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Objective:To investigate the association between serum lipid levels and inflammatory indicators in patients with primary open angle glaucoma (POAG).Methods:A case-control study was conducted.A total of 86 POAG subjects were collected as a POAG group at Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong from January 2016 to March 2022.Meanwhile, 86 with age-related cataract only, matched at age, sex and body mass index were collected as a control group.The intraocular pressure (IOP) and the mean defect of visual field (MD) were measured by Goldmann tonometer and Humphrey field analyzer, respectively.Human peripheral blood samples collected from subjects for serum lipid levels, including total cholesterol, total triglycerides, high density lipoprotein (HDL), and low density lipoprotein (LDL), were analyzed using an automated hematology analyzer and inflammatory markers including C-reactive protein, white blood cells (WBC), neutrophils, lymphocytes, monocytes, were analyzed using an automated biochemical analyzer.Indicators with statistically significant differences between the two groups were selected as independent variables, and multiple logistic regression analysis was used to determine the risk factors for POAG.Correlations between risk factors and ocular parameters (IOP and MD) were assessed using Pearson correlation analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong (No.EC20210313[2]-P03). Written informed consent was obtained from each patient before any medical examination.Results:The HDL was (1.59±0.42)mmol/L in the POAG group, which was significantly lower than (1.76±0.50)mmol/L in the control group ( t=2.435, P=0.016). The LDL was (3.34±0.66)mmol/L in the POAG group, which was significantly higher than (3.08±0.71)mmol/L in the control group ( t=2.520, P=0.013). The WBC was (6.91±1.60)×10 9/L in the POAG group, which was significantly higher than (6.11±1.29)×10 9/L in the control group ( t=3.619, P<0.001). Multiple logistic regression analysis showed that high serum LDL level ( P=0.039, OR=2.354, 95% CI: 1.105-5.303) and high WBC level ( P=0.044, OR=1.310, 95% CI: 1.007-1.703) were risk factors for POAG.Pearson correlation analysis showed that the serum LDL and WBC levels of POAG patients were moderately positively associated with IOP ( r=0.610, P<0.001; r=0.358, P=0.001). LDL level was moderately negatively associated with MD ( r=-0.496, P<0.001). WBC level was weakly negatively associated with MD ( r=-0.235, P=0.030). Conclusions:The elevated peripheral blood LDL and WBC levels are risk factors for POAG onset.The elevated LDL and WBC levels are positively correlated with IOP and negatively correlated with MD in POAG patients.
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Objective To compare and analyze differences in macular thickness and to discuss the correlation between macular thickness and visual field mean defect (MD) in early and moderate,late pseudoexfoliation glaucoma (PXG) patients and normal control subjects.Methods A series of cases-observation study was adopted.Thirty-three early and moderate PXG patients (33 eyes) and 24 late PXG patients (24 eyes) were collected in the First Hospital of Shijiazhuang from May 2013 to May 2018.Meanwhile,34 age,gender and diopermatched healthy subjects (34 eyes) were included as normal control group.Spectral domain optical coherence tomography (SD-OCT) was used to measure macular thickness and volume in every quadrant.The correlation between the macular thickness and visual field MD were analyzed.This study followed the Helsinki declaration and was approved by the ethics committee of the First Hospital of Shijiazhuang.Written informed consent was obtained from each subject prior to any medical examination.Results The average macular thickness in normal control group,early and moderate PXG group and late PXG group were (305 ± 15),(297 ± 15) and (287 ± 17) μm,respectively;the average macular volume were (0.94 ± 0.05),(0.91 ± 0.05) and (0.89 ± 0.05) μm3,respectively.The macular thickness and volume differences between the 3 groups were statistically significant in nasal inner macula,superior inner macula,temporal inner macula,inferior inner macula,superior outer macula,temporal outer macula,inferior outer macula quadrants (Fthickness =4.226,9.335,12.133,10.115,11.298,8.243,12.142;all at P＜0.05.Fvolume =3.812,9.152,12.774,8.889,11.284,7.937,11.652;all at P＜0.05).The macular thickness of early and moderate PXG group in superior inner macula,temporal inner macula,inferior inner macula,superior outer macula and temporal outer macula quadrants were statistically thinner than those in the normal control group (all at P＜0.05);the macular thickness of late PXG group in inferior inner macula,temporal inner macula,superior outer macula and inferior outer macula quadrants were statistically thinner than those in the early and moderate PXG group (all at P＜0.05);the macular thickness of late PXG group in inner and outer rings were statistically thinner than those in the normal control group (all at P＜0.05).The macular thickness was not correlated with visual field MD in normal control group and the early and moderate PXG group in every quadrants (all at P＞0.05),but it was positively correlated with visual field MD in the late PXG group in nasal inner macula,superior outer macula and temporal inner macula quadrants (r =0.527,0.544,0.417;all at P＜0.05).Conclusions SD-0CT can quantify the macular thickness,and can be used an important reference index for the staging and follow-up of PXG combined with perimetry.
