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Introduction: primary open-angle glaucoma (POAG) is a chronic and progressive anterior optic neuropathy characterized by perimetric alterations and pathological excavation of the optic disc in the absence of other ocular pathologies or congenital anomalies. It is usually accompanied by an increase in intraocular pressure. Gonioscopic examination confirms that the iridocorneal angle is open. The term "risk factor" is defined as a condition statistically leading to an increased risk of occurrence of an event. The purpose of our work is to list the main risk factors of POAG.Patients and Methods: This is a retrospective study carried out in our ophthalmology department over a period of 4 years between January 2018 and December 2021, involving one hundred patients with POAG followed in glaucoma consultation.Results: These are 100 cases, with an average age of 64.27, with a male predominance. The most found risk factors in our series are: age, intraocular hypertension (IOH), thin cornea, arterial hypertension, diabetes and family history of glaucoma.Conclusion: The identification of the main risk factors of POAG at the individual level is a major data of the management. Knowing these factors helps to monitor patients at risk more carefully and to adjust the treatment more appropriately in patients likely to develop glaucoma or to aggravate already known glaucoma. More efforts are required for early screening and education on POAG in communities, especially in a POAG high-risk population
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@#AIM: To study the postoperative incidence and related factors of high intraocular pressure after vitrectomy in patients with proliferative diabetic retinopathy(PDR). <p>METHODS: Selected in February 2014 to February 2016, 110 cases(160 eyes)of PDR patients were retrospectively analyzed; postoperative vision improvement, high intraocular pressure in patients with different stages of PDR were analyzed and related factors were detected. <p>RESULTS: Postoperative vision of PDR patients with stage Ⅳ, stage Ⅴ, and stage Ⅵ significantly improved(<i>P</i><0.01). A total of 47 eyes had high intraocular pressure, in which there were 7 eyes during 1-2mo after operation, 12 eye during 3-4mo, 13 eyes during 5-6mo and, 7 eyes during 7-8mo, 5 eyes during 9-10mo, 3 eyes during 11-12mo, the total incidence was 29.4%. There 21 eyes(44.7%)had controlled IOP after treatment with conventional drugs; IOP of 6 eyes(12.8%)with peripheral iridectomy for recommunication between anterior and posterior chamber returned to normal; IOP of 7 eyes(14.9%)returned to normal after releasing some gas; IOP of 6 eyes(12.8%)returned to normal after taking out some silicone oil; 7 eyes(14.9%)with surgical resection and local glucocorticoid hormone. Preoperative PDR staging, whether preoperative combined with retinal detachment, whether combined with intraoperative lens removal, whether with intraoperative intraocular filling, whether pan retinal photocoagulation were factors associated with postoperative high intraocular pressure(<i>P</i><0.05). After multiariable Logistic regression analysis, with retinal detachment and intraoperative intraocular filling was independent risk factors for high intraocular pressure after vitrectomy(<i>P</i><0.05). <p>CONCLUSION: Retinal detachment, intraoperative joint lens removal, intraoperative intraocular filling, pan retinal photocoagulation is correlated with high intraocular pressure after vitrectomy. Intraoperative joint lens removal, intraoperative intraocular filling and preoperative PDR staging are independent risk factors. In clinical works, standardized and personalized treatment should be given according to the patients' situation trying to avoid the high IOP after vitrectomy.
