,aiming to illustrate the above mentioned questions.
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Objective In order to explore the association between complement C3 and primary open angle glaucoma (POAG),the serum complement C3 level was detected and the polymorphism of the C3 exon gene was analyzed in patients with POAG.Methods A prospective case-control study was designed.A total of 45 patients with POAG visiting Eye &ENT hospital of Fudan University were collected from December 2014 to December 2015,and 45 age-/gender-matched healthy subjects from yearly health screening were collected as normal controls.Serum C3 concentration was detected by immunoturbidimetric assay.Meanwhile,genomic DNA was extracted from peripheral blood leukocytes,and sequencing for C3 exons was followed with PCR to analyze the gene polymorphism.Statistical analysis was performed by use of SPSS 20.0 software.Student's t test was used to evaluate the difference of serum C3 level between two groups.Chisquare test was used to analyze the difference in the distribution of C3 exon gene polymorphism between two groups.The one-way ANOVA was utilized to analyze the difference of serum C3 level among different genotypes of C3 exon.Results The serum level of C3 in POAG (104.81 ± 29.15)mg/dl was significantly lower (t =-3.162,P =0.002) compared to controls (121.06 ± 18.39) mg/dl.There were a total of seven single nucleotide polymorphisms (SNPs) (rs2230201,rs2230204,rs2230205,rs428453,rs423490rs7951,rs539822147) within the C3 exon gene region,but no mutation was detected.There was no difference in the frequency and distribution of these SNPs between POAG and controls,as well as,there was also no significant difference in serum C3 level among these SNPs genotypes.Conclusions Decreased serum C3 level in POAG patients indicated that complement C3 might be involved in the pathomechanism of glaucoma.No significant abnormality of C3 exon gene was detected,so the gene polymorphism having an impact on serum C3 level could be excluded as a reason probably.
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Objective To explore the relationship between blood lipid level and primary open angle glaucoma(POAG)and intraocular pressure(IOP).Methods A retrospective case-control study was designed.80 POAG patients from EYE & ENT hospital of FUDAN university were collected as a case group from January 2015 to May 2016.Meanwhile 80 age and gender matched healthy people were collected as a control group.The differences of gender in men subgroup (POAG:44,Control:39) and female subgroup (POAG:36,Control:41) showed no statistic significance.Serum total cholesterol(TC),total triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A(Apo A) and apolipoprotein B(Apo B) were measured using Roche automatic biochemical analyzer.The analysis of the above mentioned lipid levels between POAG group and control group was conducted by independent student′s T test and multivariate logistic regression.The relationship between lipid level and IOP was analysied using Pearson correlation test.Results The TG level was (1.40±0.71)mmol/L in the POAG group,(1.00±0.37)mmol/L in the control group.The difference had statistic significance (t=4.467,P<0.001).The HDL-C level in the POAG group was (1.22±0.36)mmol/L,(1.38±0.25)mmol/L in the control group.The difference also had statistic significance (t=-3.228,P=0.002).Comparison between the men subgroup and female subgroup found that the TG level in the POAG group of men was (1.47±0.71)mmol/L,(1.01±0.36) mmol/L in the control group and the HDL-C level were (1.14±0.31) mmol/L,(1.32±0.20)mmol/L in two groups.Both the level of TG and HDL-C had statistic significance in men (t=3.717,P<0.001;t=-3.240,P=0.002).The TC,TG level in the POAG group and control group of women respectively were (4.59±0.81)mmol/L,(1.33±0.72)mmol/L and (4.21±0.64)mmol/L,(0.99±0.38)mmol/L.Both blood level were significantly higher than the control group in women (t=2.278,P=0.026;t=2.503,P=0.016).Logistic regression analysis showed that the TG level correlated with POAG (P=0.004,OR=2.831,95% CI=1.392-5.759)and both POAG in the men and women (P=0.025,OR=3.223,95% CI=1.156-8.989;P=0.045,OR=2.554,95% CI=1.020-6.395).Pearson test showed that the TG level of POAG patients was positively associated with IOP in spite of gender(P<0.05).Conclusion The peripheral blood level of TG was significantly increased in the POAG patients and significantly correlated with IOP,which indicated that the increased peripheral blood level of TG may be the independent risk factor for the POAG..
