Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (lOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser tr...Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (lOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed peripheral iridotomy (LPI) on patients with refractory APAC, therapy. to evaluate the IOP-lowering efficacy of ALPI and laser who have previously responded poorly to intensive medical Methods Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber (AC) angle, and lOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA), best corrected VA (BCVA), lOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes. Results All patients were affected unilaterally, with average age of (54.6±11.7) (range, 37.0-75.0) years old. The mean lOP value of the affected eyes dropped from (31.6±7.7) (range, 21.0-39.0) mmHg at enrollment to (18.4±8.7) (range, 10.0-27.0) mmHg 2 hours after ALPI. At follow-up day 7, the mean lOP value maintained at (14.8±4.2) (range, 9.0-21.0) mmHg, which was significantly different (P=0.000) compared with baseline. The average decrease of lOP in the APAC eyes was (16.8±7.4) (range, 12.0-21.0) mmHg. At follow-up three years later, the mean lOP of the APAC eyes stabilized at (16.3±3.2) (range, 9.0-20.0) mmHg with at least 180° of AC angle opened. Conclusion ALPI and LPI lower the lOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.展开更多
Purpose: To identify the anterior segment parameters associated to acute primary angle closure. Patients and Methods: Case-control study in 58 primary angle closure suspect eyes (PACS, control group) and in 19 acute p...Purpose: To identify the anterior segment parameters associated to acute primary angle closure. Patients and Methods: Case-control study in 58 primary angle closure suspect eyes (PACS, control group) and in 19 acute primary angle closure fellow eyes, case group. All subjects underwent SL OCT imaging in a dark room. Results: The SS, ACD and ACV measures were significantly smaller in case group than in control group (p = 0.011;p < 0.001;p = 0.007 respectively);while the IT was significantly greater (at 500 and 750 μm) (p = 0.038 and p = 0.050). The difference between quadrants were statistically significant only for control group (p = 0.001;p = 0.003;p = 0.009;p = 0.018;p = 0.002 and p 500, AOD500, AOD750, TISA500, and TISA750 respectively. Conclusion: Acute primary angle closure is associated to the smaller anterior segment dimensions and the thicker iris compared to PACS.展开更多
·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicr...·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicroscopy(UBM).·METHODS: Patients(n =23, 31 eyes) were randomized to receive phacoemulsification or combined phacotrabeculectomy(n =24, 31 eyes). Best-corrected visual acuity(BCVA), intraocular pressure(IOP), the main complications following surgery, and indentation gonioscopy and angle parameters measured using UBM were documented preoperatively and postoperatively.· RESULTS: The improvement in BCVA in the phacoemulsification group was significantly greater than in the combined group(P 【0.05). IOP in the phacoemulsification group was slightly higher than in the combined group following 1wk of follow-up(P 【0.05),whereas there was no significant difference between the two groups at the latter follow-up(P 】0.05).Phacoemulsification alone resulted in a slight increase in the trabecular ciliary processes distance compared with the combined surgery(P 【0.05), whereas the other angle parameters showed no significant difference between the groups. Complications in combined group were greater than phacoemulsification only group.·CONCLUSION: Both surgeries effectively opened the drainage angle and deepened the anterior chamber, and IOP was well controlled postoperatively. However,phacoemulsification showed better efficacy in improving visual function and showed reduced complications following surgery.展开更多
AIM:To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angleclosure(APAC) and age-related cataracts. METHODS:Twenty eyes of 20 APAC patients and 15 eyes of 15 age-rela...AIM:To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angleclosure(APAC) and age-related cataracts. METHODS:Twenty eyes of 20 APAC patients and 15 eyes of 15 age-related cataract patients were included in this cross-sectional study. Aqueous humor samples were collected prospectively. The levels of 20 proinflammatory cytokines were evaluated in the aqueous humor of the APAC and cataract patients using the multiplex bead immunoassay technique. Clinical data were collected for correlation analysis.RESULTS:Seven of the 20 proinflammatory cytokines included in the magnetic bead panel were detectable in both APAC eyes and cataract eyes:interleukin(IL)-10, IL-12, IL-15, IL-21, IL-6, chemokine(C-C motif) ligand 20, and tumor necrosis factor alpha(TNF-α). IL-27 was only detectable in APAC eyes. Compared with the cataract eyes, the APAC eyes had significantly elevated concentrations of IL-12(P=0.036), IL-15(P=0.001), IL-6(P=0.012), and IL-27(only detectable in APAC eyes). Age was positively correlated with IL-12(P=0.022) and IL-6(P=0.037), and time elapsed between APAC onset and aqueous humor samples collection was positively correlated with IL-15(P=0.037), IL-27(P=0.040), and TNF-α(P=0.042).CONCLUSION:Several proinflammatory cytokines including IL-12,IL-15, IL-6 and IL-27, were elevated in the APAC eyes and may be implicated in its pathologic mechanism.展开更多
基金This work was supported by grants from National Natural Science Foundation of China (No. 30921064 and No. 90820307), Ministry of Science and Technology of China (No. 2010IM030800), and the Beijing Municipal Health Bureau High-level Medical Professionals Promotion Project (No. 2011-3-044).