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· AIM:To explore the modulation effects of 17-β estradiol (E2) and tamoxifen (TAM) in chronic intraocular hypertension mouse model.· METHODS:We performed anterior chamber injection of magnetic beads to induced chronic ocular hypertension models.Adult C57BL/6 male mice were used in the experiments and randomly divided into four groups:control,Beads group,E2 group and E2+TAM group.The intraocular pressure (lOP) were measured by Tonolab tonometer.Central retinal thickness was evaluated by HE staining.Brn3a as a specific marker of retinal ganglion cells (RGCs),were stained and counted by immunohistochemistry (IHC) staining.Glial fibrillary acidic protein (GFAP) as a marker of proliferation of astrocytes,was quantified using western blotting.· RESULTS:The IOP level was significantly elevated after anterior chamber injection of magnetic beads compared to control group (P＜0.05),while in E2 and E2+TAM group,the IOP levels were reduced (P＜ 0.05 vs Beads group),especially in E2+TAM group in 2wk.The RGCs happened to degenerated in Beads group after 2wk,while the effects were reversed by E2+TAM (P＜0.05).The central retinal thickness showed no significant statistical difference among the four groups after 2wk (P ＞ 0.05).The expression level of GFAP increased caused via beads injection,however,decreased in E2 and E2+TAM group (P＜0.05).· CONCLUSION:E2 and E2+TAM could both effectively decrease the IOP level in chronic intraocular hypertension mouse model,increase the survival of RGCs from high intraocular pressure,suppress expression of GFAP,which indicated neuroprotective effects of E2 and TAM in glaucoma through an anti-inflammatory effects.
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Objective To observe the effects of A2a adenosine receptor antagonist SCH442416 and ZM241385 on the expression of glutamine synthetase(GS) and L-Glutamate/L-Aspartate Transporter(GLAST) in rat retina under chronic ocular hypertension model.Methods Rat chronic ocular hypertension models were induced in the right eye of 12 male Sprague Dawley rats by blocking three episcleral veins,the left eye as control one.Intraocular pressure (IOP) was measured and compared at postoperative 1 week,2 weeks and 3 weeks.54 male chronic ocular hypertension rats were divided into 3 groups randomly,topically applying A2a adenosine receptor antagonist SCH442416,ZM241385 and carrier,respectively,three times a day for three weeks.At three weeks,mRNA and protein expression of GS and GLAST in rat retina were analyzed by RealTime-PCR and Western-blot.Results The average IOP of the modeling eyes at postoperative 1 week,2 weeks and 3 weeks were higher than that of the control eyes (all P ＜ 0.05).The mRNA and protein expression of GS and GLAST in the retina of SCH442416 and ZM241385 groups increased significantly compared to the carrier group (all P ＜ 0.05).However,the differences of mRNA and protein expression of GS and GLAST between SCH442416 and ZM241385 groups was not significant(all P ＞ 0.05).Conclusion Rat chronic ocular hypertension model can be induced by blocking three episceral veins successfully and effectively.A2a adenosine receptor antagonist SCH442416 and ZM241385 increase the expression of GS and GLAST.There seems no difference between the effects of these two drugs.
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Objetivo: evaluar la efectividad del implante de la válvula de Ahmed (VA) en niños desde los 2 años de vida hasta los 16 años de edad, que presentaron glaucoma refractario al tratamiento quirúrgico convencional, atendidos en el Hospital Garrahan durante el periodo comprendido entre el 1 de enero de 2006 hasta el 30 de Junio de 2014. Resultados: Se incluyeron 16 ojos de 13 pacientes con un total de 17 VA colocadas. La presión intraocular (PIO) promedio de las tres últimas tomas antes de la colocación de la VA fue de 25,38 mm Hg con un rango de 19,33 mm Hg a 39,33 mm Hg. Todos estos pacientes se encontraban con tratamiento farmacológico tópico y nueve pacientes (69,2%) estaban medicados con acetazolamida vía oral. Trece ojos de 16 incluidos en este trabajo (81,25%) recibieron más de una cirugía filtrante previa. Los 3 ojos (18,75%) no operados previamente eran glaucomas secundarios a uveítis; se decidió colocar el dispositivo de drenaje de primera elección. Un solo ojo (6,25%) incluido en la presente serie requirió la colocación de una segunda VA. La PIO promedio al año de cirugía de la válvula fue de 13,36 mm Hg. y en los pacientes a los que se logró seguir por cinco años la PIO se mantuvo por debajo de 20 mm Hg. Ninguno de los pacientes a los que