Search

Introduction Corneal biomechanical properties could affect intraocular pressure (IOP) measurement. To evaluate the differences of corneal biomechanical properties of various types of glaucoma, assess their effect on IOP measurements. Methods An observational clinical study of 486 subjects including 102 normal subjects, 104 ocular hypertension (OHT), 89 normal tension glaucoma (NTG) and 191 high tension glaucoma (HTG). Corneal biomechanical parameters were measured using ocular response analyzer (ORA). The main parameters assessed were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated pressure measurement (IOPg) and corneal compensated intraocular pressure (IOPcc). Ultrasound pachymetry was used to measure central corneal thickness (CCT). IOP was measured by Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT). Visual field (VF) and refractive status were also recorded. Results were analyzed by One-way analysis of variance, univariate and multivariate linear regression analyses, and Bland-Altman plots. Results Multiple comparison by ANOVA showed significantly lower CH and CRF in NTG compared to HTG, OHT and normal subjects (CH:0.011, 0.015 and 0.033, CRF: 0.001

INTRODUCTION To compare the long-term effect after modified CO2 laser-assisted sclerectomy surgery (MCLASS) and conventional trabeculectomy (TRAB) in medically uncontrolled Chinese primary open-angle glaucoma (POAG) patients. This was a retrospective comparative study. METHODS A total of 87 patients were reviewed, including 45 in the MCLASS group and 42 in the TRAB group. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and use of supplemental medical therapy were retrospectively compared at baseline, and until 36 months postoperatively. RESULTS Patients in both groups achieved a significant IOP decrease from baseline (P

Background To evaluate the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS)-based multi-pathway glaucoma surgeries in intractable pediatric glaucoma. Methods Retrospective, self-controlled, interventional case series. Twenty-three intractable pediatric glaucoma patients (26 eyes) who underwent CLASS-based multi-pathway surgeries were enrolled, including CLASS combined with trabeculectomy and CLASS combined with combined trabeculectomy and trabeculotomy. Complete examinations were performed before and after surgery. Intraocular pressure (IOP) change, complete and qualified success rates (CSR, QSR), best-corrected visual acuity (BCVA), number of IOP-lowering eyedrops and adverse events were recorded. Results The mean age at surgery was 8.72 ± 5.46 years and the mean follow-up time was 25.49 ± 10.87 months. Baseline IOP, number of IOP-lowering eyedrops and logMAR BCVA were 32.00 ± 4.83 mmHg, 3.21 ± 0.71 and 1.31 ± 0.90 respectively. The mean IOP was 12.05 ± 5.02, 11.71 ± 3.25 and 12.67 ± 3.38 mmHg at 6 months, 1 year and 2 years after surgery, which were significantly lower than baseline (all p p

Background: The retinal microvasculature within the macula in glaucomatous eyes is not clear. Objectives: To detect macular vessel density (MVD) changes in primary angle-closure glaucoma (PACG). Methods: Twenty-two PACG patients who had an episode of acute primary angle closure were included. Structural optical coherence tomography (OCT) scans were conducted to measure the thickness of the peripapillary retinal nerve fiber layer and macular ganglion cell complex (GCC). The MVD was measured with OCT angiography. Results: A weakened macular microvascular network that had an expanded fovea avascular zone was observed in the case group. Compared with the control group, the case group had a lower MVD ( p < 0.001). Single correlation analysis revealed a significant correlation of the MVD with best-corrected visual acuity (BCVA) ( r = −0.65, p = 0.001), GCC ( r = 0.50, p = 0.018), and the visual field mean deviation ( r = −0.54, p = 0.009) in the case group. Moreover, in the mixed-effect models, the MVD was found to be positively correlated with GCC ( p = 0.017) and negatively correlated with LogMar BCVA ( p < 0.001). Conclusions: After an acute angle-closure attack, the macular microvascular network is attenuated, and the MVD decreases significantly.