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Objective A large sample of multi-factor Logistic analysis of clinical biochemical indicators from elderly cataract patients were done to find the characteristics of possible changes in potential factors for cataract-related indicators and explore the pathogenesis of cataract from the perspective of laboratory diagnosis.Methods A retrospective case control study was conducted .Cataract patients from Eye-Ear Nose Throat Hospital of Fudan University were collected during June 2011 to July 2015 and routinely tested for 14 clinical biochemistry indicators including ALB , GLU, TP, GLB, BUN, URCA, Cr, LDH, ALP, Ca, Na, K, Cl, and P.The mean age of the 3 527 cataract patients (1 804 males, 1 723 females) was (64.47 ±11.29) years.Those data were reserved by LIS (Laboratory Information System) system and were retrieved for large data analysis . The control group was filtered from hospitalized patients besides cataract patients during January 2014 to July 2015.The mean age of the 3 333 control subjects ( 1 770 males, 1 563 females ) was ( 64.04 ±9.03 ) years.Biochemical indicators between cataract group and control group were analyzed by independent student′s t-test and Logistic regression .Meanwhile , the objects were divided into 3 groups according to the age (40-59 years,60-79 years,≥80 years) for independent student′s t-test with the control group respectively .Results There are no statistical difference in age ( t=1.663,P=0.096) and gender ( t=2.63,P=0.105 0) between cataract group and control group ( P>0.05).The results of Logistic regression between cataract group and control group were as follow : ALB (OR=1.053,95%CI=1.019-1.088),BUN(OR=1.113,95% CI=1.076-1.152),Cr(OR=1.007, 95%CI=1.003-1.010),GLB(OR=1.049,95% CI=1.018 -1.081),GLU(OR=1.175,95% CI=1.139-1.211),Cl(OR=1.059,1.032 -1.088),Na(OR=1.180,95% CI =1.150 -1.212).Those might be enrolled as risk factors for cataract (P<0.05).The level of ALB, GLU, Na and Cl in cataract group according to different age groups were significantly higher ( t=8.780,t=4.670, t=9.695, t=6.415, P<0.05) than that of control in 40-59 age group;the level of ALB, BUN, Cr, GLU, Na and Cl in cataract group was significantly higher ( t=4.974, t=9.414, t=4.123, t=6.906, t=14.741, t=9.212, P<0.05) than control in 60 -79 age group; the level of BUN, Cr, GLU, Na and Cl in cataract group was significantly higher (t=6.077, t=4.906, t=2.626, t=5.459, t=3.424, P<0.05) than control in 80-age group.Conclusions The level of ALB, BUN, GLB, Cr, GLU, Na and Cl in peripheral blood of cataract patients was significantly increased which suggested that those change might associated with the pathogenesis of cataract .
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Standardization of residency training aims to improve the overall quality of residents and bring up high-quality medical students.Research capabilities and innovative spirit of young physicians play important roles in the sustainable development of hospitals.This article describes the experience in strengthening research training in the United States residency program,provides recommendations to resolve the problems of our residency standardized training and new ideas for the domestic medical institutions to strengthen the young physicians' sense of innovation and scientific research ability.