se les colocó válvula necesitó inhibidores de la anhidrasa carbónica por vía oral. Un 64,72% de los ojos a los que se les colocó VA no necesitó medicación para regular la PIO. Del 35,28% de los 17 ojos posquirúrgicos que debieron usar medicación tópica encontramos que un ojo (5,88%) requirió una droga, cuatro ojos (23,52%) demandaron el uso de dos drogas y un solo ojo (5,88%) necesitó tres drogas tópicas para mantener su PIO menor a 20 mm Hg. Las complicaciones posquirúrgicas tardías de la colocación de VA fueron en cuatro casos (23,5%) quistes conjuntivales perivalvulares, en uno (5,88%) hubo exposición del tubo que requirió su reposicionamiento, un caso (5,88%) presentó alteraciones de la motilidad ocular y otro (5,88%) desprendimiento de retina. Conclusión: La colocación de la VA es efectiva para el tratamiento del glaucoma infantil refractario porque se consiguió una disminución del 100% de la presión intraocular, con y sin medicación coadyuvante en los diversos controles de nuestro grupo de pacientes estudiados. El 64,7% de los pacientes no necesitó medicación tópica posterior a la cirugía y ninguno de ellos necesitó tratamiento con medicación sistémica para regular la PIO (AU)
Objective: To assess the effectiveness of Ahmed valve (AV) implantation in children between 2 and 16 years of age with glaucoma refractory to conventional surgical treatment seen at the Garrahan Hospital from January 1, 2006 to June 30, 2014. Results: 16 eyes of 13 patients were included of a total of 17 AV implanted. Mean intraocular pressure (IOP) of the last three taken before AV placement was 25.38 mm Hg with a range of 19.33 mm Hg to 39.33 mm Hg. All the patients were receiving topical drug treatment and nine (69.2%) received oral acetazolamide. Thirteen of 16 eyes included in the study (81.25%) underwent more than one previous filtration surgery. The three eyes (18.75%) that did not undergo surgery had glaucoma secondary to uveitis; a first-choice drainage device was placed. Only one eye (6.25%) included in this series required placement of a second AV. Mean IOP one year after implantation of the valve was 13.36 mm Hg and in those patients followed-up for five years IOP remained below 20 mm Hg. None of patients in whom an AV was implanted needed oral carbonic anhydrase inhibitors. Overall, 64.72% of the eyes with an AV implant did not need medication to regulate IOP. Postsurgically, of 35.28% of 17 eyes that needed topical medication, we found that one eye (5,88%) required one drug, four eyes (23.52%) needed two drugs, and only one eye (5.88%) needed three drugs to maintain IOP below 20 mm Hg. Late surgical complications of AV placement were perivalvular conjunctival cysts in four cases (23.5%), exposition of the tube that needed repositioning in one case (5.88%), alterations of ocular movements in one (5.88%), and retinal detachment in another (5.88%). Conclusion: AV implantation is effective in the treatment of refractory childhood glaucoma as it decreases IOP by 100% with or without coadjuvant medication in the follow-up of our patients. Of all patients, 64.7% did not need topical medication after surgery and none of the patients needed systemic medication to regulate IOP (AU)
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Humans , Child, Preschool , Child , Adolescent , Glaucoma Drainage Implants , Glaucoma/surgery , Intraocular Pressure , Postoperative Complications , Retrospective StudiesABSTRACT
? AlM: To analyze the incidence, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy ( PPV) . ?METHODS: Totally, 146 patients (146 eyes) undergone PPV in our hospital were selected. Age, gender, eye, course and operation time of patients were compared, in order to understand the incidence rate and characteristics of high intraocular pressure. Primary diseases, intraoperative treatment methods and intraocular tamponade type were compare, in order to analyze the related risk factors of high intraocular pressure. ? RESULTS: Forty - seven patients occurred high intraocular pressure after operation, the incidence rate was 32. 2%. There was no significant difference in age, gender, eye, course and operation time (P>0. 05). The incidence rate in diabetic patients with simple vitreous hemorrhage and with tractional retinal detachment were 21.1% and 57.6%, respectively (P 0. 05 ). The incidence rate of using silicone oil, C3 F8 and simple ventilation were 59. 7%, 34. 5% and 14. 5%, respectively (P ? CONCLUSlON: After vitrectomy intraocular hypertension incidence and preoperative, intraoperative treatment of primary disease is closely related to factors such as the way and intraocular tamponade.