Purpose: To evaluate the efficacy and safety of modified CO2 laser-assisted sclerectomy surgery (MCLASS) compared with conventional trabeculectomy (TRAB) in medically uncontrolled Chinese primary open-angle glaucoma (POAG) patients.Methods: A total of 87 patients were reviewed, including 45 in the MCLASS group and 42 in the TRAB group. Intraocular pressure (IOP), best corrected visual acuity (BCVA) and use of supplemental medical therapy were retrospectively compared at baseline and until 24 months postoperatively.Results: Patients in both groups achieved a significant IOP decrease from baseline (P < 0.001), and postoperative IOP in the MCLASS group was significantly lower than that of the TRAB group at 12 and 24 months. The reduction of medication was statistically significant in both groups, and the number of postoperative medications was significantly higher in the TRAB group at 12 and 24 months. At 12 and 24 months, the complete success rates were 60% and 53.3%, respectively, for MCLASS versus 66.7% and 59.5%, respectively, for TRAB; the qualified success rates were 91.1% and 88.9%, respectively, for MCLASS versus 83.3% and 80.9%, respectively, for TRAB. BCVA deterioration post-TRAB was clinically more serious than that of post-MCLASS at 12 and 24 months, respectively. However, there was no statistically significant difference between the two groups at any time point postoperatively. Compared with MCLASS, more complications occurred postoperatively in the TRAB group. Conclusion: MCLASS is an effective surgical option for Chinese POAG patients, showing success rate results comparable with TRAB while having greater IOP reduction, fewer medications and a lower risk of complications compared to TRAB up to 24 months.

To describe the ultrasound biomicroscopy (UBM) findings of extremely rare ciliary body lymphoma. This was a retrospective noncomparative case series study. Five patients (8 affected eyes) diagnosed with ciliary body lymphoma at Peking Union Medical College Hospital from 2008 to 2019 were included. The UBM findings, including the location, height, and acoustic features, were documented to assess the tumour characteristics. UBM in all 8 (100%) affected eyes revealed 360° ring-like, solid infiltration of the ciliary body with low and homogeneous internal reflectivity. The continuity of the tumours could be most vividly demonstrated by transverse sections. Ciliary body lymphoma tends to grow in a characteristic circumferential 360° pattern, and the name “ring lymphoma of the ciliary body” is proposed.

Purpose: To investigate if optical quality assessed by Optical Quality Analysis System (OQAS) is a new factor for psychological disturbance and vision-related quality of life (QoL) in Chinese patients with primary open-angle glaucoma (POAG). Methods: This is a cross-sectional study. OQAS, automated static perimetry, the Hospital Anxiety and Depression Scale (HADS) Questionnaire, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were used to assess optical quality, visual field, psychological health, and QoL in 64 POAG patients. Correlation between the OQAS parameters and QoL or psychological health was analyzed by linear regression model. Results: OQAS parameters, the modulation transfer function cutoff frequency (MTF cutoff) and the mean OQAS values (mean OV) were significantly related to mean deviation (MD). Statistically significant correlation was also found between MTF cutoff, the mean OV, and QoL in more than half of the NEI VFQ-25 subscale scores and the composite. The correlation coefficients between OQAS parameters and QoL were similar to those between MD and QoL in most of the subscale scores. HADS-Depression and HADS-Anxiety scores significantly correlated with MD in the worse eye, the composite and 3 subscales of NEI VFQ-25, general health, social function, and mental health, but were not correlated with optical quality parameters measured by OQAS. Conclusions: OQAS-assessed optical quality is negatively related to MD and is a valid indicator for vision-related QoL, but not for psychological health in our study group. OQAS might be an alternative or supplement to perimeter in POAG patients.