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Background Glucocorticoid drugs have been used increasingly in ophthalmology.It has been established that glucocorticoid are associated with a rise in intraocular pressure (IOP) and the development of glaucoma.Selective laser trabeculoplasty (SLT) is thought to be effective in treating patients with glucocorticoidinduced elevated IOP.Objective This study was to assess the efficacy of SLT in lowering IOP in patients with glucocorticoid-induced ocular hypertension.Methods A retrospective case series study was adopted.SLT around 360° chamber angle was performed in 9 eyes of 9 patients with glucocorticoid-induced glaucoma in Eye & ENT Hospital of Fudan University,including 5 eyes of 5 patients owing to use of glucocorticoid eye drops for long-term after laser in situ keratomileusis (LASIK) and 4 eyes of 4 patients who received intravitreal injection of 0.1 ml triamcinolone acetonide (TA) (4.0 mg) for macular edema induced by central retinal vein occlusion(CRVO).All of the patients were lack of preexisting glaucoma or ocular hypertension and underwent unsuccessful maximum tolerated medical therapy before SLT treatment.The base IOP was 35-44 mmHg and glucocorticoid drugs were ceased for 2-12 months prior to the SLT.The patients were followed-up for 6 months.IOP was measured and recorded before and 1 hour,1 week,1 month and 3 months,6 months after SLT.The difference of IOP was compared by repeated measures analysis of variance and multiple comparison analysis.Results All the patients received single SLT operation.The mean IOP was (40.0±2.9) mmHg before operation,but the IOP was (37.9±8.1),(34.9±5.9),(27.6±6.7),(21.6±6.9) and (17.9±2.9)mmHg 1 hour,1 week,1 month,3 months and 6 months after SLT.The IOP at 1 month,3 months and 6 months after SLT were significantly lower than that before operation (all at P＜0.05).Two patients received a filtration surgery for uncontrolled IOP at 1 month and 3 months after SLT respectively,and another patient still used 2 kinds of lowing-IOP eye drops until the end of following-up duration.Conclusions SLT reduce IOP in 6 eyes of 9 patients with glucocorticoid-induced increased IOP from the initial 1 month through 6 months after SLT.
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Background Selective laser trabeculoplasty (SLT) is a safe and effective therapy to the treatment of primary open angle glaucoma (POAG),and the clinical application is approved by American FDA.However,the relevant researching outcomes from several single-center study are in dispute owing to non-uniform approach in China.A muhicenter clinical trial is need to verify the effectiveness of SLT for Chinese POAG.Objective This study was to investigate the safety and efficacy of SLT in Chinese POAG patients.Methods A prospective,multicenter and self-controlled clinical trail was designed.Sixty-two eyes of 62 POAG patients with the age of ≥ 18 years were enrolled.Frequency SLT was performed around 360° angle using Lumenis Selecta DuetTM or Lumenis Selecta Ⅱ laser instrument,with the 100 non-overlapping spots,3 ns preset time,400 μm size of laser spot and 0.6 mJ energy.The operated eyes were followed-up for 6 months.The curative effects were checked including intraocular pressure (IOP),IOP-lowing value,number and percentage of IOP-lowing 20％ and 30％.The therapyrelated complications were recorded including the number of conjunctival congestion and cloudy of the anterior chamber.Results The preoperative IOP was (25.7±2.6) mmHg in the 62 eyes.The IOP was significantly lowed 1 day,2 weeks,4 weeks,3 months and 6 months after SLT in comparison with preoperative IOP (all at P＜0.001) with the lowest value of (16.5±4.5)mmHg in postoperative day 1.IOP was stable from 4 weeks to 6 months after operation.The mean lowing-value of IOP was 5.3-9.2 mmHg from 1 day through 6 months after SLT.The percentage of eyes 20％ drop in lOP was 83.9％,and that of 30％ drop was 58.1％ in postoperative day 1.In 6 months after SLT,percentages of eyes 20％ and 30％ drop in IOP were 56.5％ and 27.4％,respectively.Conclusions SLT is a safe and effective method of lowing IOP for POAG eyes in Chinese population.
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The management of open-angle glaucoma is a long-term,even lifelong procedure.A right medical decision can gain better efficacy and economic benefit and effectively avoid medical risk.Selective laser trabeculoplasty (SLT) is a therapy approved by FDA of USA and has been applied in China over decade.However,the clinical efficacy assessment is still controversial in China.For re-evaluation of the indication,methodology,technical parameters,and the efficacy of SLT will give full play to its advantage of the potential sufficient control of intraocular pressure (IOP) in glaucomatous treatment.The development of history,mechanism and effectiveness in control IOP,security and operation of SLT are reviewed.The suitable population,technique parameters,multiple centers clinical trial and the cost-effectiveness of SLT for Chinese glaucomatous patients are also proposed.