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@#AIM: To analyze the diagnostic value of macular ganglion cell complex(mGCC)in primary glaucoma and explore the correlation between mGCC and peripapillary retinal nerve fiber layer(pRNFL)and visual field, in order to provide scientific reference for the diagnosis and treatment of primary glaucoma. <p>METHODS: Eighty eyes in 67 primary glaucoma patients admitted to our hospital from January 2015 to December 2016 were included in the observation group. Another 80 eyes in 40 healthy subjects in our hospital were included in the control group during the same period. The mGCC and pRNFL thicknesses of two groups were measured with an optical coherence tomography(OCT). The thickness of mGCC and pRNFL and visual field were compared between the two groups. The diagnostic value of mGCC for primary glaucoma was analyzed. The correlation between mGCC and pRNFL and visual field mean defect was detected. <p>RESULTS: The superior, inferior and average mGCC thickness in the observation group was significantly lower than that in the control group(<i>P</i><0.05). The superior, inferior and average pRNFL thickness in the observation group were significantly lower than those in the control group, the difference was statistically significant(<i>P</i><0.05). The visual field mean defect in the observation group was significantly higher than that in the control group, the difference was statistically significant(<i>P</i><0.05). Pearson correlation analysis showed that there was a significant positive correlation between mGCC and pRNFL(<i>r</i>=0.58, <i>P</i><0.01)and there was a significant negative correlation between mGCC and the average visual field defect(<i>r</i>=-0.69,<i> P</i><0.01)in the observation group. ROC curve analysis showed that the intercept point value of mGCC in the diagnosis of primary glaucoma was 86.39μm. The sensitivity was 82.5% and the specificity was 76.25%. <p>CONCLUSION: The mGCC has a certain diagnostic value for primary glaucoma. There is positive correlation between mGCC and pRNFL and negative correlation between that and visual field mean defect.
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·AIM: To evaluate the efficacy of anti - vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) on pathological myopia (PM) combined with choroidal neovascularization (CNV). ·METHODS: Forty-three patients (45 eyes) diagnosed by fundus fluorescein angiography (FFA), indocyanine green angiography ( ICGA ) and optical coherence tomography (OCT) with PM combined with macular CNV were recruited in this study. The patients were randomly divided into two groups for different treatments, intravitreal injection with Ranibizumab (20 patients, 22 eyes) and PDT(23 patients,23 eyes). After treatment,all patients had been followed up monthly for 12mo. The further treatments were operated according to referral situations. The best corrected visual acuity (BCVA) was recorded with the ETDRS chart and the mean defect(MD) of the center 10° visual field was measured. At the last follow-up,the therapy efficacy was determined by ETDRS numbers and MD and analyzed. ·RESULTS: Before treatment, there was no significant difference on the baseline in ETDRS and MD between ranibizumab group and PDT group (P>0.05). After 12mo treatment, the ETDRS number in ranibizumab group (39.23±20.06) significantly increased (by 5.88 ± 9.03, P<0.05), but the PDT group (37. 38 ± 16. 95) was not significantly improved(by 0.33±6.94,P>0.05). The MD in ranibizumab group decreased significantly (P<0.05), and no significant change was found in PDT group(P>0.05). · CONCLUSION: In the treatment of macular CNV complicated by the PM, ranibizumab injection can improve visual function better than PDT.
