ABSTRACT
Objective To observe the fundus lesions in the unilateral rhegmatogenous retinal detachment (RRD) eyes and contralateral eyes in non-traumatic emmetropia patients,and explore the risks of lateral eyes.Methods This is a retrospective case analysis.A total of 426 patients of unilateral RRD diagnosed by clinical examination were enrolled in this study.There were 273 males and 74 females.The average age of onset was 54.7 years.81.46％ of them (347 patients) were 51-70 years old.The average detachment time was 2.12 months.They were divided into two groups,equal or lesser than 50 years old group and more than 50 years old group.A total of 100 patients (200 eyes) with ocular surface disorders were randomly selected as control.The lattice-like degeneration,cystic degeneration and dry retinal holes were treated with prophylactic laser photocoagulation.Follow-up period was 6 to 24 months.The age,gender,proliferative vitreous retinopathy (PVR) grading,best corrected visual acuity (BCVA),distribution and quantity of retinal holes,and posterior vitreous detachment (PVD) were retrospectively analyzed.The incidence of PVD among different age groups was compared with Chi square.Results Among 426 RRD eyes,there were 239 eyes (56.10％) with PVD.Among them,there were 30 eyes with age equal or lesser than 50 years old (12.55％) and 209 eyes with age more than 50 years old (84.75％).There were 187 eyes (43.90％) without PVD,which including 38 eyes with age equal or lesser than 50 years old (20.32％) and 149 eyes with age more than 50 years old (79.68％).The incidence of PVD among different age groups was statistically significant (x2=4.72,P＜ 0.05).There were 10,254,40 and 5 eyes in class A,B,C and D of PVR,respectively;117 eyes without PVR.The retinal hole was located in superior temporal,inferior temporal,superior nasal,inferior nasal and macular in 305,91,22,4 and 4 eyes,respectively.The number of holes was 1,2,and more than 3 in 297,89 and 40 eyes,respectively.The retinal detachment range of 1,2,3 quadrants and total dissociation were 92,230,71,33 eyes,respectively.The fundus lesion was found in 47 eyes (11.03％) in the lateral eyes.There were 20 RRD eyes in class B of PVR,and 27 RRD eyes in class C of PVR.Retinal degenerated area was found.Among them,the degeneration of 41 eyes was located in the temporal retina,45 eyes involved in a quadrant.There were 16 eyes with peripheral retinal dry holes;the holes diameter was less than 1,1-2,greater than 2 optic-discs in 6,11 and 5 retinal holes.At the end of the follow-up,there were 47 eyes with almost normal visual field,16 eyes with decreased visual acuity,noeyes with retinal detachment.In the control group,4 patients (5 eyes,2.50％) had fundus lesions.Conclusion The unilateral RRD in non-traumatic emmetropia mostly occurs in elderly patients;11.03％ of patients had fundus lesions in the contralateral eyes,higher than the general population.
ABSTRACT
AIM: To explore the differences of anterior segment parameters in the patients with fellow eyes of unilateral acute angle-closure glaucoma ( AACG ) , primary angle-closure suspects ( PACS) and normal group. METHODS: Twenty-six eyes of 26 patients with fellow eyes of AACG, 28 eyes of 28 age- and gender-matched PACS and 34 normal eyes were imaged using optical coherence tomography ( OCT) and pentacam scheimpflug system ( Pentacam ) . Anatomical parameters including central corneal thickness ( CCT ) , corneal volume ( CV ) , pupillary diameter ( PD ) , central anterior chamber depth ( CACD ) , peripheral anterior chamber depth ( PACD ) , anterior chamber volume ( ACV ) and anterior chamber angle ( ACA) were obtained from Pentacam. Iris thickness (IT750,IT2000), cross-sectional area (IS), volume (IV) and angle opening distance 500 (AOD500) were estimated using OCT combined with a computer image processing. Statistic analysis was performed with SPSS. RESULTS: There were no significant differences in corneal parameters (CCT, CV), PD and iris values (IT750, IT2000, IS, IV) among the three groups (P> 0. 05). Compared with the fellow eyes of AACG and PACS, normal eyes had larger ACV, wider AOD500 and ACA, deeper CACD and PACD ( P 0. 05). Using the fellow eyes of AACG as the standard to predict high risk of angle closure, areas under the receiver operating characteristic curve of the above parameters were all less than 0. 7. CONCLUSION:All the anterior segment parameters are no different significantly between the fellow eyes of AACG and PACS. They may be notaccurate criteria for determining high risk group of PACS.
ABSTRACT
PURPOSE: To study long-term change of intraocular pressure (IOP) in attacked and fellow eyes after laser iridotomy (LI) in the patients with acute angle-closure glaucoma (AACG). METHODS: All eyes of 72 patients were studied for more than 6-month follow-up (range: 6-67 months). LI was performed in both eyes. Subsequent long-term IOP change, and additional medical or surgical management were analyzed retrospectively. We defined re-elevation as, (1) IOP greater than 21mmHg or, (2) progression of glaucomatous optic disc change or visual field defect despite initial reduction of IOP after LI. RESULTS: The mean IOP of attacked eyes dropped from 46.6 +/- 16.5 to 13.8 +/- 6.9 mmHg after LI. Among the attacked eyes, 32 (44.4%) required further medical therapy due to re-elevation of IOP, of which 4 (5.6%) eventually underwent operation. Among the fellow eyes, 16 (22.2%) underwent further medical therapy, although none required surgery. CONCLUSIONS: We recommend close, long-term follow-up for patients with AACG, because there is high risk of re-elevation of IOP, despite well-controlled immediate IOP after LI in both attacked and fellow eyes.