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<p><b>BACKGROUND</b>The extent of our knowledge of the epidemiology of pediatric glaucoma in China is limited. To better characterize the epidemiology of pediatric glaucoma in eastern China, we report the clinical profile, etiologies, and treatment modalities in patients <18 years of age in Shanghai Eye, Ear, Nose and Throat Hospital.</p><p><b>METHODS</b>The medical records of patients presenting glaucoma between January 2003 and December 2010 were retrospectively reviewed. The demographic characteristics, the proportion of different glaucoma subtypes and surgical precedures were collected and analyzed.</p><p><b>RESULTS</b>A total of 1 142 eyes of 734 pediatric patients (500 males) were included. Congenital glaucoma was the leading subtype, accounting for 47.55% of all patients. The ratio of boys to girls was 2.5:1. Patients with congenital glaucoma affecting both eyes accounted for 72.5% of all patients examined. Patients with primary juvenile glaucoma were the second most common group (n = 125, 17.03%). Traumatic glaucoma was the third most common subtype (n = 81, 11.03%). The type of surgery was related to the subtype of glaucoma.</p><p><b>CONCLUSIONS</b>Congenital glaucoma, primary juvenile glaucoma, and traumatic glaucoma are the most prevalent subtypes in pediatric glaucoma patients in Shanghai Eye, Ear, Nose and Throat Hospital. The characteristics of congenital glaucoma in China are similar to those in Western countries.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , China , Glaucoma , Epidemiology , Hospitals , Retrospective StudiesABSTRACT
<p><b>BACKGROUND</b>Lowering intraocular pressure (IOP) is currently the only therapeutic approach in primary open-angle glaucoma. and the fixed-combination medications are needed to achieve sufficiently low target IOP. A multicenter prospective study in the Chinese population was needed to confirm the safety and efficacy of Bimatoprost/Timolol Fixed Combination Eye Drop in China. In this study, we evaluated the safety and efficacy of Bimatoprost/Timolol Fixed Combination with concurrent administration of its components in Chinese patients with open-angle glaucoma or ocular hypertension.</p><p><b>METHODS</b>In this multicenter, randomized, double-masked, parallel controlled study, patients with open-angle glaucoma or ocular hypertension who were insufficiently responsive to monotherapy with either topical β-blockers or prostaglandin analogues were randomized to one of two active treatment groups in a 1:1 ratio at 11 Chinese ophthalmic departments. Bimatoprost/timolol fixed combination treatment was a fixed combination of 0.03% bimatoprost and 0.5% timolol (followed by vehicle for masking) once daily at 19:00 P.M. and concurrent treatment was 0.03% bimatoprost followed by 0.5% timolol once daily at 19:00 P.M. The primary efficacy variable was change from baseline in mean diurnal intraocular pressure (IOP) at week 4 visit in the intent-to-treat (ITT) population. Primary analysis evaluated the non-inferiority of bimatoprost/ timolol fixed combination to concurrent with respect to the primary variable using a confidence interval (CI) approach. Bimatoprost/timolol fixed combination was to be considered non-inferior to concurrent if the upper limit of the 95% CI for the between-treatment (bimatoprost/timolol fixed combination minus concurrent) difference was ≤ 1.5 mmHg. Adverse events were collected and slit-lamp examinations were performed to assess safety. Between-group comparisons of the incidence of adverse events were performed using the Pearson chi-square test or Fisher's exact test.</p><p><b>RESULTS</b>Of the enrolled 235 patients, 121 patients were randomized to receive bimatoprost/timolol fixed combination and, 114 patients were randomized to receive concurrent treatment. At baseline the mean value of mean diurnal IOP was (25.20 ± 3.06) mmHg in the bimatoprost/timolol fixed combination group and (24.87 ± 3.88) mmHg in the concurrent group. The difference between the treatment groups was not statistically significant. The mean change from baseline in mean diurnal IOP (± standard deviation) in the bimatoprost/timolol fixed combination group was (-9.38 ± 4.66) mmHg and it was (-8.93 ± 4.25) mmHg in the concurrent group (P < 0.01). The difference