文摘Background Argon laser peripheral iridoplasty (ALPI) is proved to be effective in lowering intraocular pressure (lOP) of patients with mild acute primary angle closure (APAC). It is unclear whether this laser treatment is equally efficient in managing patients with severe APAC. This study aimed peripheral iridotomy (LPI) on patients with refractory APAC, therapy. to evaluate the IOP-lowering efficacy of ALPI and laser who have previously responded poorly to intensive medical Methods Thirty-six patients (8 men and 28 women) were identified as medically refractory APAC, who still had ocular pain, red eye, hazy cornea, closed anterior chamber (AC) angle, and lOP of not less than 21 mmHg after two days or more of anti-glaucoma medication. All enrolled patients underwent ophthalmologic examinations including measurement of visual acuity (VA), best corrected VA (BCVA), lOP, biomicroscopy, and gonioscopy followed by ALPI immediately in the APAC eye and LPI in both eyes. Results All patients were affected unilaterally, with average age of (54.6±11.7) (range, 37.0-75.0) years old. The mean lOP value of the affected eyes dropped from (31.6±7.7) (range, 21.0-39.0) mmHg at enrollment to (18.4±8.7) (range, 10.0-27.0) mmHg 2 hours after ALPI. At follow-up day 7, the mean lOP value maintained at (14.8±4.2) (range, 9.0-21.0) mmHg, which was significantly different (P=0.000) compared with baseline. The average decrease of lOP in the APAC eyes was (16.8±7.4) (range, 12.0-21.0) mmHg. At follow-up three years later, the mean lOP of the APAC eyes stabilized at (16.3±3.2) (range, 9.0-20.0) mmHg with at least 180° of AC angle opened. Conclusion ALPI and LPI lower the lOP of medically refractory cases of APAC though they have responded poorly to anti-glaucoma medication.
文摘Purpose: To identify the anterior segment parameters associated to acute primary angle closure. Patients and Methods: Case-control study in 58 primary angle closure suspect eyes (PACS, control group) and in 19 acute primary angle closure fellow eyes, case group. All subjects underwent SL OCT imaging in a dark room. Results: The SS, ACD and ACV measures were significantly smaller in case group than in control group (p = 0.011;p < 0.001;p = 0.007 respectively);while the IT was significantly greater (at 500 and 750 μm) (p = 0.038 and p = 0.050). The difference between quadrants were statistically significant only for control group (p = 0.001;p = 0.003;p = 0.009;p = 0.018;p = 0.002 and p 500, AOD500, AOD750, TISA500, and TISA750 respectively. Conclusion: Acute primary angle closure is associated to the smaller anterior segment dimensions and the thicker iris compared to PACS.
文摘·AIM: To evaluate the difference in angle parameters and clinical outcome following phacoemulsification and combined phacotrabeculectomy in patients with acute primary angle closure(APAC) using ultrasound biomicroscopy(UBM).·METHODS: Patients(n =23, 31 eyes) were randomized to receive phacoemulsification or combined phacotrabeculectomy(n =24, 31 eyes). Best-corrected visual acuity(BCVA), intraocular pressure(IOP), the main complications following surgery, and indentation gonioscopy and angle parameters measured using UBM were documented preoperatively and postoperatively.· RESULTS: The improvement in BCVA in the phacoemulsification group was significantly greater than in the combined group(P 【0.05). IOP in the phacoemulsification group was slightly higher than in the combined group following 1wk of follow-up(P 【0.05),whereas there was no significant difference between the two groups at the latter follow-up(P 】0.05).Phacoemulsification alone resulted in a slight increase in the trabecular ciliary processes distance compared with the combined surgery(P 【0.05), whereas the other angle parameters showed no significant difference between the groups. Complications in combined group were greater than phacoemulsification only group.·CONCLUSION: Both surgeries effectively opened the drainage angle and deepened the anterior chamber, and IOP was well controlled postoperatively. However,phacoemulsification showed better efficacy in improving visual function and showed reduced complications following surgery.
基金Supported by the National Natural Science Foundation of China(No.81670847No.81600728)
文摘AIM:To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angleclosure(APAC) and age-related cataracts. METHODS:Twenty eyes of 20 APAC patients and 15 eyes of 15 age-related cataract patients were included in this cross-sectional study. Aqueous humor samples were collected prospectively. The levels of 20 proinflammatory cytokines were evaluated in the aqueous humor of the APAC and cataract patients using the multiplex bead immunoassay technique. Clinical data were collected for correlation analysis.RESULTS:Seven of the 20 proinflammatory cytokines included in the magnetic bead panel were detectable in both APAC eyes and cataract eyes:interleukin(IL)-10, IL-12, IL-15, IL-21, IL-6, chemokine(C-C motif) ligand 20, and tumor necrosis factor alpha(TNF-α). IL-27 was only detectable in APAC eyes. Compared with the cataract eyes, the APAC eyes had significantly elevated concentrations of IL-12(P=0.036), IL-15(P=0.001), IL-6(P=0.012), and IL-27(only detectable in APAC eyes). Age was positively correlated with IL-12(P=0.022) and IL-6(P=0.037), and time elapsed between APAC onset and aqueous humor samples collection was positively correlated with IL-15(P=0.037), IL-27(P=0.040), and TNF-α(P=0.042).CONCLUSION:Several proinflammatory cytokines including IL-12,IL-15, IL-6 and IL-27, were elevated in the APAC eyes and may be implicated in its pathologic mechanism.