Purpose To investigate if optical quality assessed by Optical Quality Analysis System(OQAS)is a new factor for psychological disturbance and vision related quality of life(QoL) in Chinese patients with primary open angle glaucoma (POAG).Methods Cross-sectional study. OQAS, automated static perimetry, the Hospital Anxiety and Depression Scale (HADS) Questionnaire and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) were used to assess optical quality, vision field, psychological health and QoL in 64 POAG patients. Correlation between the OQAS parameters and QoL or psychological health was analyzed by linear regression model.Results OQAS parameters, the modulation transfer function cut off frequency (MTF cutoff) and the mean OQAS values (mean OV), were significantly related to mean deviation (MD). Statistically significant correlation was also found between MTF cutoff, the mean OV and QoL in more than half of the NEI VFQ-25 subscale scores and the composite. The correlation coefficients between OQAS parameters and QoL were similar to those between MD and QoL in most of the subscale scores. HADS-Depression and HADS-Anxiety scores significantly correlated with MD in the worse eye, the composite and 3subscales of NEI VFQ-25, general health, social function and mental health, but uncorrelated with optical quality parameters measured by OQAS.Conclusions OQAS assessed optic quality is negatively related to MD and is a valid indicator for vision related QoL, but not for psychological health in our study group. OQAS might be an alternative or supplement to perimeter in POAG patients.

Supplemental Digital Content is available in the text, Background: Dry eye disease (DED) is a chronic ocular surface disease that affects hundreds of millions of people worldwide. Although 0.05% cyclosporine ophthalmic emulsion (CsA OE) has long been prescribed in the U.S. for the treatment of DED, it is not commercially available in China. Our study aims to compare the efficacy and safety profile of 0.05% CsA OE versus vehicle in Chinese patients with moderate to severe DED. Methods: This was a multicenter, randomized, double-masked, 2-parallel-arm, 3-month phase III study. Patients with moderate to severe DED were randomized to receive twice-daily 0.05% CsA OE or its vehicle, along with unpreserved hypromellose eye drops 3 times per day. Patients were followed up at day 7, 28, 56, and 84, as well as 2 weeks after the medications were discontinued for safety assessment. Results: A total of 240 patients were randomized. The overall effective rate (OER) and efficacy index were significantly better in the CsA OE than vehicle group at all follow up times (all P

Background: To detect the macular vessel density (MVD) changes in primary angle closure glaucoma (PACG) and to investigate the correlation between MVD and other glaucomatous changes. Methods: A case-control study. Eyes of 22 PACG patients with an episode of acute primary angle closure (APAC) in one of the two eyes. Structural OCT scans were used to obtain peripapillary retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) thickness and C/D area ration. OCT angiography (OCTA) was used to measure MVD. Results: In the control group, the dense macular blood vessels were visible on OCTA， the macular vessels were sparse in the case group, and with an enlarged fovea avascular zone. There was a reduction in MVD in the case group compared with the controls (P

To investigate if a new ultrasound biomicroscopy (UBM) parameter, iris lens distance (ILD), and its model could predict clinically significant intraocular pressure (IOP) elevation after darkroom provocative test (DRPT). Cases with a peripheral anterior chamber depth less than one-fourth corneal thickness were enrolled. All subjects underwent UBM examination and DRPT if possible. Anterior chamber depth (ACD) and ILD were measured in the central axis at different positions in dark (ACDD, ILDD) and bright (ACDB, ILDB). An IOP elevation over 5 mmHg and 8 mmHg was set as cutoffs for a positive DRPT result (positive-5 and positive-8). SAS 9.3 statistical software was used to manage and analyze data and calculate the linear probability model (LPM). Another 17 patients (34 eyes) were included to validate the model. Two hundred and ten (210) UBM images qualified for analysis. ILD was significantly less in the dark than in the bright and in patients with a positive DRPT result (p < 0.001). The LPM for positive-5 and positive-8 were P = 1.14 + (− 0.49*ILDD) + (− 0.41*ACDD) (n = 210, R2 = 0.1079, AUC = 0.715), and P = 0.87 + (− 0.44*ILDD) + (− 0.35*ACDD) (n = 210, R2 = 0.1358, AUC = 0.807), respectively. LPMs based on ILD could predict the risk of an IOP elevation over 5 mmHg or 8 mmHg. The LPM for positive-8 reached a good level of diagnostic accuracy.