between the two treatment groups (bimatoprost/timolol fixed combination minus concurrent) in the change from baseline of mean diurnal IOP was -0.556 mmHg (95% CI: -1.68, 0.57, P = 0.330). The upper limit of the 95% CI was less than 1.5 mmHg, the predefined margin of non-inferiority. Adverse events occurred in 26.4% (32/121) of the bimatoprost/timolol fixed combination patients and 30.7% (35/114) of the concurrent patients. The most frequent adverse event was conjunctival hyperemia, which was reported as treatment related in 16.5% (20/121) in the bimatoprost/timolol fixed combination group and 18.4% (21/114) in the concurrent group (P > 0.05).</p><p><b>CONCLUSIONS</b>Bimatoprost/Timolol Fixed Combination administered in Chinese patients with open-angle glaucoma or ocular hypertension was not inferior to concurrent dosing with the individual components. Safety profiles were similar between the treatment groups.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Amides , Therapeutic Uses , Bimatoprost , Cloprostenol , Therapeutic Uses , Glaucoma, Open-Angle , Drug Therapy , Ocular Hypertension , Drug Therapy , Timolol , Therapeutic UsesABSTRACT
Objective To observe the characteristics of morphosis parameter of the optic disc of physiologie large cup. Methods 100 eyes with physiologic large cup and 74 eyes with normal cup were examined by Heidelberg Retina Tomograph(HRT).The differences of morphosis parameters between two groups were analyzed comparatively on disc area(DA),cup volume(CV),cup/disc area ratio(C/DR),rim area(RA),cup volume(CV),rim volume(RV),mean cup depth(MeCD),maximum cup depth (MxCD),cup shape measure(CSM),height variation contour(HVC),mean retinal nerve fiber layer thickness(mRNFLt),and retinal nerve fiber layer cross-section area(RNFLcsa).The characteristics of the inferior.superior,nasal,and temporal quadrants of the physiologic large cups were analyzed.Results DA,CA,C/DR,CV,MeCD,CSM(P=0.00.respectively)and MxCD(P=0.04)were significantly larger in eyes with physiologic large cup than in eyes with normal cup.RA,RV,HVC,mRNFLt,RNFLcsa(P=0.00,respectively)were significantly smaller in eyes with physiologic large cup than in eyes with normal cup.The temporal quadrant of RV of the physiologic large cup is the narrowest.RNFLcsa decreased as the following order:superior,inferior,nasal,and temporal(P＜0.05).Conclusions Morphosis parameter of the optic discs of physiologic large cup has its own representation on characteristics.Compared to normal cups,physiologic large cups had larger discs but smaller mRNFLt.The nasal quadrant of DA was larger than the inferior quadrant.
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Objective To study the cultivation of retinal progenitor cells of different ages. Methods Retinal progenitor cells of E14 and E18 SD rats were isolated,cultivated in suspension in modified DMEM/F12 serum-free medium and then differentiation was induced in vitro.Cells were observed under phase-contrast microscopy daily and identified by immunocytochemistry,scanning electron microscopy and transmission electron microscopy. Results Cultivated in DMEM/F12 serum-free medium,retinal progenitor cells formed cell spheres.After being plated,isolated cells migrated outwards and differentiated.Scanning electron microscopy demonstrated the morphology of the cell spheres and differentiated cells.Transmission electron microscopy demonstrated that there were stem cell-like cells in cell spheres and neuron-and glia-like cells after the plating.Immunocytochemistry demonstrated that most cells in spheres expressed neural stem cell marker nestin and cell division marker BrdU.After the plating,retinal progenitor cells could be induced to differentiate into various retinal cells,including Thy1.1-positive retinal ganglion cells.The percentage of retinal ganglion cells was 16.91%?4.05% at E14 and 4.65%?1.88% at E18.The differences were statistically significant(t=15.04,P
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Primary angle closure glaucoma is different from primary open angle glaucoma in the nature of epidemiology, pathogenesis, clinical course, guideline of diagnosis, therapeutic and prophylactic. The characteristics of primary angle closure glaucoma should be comprehensively understood and need evaluation by further research.