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AIM:To observe and analyze the change of visual field and retinal nerve fiber layer thickness of primary open-angle glaucoma ( POAG ) after the Ex-press glaucoma shunt implantation. ●METHODS:A total of 14 patients (24 eyes) with POAG were underwent Ex-press glaucoma shunt implantation. Visual acuity, intraocular pressure ( lOP ) , mean defect ( MD) , pattern standard deviation ( PSD ) , retinal nerve fiber layer thickness ( RNFLT ) , and corneal endothelial cell number were collected preoperatively. Visual acuity and lOP were collected in 1wk, 1 and 3mo postoperatively respectively. Also, MD, PSD, RNFLT, and corneal endothelial cell number were collected preoperatively and 3mo postoperatively respectively. Complication, the additional treatment, success rate were analyzed. ●RESULTS:There was no significant difference (P>0. 05) in visual acuity preoperative and postoperative 1wk, 1, 3mo. Visual acuity did not significantly reduce after operation. Compared with preoperative, there was significant decreased (P 0. 05 ) after postoperative 3mo. Corneal endothelial cell number decrease had significant difference (Z=-2. 585, P=0. 01) between preoperative and postoperative 3mo. Success rate: complete success: 79. 2% ( 19 eyes ); partial success:8. 3% (2 eyes);failure:12. 5% (3 eyes). ●CONCLUSION: Ex-press glaucoma shunt implantation could efficiently decrease the lOP in POAG patients. Although it results in reduction of RNFLT in short time. The visual acuity and visual field keep stable after operation. lt is a safe and effective device for treating primary open-angle glaucoma.
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Glaucoma is a chronic, progressive bilateral optic neuropathy which disturbs the structural or functional integrity of the optic nerve that causes characteristic atrophic changes in it, which leads to specific visual field defects over time with loss of visual function. Primary open angle glaucoma (POAG) is the most common form of glaucoma in India and is fast emerging as a major cause of bilateral blindness. This rural hospital based study was conducted to evaluate whether glaucomatous visual field defects particularly the mean defect of Humphrey visual field could be related to VEP parameters of patients having POAG. Visual field by Humphrey perimeter and simultaneous recordings of pattern reversal visual evoked potential (PRVEP) were assessed in 100 patients with POAG. There was a significant (P<0.05) negative correlation of P100 latency, N155 latency and P100 duration and a highly significant (P<0.001) positive correlation of P100 amplitude with mean deviation (index of global visual field damage, MD) of Humphrey visual field in the subjects of POAG in various age groups. N70 latency showed a non-significant positive correlation with MD. The VEP changes observed by us in POAG patients were consistent with the progressing mean defect quantitatively. Therefore, it can be concluded that the VEP parameters can be useful quantitative indices in the evaluation of glaucomatous visual function damage.
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Dynamic strategy(DS) is a fast threshold algorithm for the Octopus 101 perimeter. To analyze the efficiency of DS, we compared the results of visual field measurements using DS and conventional normal strategy(NS). Subjects comprised 60 eyes of 30 normal individuals in the 3rd decade who has not experienced perimetry before. Program G2 was performed on all subjects at random and enough intervals between the two tests(more than 1 hour). Mean testing time was 1047.63+/-219.38 seconds in NS and 684.98+/-130.95 seconds in DS. Testing time reduction rate was 32.69+/-14.35% on average. Mean defect(MD) was 2.80+/-1.02dB, 2.15+/-0.94dB in the two strategies, respectively. Corrected loss variance(CLV) was 1.31+/-0.50dB2 and 1.03+/-0.61dB2 in each test. There was significant difference in MD and CLV statistically(P0.01). It took less time with DS than NS in Octopus 101 perimeter, but further study will be needed for clinical application of DS.
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Octopodiformes , Tests du champ visuel , Champs visuelsRésumé
Nasal step index(NSI) is an index of light sensitivity of the nasal step area, the early sign of visual field defects in glaucoma. It represents the asymmetry between the upper-nasal and lower-nasal quadrant within 30 degree field. We applied this index to 66 eyes with normal visual field and 204 eyes with mild-to-moderate glaucomatous visual field defect (mean defect(MD)or=1.04), respectively. AUC values related to the validity of this study were NSI-1:0.38, NSI-2;0.44 and MD;0.83 in early glaucoma patients. But AUC values in high NFBI patients were NSI -1;0.50, NSI -2;0.50, MD;0.82. Therefore, NSI is shown to have lesser diagnostic value than MD in detection of early glaucoma in this study.