Background: To evaluate the anterior segment parameters of first-time acute primary angle closure(APAC) eye and the fellow eye (primary angle closure suspect, PACS) with anterior segment optical coherence tomography (AS-OCT) and analyze the possible factors associated with the attack of APAC. Methods: Thirty patients with first-time unilateral APAC (APAC 30eyes, PACS 30eyes) were collected from August 2013 to August 2014 in the ophthalmology department of Peking Union Medical College Hospital. Central cornea thickness (CCT), pupil diameter (PD), anterior chamber depth (ACD), lens vault (LV), anterior chamber width (ACW), angle open distance at 500μmand 750μm from the sclera spur (AOD500, AOD750), trabecular iris area at 500μmand 750μm from the sclera spur(TISA500, TISA750), sclera spur angle (SSA) of both eyes were measured by AS-OCT. Paired t-test was applied to find the differences and conditional logistic regression analysis was performed to find the associatedfactors with the prediction of APAC. Results: Compared with the fellow PACS eyes, first-time APAC eyes showed significantlarger CCT (522.7±31.3vs557.3±42.7mm,P=0.000), PD (2.90±1.19vs3.78±1.29mm, P=0.000) and LV (1.08±0.36vs1.24±0.42mm, P=0.006),smaller ACD (1.81±0.45vs1.64±0.44mm,P=0.001), AOD500 (0.097±0.065vs0.059±0.039,P=0.004), AOD750 (0.157±0.10vs0.120±0.068mm,P=0.017), TISA500 (0.036±0.021vs0.020±0.016mm2, P=0.001), TISA750 (0.065and 0.041mm2, P=0.018) and SSA (11.13±6.92and 6.68±4.43°, P=0.001). The results of conditional logistic regression analysisshowed greater LV(OR=40.259[1.021,1779.193],P=0.014) hadthe strongest correlation with the attack of APAC. Conclusions: Greater LV is the most significant factor associated withfirst-time APACcompared with the fellow PACS eye and may play a critical role in the progression of PACS to APAC.

This article reports a rare case of bilateral choroidal occlusion that occurred in a 24-year-old woman with antiphospholipid syndrome (APS) associated with systemic lupus erythematosus (SLE). This young lady concurred with aorta ventralis thrombosis and bilateral iliac artery occlusion when presented, and experienced a rapid deterioration of vision. She also has a history of recurrent miscarriage. Corticosteroid, immunosuppression and anticoagulation therapy were administered. Patients with APS associated with SLE are at risk for thrombotic phenomena, which may affect the ocular vessels of all sizes, including choroidal vessel. Our case alerts ophthalmologists and rheumatologists that bilateral choroidal occlusion may indeed be developed in patients with APS associated with SLE, and is a potential cause of visual morbidity.

To compare the postoperative intraocular pressure (IOP) of eyes following pars plana vitrectomy (PPV) combined with intravitreal silicone oil (SO) tamponade by Corneal Visualization Scheimpflug Technology (CST), Goldmann applanation tonometry (GAT) and non-contact tonometry (NCT). Thirty-eight participants who had undergone PPV combined with SO tamponade to treat vitreoretinal diseases were enrolled. Postoperative IOP measurements were obtained using CST, NCT and GAT. Inter-device agreement was assessed by Bland–Altman analysis. The correlation coefficient was used to describe the potential postoperative factors affecting the postoperative IOP differences between each device. Bland–Altman analysis revealed the bias between CST and GAT, between CST and NCT, and between GAT and NCT to be −0.2, 2.1 and 2.4 mmHg, respectively. CST and GAT correlated well with each other. NCT values were lower than those of GAT and CST (all p

