Long-term intraocular pressure fluctuation of primary angle closure disease following laser peripheral iridotomy/iridoplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies indicated that short-term and long-term intraocular pressure (IOP) fluctuations in primary open angle glaucoma patients might lead to glaucomatous progression. However, seldom study has evaluated the long-term fluctuation of IOP in primary chronic angle closure diseases. The objective of this study was to investigate the long-term IOP fluctuation of primary angle closure diseases and its associations following laser peripheral iridotomy (LPI) with or without laser peripheral iridoplasty.</p><p><b>METHODS</b>A total of 158 patients with primary angle closure suspect (PACS, n = 21), primary angle closure (PAC, n = 81) and primary angle closure glaucoma (PACG, n = 55) had been treated by LPI with or without laser peripheral iridoplasty and followed up for more than 12 months. IOP was measured with Goldman applanation tonometer. Multivariate linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of long-term IOP fluctuation (maximum IOP minus minimum IOP) with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline vertical cup/disc ratio (VCDR), baseline mean deviation (MD), need for IOP-lowering medications.</p><p><b>RESULTS</b>IOP fluctuation during follow-up in PACS, PAC and PACG groups were (4.83 ± 2.90), (5.67 ± 3.35), and (9.40 ± 7.14) mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP (r = 0.356, P < 0.001), PAS (r = 0.374, P < 0.001). IOP fluctuation was higher in patients with higher baseline IOP (0.18 mmHg per unit increase, 95%CI: 0.05 - 0.31 mmHg).</p><p><b>CONCLUSIONS</b>Long-term IOP fluctuation in PACG group was larger than that in PACS or PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation.</p>

Gene expression profile changes caused by the dysfunction of Mer during retinal pigment epithelium phagocytosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Studies indicated that Mer might be the main contributor to the specific internalization of photoreceptor outer segments (POS) in retinal pigment epithelium (RPE). It is very important to understand the mechanism of POS phagocytosis under the pathway of Mer and its ligands. The objective of this study was to identify changes in gene expression profiles caused by Mer gene knockout (Mer-/-) during phagocytosis of POS in RPE.</p><p><b>METHODS</b>RPE from both Mer-/- and wild-type (WT) mice were isolated and cultured to the 3rd passage. POS were subjected to culture medium with 20 nmol/L Gas6 and protein S to activate specific mer-mediated phagocytosis. RPE phagocytosis was evaluated by phagocytosis assays and differential gene expression identified by microarray at 3 and 12 hours; the 0-hour time point served as the control. Three independent samples for each Mer-/- or WT RPE were subjected to the same protocol of microarray. Five genes were confirmed by real-time quantitative PCR (QPCR).</p><p><b>RESULTS</b>The Mer-/- RPE had less internalized POS than WT RPE after both 3 and 12 hours in phagocytosis assay. Compared to WT RPE and the 0-hour control, 38 and 45 different known genes were increased and 68 and 59 known genes were decreased in Mer-/- RPE after 3 and 12 hours, respectively. Abnormal POS phagocytosis in Mer-/- RPE was associated with significant gene expression changes in, for example, signal transduction (WNT, MAPK), phagocytosis (Vav3, Hsd11b1), cytoskeleton components (Myo7a), and metabolism, in a time-specific manner. QPCR results showed Vav3, Hsd11b1, Myo7a, Rtn2 and Itga8 in those independent samples were consistent with microarray.</p><p><b>CONCLUSION</b>Gene expression profiles modulated in a time-specific manner in Mer-/- RPE indicate a possible internalization mechanism for abnormal POS phagocytosis, which gives insight into the mechanism of retinitis pigmentosa caused by the mutation of MerTK in humans.</p>

The correlation between the structural parameters provided by the Heidelberg retina tomography (HRT) and laser diagnostics glaucoma scanning system (GDx) in primary open angle glaucoma / 眼科

Objective To investigate the correlation between the structural parameters provided by the Heidelberg retina tomogra- phy (HRT) and the structural parameters provided by laser diagnostics glaucoma scanning system (GDx), to discuss whether the correla- tion between them be used to make a more accurate diagnosis. Design Case control study. Participants Thirty-two patients (49 eyes) with primary open angle glaucoma and 15 patients only with abnormal GDx results. Methods The patients underwent examination with HRT, GDx. The relations between the topographic parameters of GDx Ecc and HRT were analysed by linear regression. F test was used to analyse whether there was a spatial correspondence between the GDx Ecc and HRT I]. Maim Outcome Measures The topographic parameters generated by GDx Ecc and HRTⅡ. Results In glaucoma group, among the topographic parameters generated by GDx Ecc and HRTⅡ. The correlation between NFI and rim area was significant (r=-0.68,P=-0.000). The spatial correspondence between GDx Ecc and HRTⅡwas also significant. In control group, NFI and rim area also had the significant correlation among the parameters of optic nerve head and retinal nerve fiber layer (r=-0.79, P=0.001). But there was no spatial correspondence between the GDx Ecc and HRTⅡ. Conclusions There is a spatial correspondence between GDx and HRT, but this correspondence doesn't existence in patients only with abnormal GDx result. This difference can be used to make a more accurate diagnosis.

Comparison of early optic nerve damage between primary open angle glaucoma and primary angle-closure glaucoma / 眼科

Objective To compare the difference of early optic nerve damage and visual field defect between primary open angle glaucoma(POAG)and primary angle-closure glaucoma(PACG).Design Prospective case series.Participants 30 eyes of 23 patients with early POAG and 30 eyes of 22 patients with early PACG were recruited.Methods Routine ophthalmologic exams,visual field (Humphrey Field Analysis 24-2),scanning laser polarimetry GDx ECC(Full Exam)were performed.Different types of RNFLD and GDx ECC parameters were compared between the two groups through X square-test and independent samples t-test,respectively.Both the intra-group globe visual indices and retinal sensitivity loss of each illumination target were compared with independent samples t-test. Main Outcome Measure GDx ECC parameters,types of RNFLD,visual indices and retinal sensitivity loss of each illumination target. Results Significant differences in all GDx ECC parameters of the two groups were found except Superior Average and Symmetry.In GDx ECC reports,diffuse RNFLD in POAG and PACG were 40% and 10%,respectively(P＜0.05),while localized RNFLD were 53% and 63%,respectively.The differences of PSD and CPSD between groups were significant.More localized retinal sensitivity loss in the superiotemporal visual field in PACG were found.Conclusion The diffuse RNFL damage of early POAG is more than that of PACG. Differences between POAG and PACG in retinal sensitivity loss of the superiotemporal visual field are found,which are consistent with the RNFL damages.The pattern of RNFL damage and the visual field defects are different both functionally and structurally,which may give insight into the different etiologies of POAG and PACG.