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Background Glial cells perform specialized function in many aspects of the development,homeostasis,and function of neurons.Retinal ganglion cells (RGCs)and glia interactions are critically important in glaucomatous neurodegeneration.However,the precise mechanisms of glial activation and ganglion cells damage are still remained unclear. Objective This study was to assess the early responses of glial cells in the retina,optic nerve and optic chiasm in rat models of acute high intraocular pressure (IOP),and to examine the expression of nestin,a neuronal progenitor marker,in the reactive glias. Methods Acute high IOP of 110 mmHg was induced in the right eyes of 6 clean adult female Wistar rats by infusing normal saline solution into the anterior chamber for 60 minutes.Three normal matched Wistar rats were used as controls.The rats were sacrificed by overanaesthesia and sections of retina,optic nerve and optic chiasm were collected on 3 days and 7 days after the injection.Rat retina was examined by Nissl staining to illustrate the gross structure changes.Loss of axons of RGCs in the optic nerve was assessed by immunostaining of β Ⅲ-tubulin.Double labeling of glia] fibrillary acidic protein (GFAP) and nestin was performed in sections of retina,optic nerve and optic chiasm to evaluate the glial responses.The use of the animals complied with Statement of Animal Ethic Committee of Peking University Third Hospital. Results In control rats,GFAP-positive glial cells were observed in the retina,optic nerve and optic chiasm,where only weak positive response for nestin was noticed.Three days after acute IOP elevation,thickness of inner plexus form layer was significantlydecreased in comparison with the control rats.A loss of 46％ RGCs was found in the rats with ocular hypertension.Obvious increase of GFAP expression was displayed in the retina,and processes of GFAP-positive glia cells extended into outer retina accompanied with significant up regulation of nestin.Axons in the optic nerve demonstrated a tendency of degeneration.Nestin expression increased significantly in the GFAP-positive glias in the optic nerve.Cross-sectional area of optic chiasm corresponding to the injured retina decreased relative to its countcrpart.Astrocyte like GFAP and nestin-colabeled glials were observed in this part of optic chiasm.The pathological changes of the retina,optic nerve and optic chiasm in hypertensive eyes aggravated on 7 days. Conclusions Acute ocular hypertension induce early onset of RGCs loss and axon degeneration.Neuronal injury is accompanied with glial reaction.Reactive glial cells express neuronal progenitor markers.The structural changes of the optic nerve and optic chiasm occur simultaneously with the high IOP.
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Objective To investigate the effect of low-intensity ultrasound on intraocular hypertension and its mechanicsm.Methods The intraocular hypertension rabbits were treated with ultrasound.The intraocular pressure(IOP),trabecular meshwork HE staining,EM microscopy,extracellular matrix through immunohistochemistry were performed.Results After treatment,IOP was descended and trabecula interspace was wider than the control eye.The expression of collagen I,laminin and fibronectin was inhibited.Conclusion Low-intensity ultrasound can decrease IOP.It may be related with the change of histologic structure of trabecular meshwork.
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AIM: To study the experimental method of inducing the chronic intraocular hypertension in rat eyes.METHODS: Twenty Wistar rats were randomly divided into ocular hypertension and Sham control groups. Intraocular pressure (IOP) was raised by electrocoagulating at least 3 episcleral and limbal veins on the right eye of each rat in ocular hypertension group and its contralateral eye was used as control. At 1, 2, 3, 4 and 8wk after the electrocoagulation of the veins, IOP were measured. RESULTS: The treatment of electrocoagulation caused a significant IOP increase of the right eyes over the baseline, over the contralateral eyes, and over the sham control eyes (repeated measures ANOVA, P＜0.001). At 1wk,IOP was (30.12± 5.L8 ) mmHg (1kPa=7.5mmHg), and maintained the high IOP up to 8wk.CONCLUSION: The chronic intraocular hypertension model could be successfully created by electrocoagulating three or more episcleral and limbal veins.