Complement activation, specifically complement 3 (C3) activation and C3a generation, contributes to an imbalance between angiogenic stimulation by vascular endothelial growth factor (VEGF) and angiogenic inhibition by pigment epithelial derived factor (PEDF), leading to pathological angiogenesis. This study aimed to investigate the effects of C3a and small interfering RNA (siRNA) targeting C3 on the levels of VEGF and PEDF mRNAs in human retinal pigment epithelial (RPE) cells. ARPE-19 cells were cultured in the presence of exogenous C3a at 0.1 μM and 0.3 μM C3a for 24, 48, and 72 hours. 0.1 pmol/μL duplexes of siRNA targeting C3 were applied for C3a inhibition by transfecting ARPE-19 cells for 48 hours. RT-PCR was performed to examine the level of VEGF and PEDF mRNA. A random siRNA duplex was set for control siRNA. Results demonstrated that exogenous C3a significantly upregulated VEGF and downregulated PEDF mRNA levels in cultured ARPE-19 cells, and siRNA targeting C3 transfection reversed the above changes, significantly reducing VEGF and enhancing PEDF mRNAs level in ARPE-19 cells compared to the control. The present data provided evidence that reducing C3 activation can decreases VEGF and increase PEDF mRNA level in RPE and may serve as a potential therapy in pathological angiogenesis.

Purpose To compare the in vivo lamina cribrosa position in patients with normal-tension glaucoma (NTG) and high-tension glaucoma (HTG). Methods The comparative cross-sectional study included three age- and sex-matched groups: 26 eyes of 26 NTG patients, 26 eyes of 26 HTG patients and 25 eyes of 25 healthy controls. Serial horizontal B-scan images of the optic nerve head were obtained from each eye using enhanced depth imaging optical coherence tomography. Mean and maximum lamina cribrosa depths were measured in 11 equally spaced horizontal B-scans. Statistical analysis was conducted to compare lamina cribrosa depth among the three groups and to correlate lamina cribrosa depth with age, retinal nerve fibre layer (RNFL) thickness and visual field (VF) mean deviation (MD). The area under the receiver operating characteristic curve (AUC) for lamina cribrosa depth was calculated. Results Mean and maximum lamina cribrosa depths were significantly greater in HTG than in NTG eyes, and in NTG than in normal eyes in all 11 scans (all p

Purpose To investigate whether peripapillary choroidal thickness in perimetrically affected eyes of primary open-angle glaucoma (POAG) patients differs from that in perimetrically unaffected fellow eyes and eyes of healthy controls. Design Retrospective, comparative, cross-sectional study. Methods Thirty-one POAG patients with unilateral visual field loss and 31 healthy controls were included. Eyes were divided into 3 groups: 31 eyes in group A (eyes with visual field loss), 31 eyes in group B (perimetrically unaffected fellow eyes), and 31 eyes in group C (age- and sex-matched controls). A 360-degree 3.4-mm diameter peripapillary circle scan was performed for retinal nerve fiber layer (RNFL) assessment using enhanced depth imaging optical coherence tomography. The observer used the manual segmentation function to delineate the posterior edge of the retinal pigment epithelium and the sclerochoroidal interface. The RNFL thickness algorithm function was used to generate the choroidal thickness automatically in corresponding sectors. Statistical analysis was conducted to compare mean choroidal thickness and RNFL thickness among 3 groups and to correlate choroidal thickness with age, RNFL thickness, and visual field mean deviation. Results The global mean RNFL and choroidal thickness measurements were 62.3 ± 16.7 μm and 154.3 ± 69.7 μm in group A, 90.4 ± 12.2 μm and 154.7 ± 68.9 μm in group B, and 106.6 ± 9.2 μm and 154.2 ± 60.9 μm in group C. The RNFL thickness was significantly thinner in group A than in groups B and C globally and at all peripapillary locations (all P = .000). The RNFL thickness also was significantly thinner in group B than in group C ( P = .000 to .021). However, choroidal thickness measurements did not differ among 3 groups globally or at any peripapillary location ( P = .273 to .934, P = .757 to .994, and P = .808 to .975, respectively). Age was the only significant factor associated with peripapillary choroidal thickness in each group ( r = −0.418 to −0.641, r = −0.569 to −0.690, and r = −0.689 to −0.827, respectively; all P Conclusions There was no significant difference in peripapillary choroidal thickness of POAG eyes with visual field loss compared with that of perimetrically unaffected fellow eyes and eyes of healthy controls, which does not support using peripapillary choroidal thickness as a clinical parameter in POAG diagnosis or management.