Values of macular ganglion cell-inner plexiform layer and 10-2 visual field measurements in detecting and evaluating glaucoma

AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.

A pedigree with retinitis pigmentosa and its concomitant ophthalmic diseases

AIM:To characterize the ophthalmic clinical phenotype of a family with retinitis pigmentosa(RP)and closed-angle glaucoma and to detect pathogenic genes and mutation sites causing RP in this family.METHODS:Ophthalmic clinic performance was examined in detail in 8 enrolled family members.Genomic DNA was extracted from the peripheral blood of 4 family members for whole-exome sequencing(WES)to select potential genetic mutations whose structures were identified by bioinformatics analysis.Then,Sanger sequencing was used in 12 family members and control group members to validate and confirm the disease-causing mutation loci,and we analyzed the genotype-phenotype relationships.RESULTS:The known c.512C>T(p.P171L)mutation in the rhodopsin(RHO)gene was only found in afflicted family members and was confirmed by WES and Sanger sequencing as the pathogenic mutation in this family.In addition to being diagnosed with RP,family member III:4 was found to have bilateral closed-angle glaucoma,high myopia,and concurrent cataracts,and family members II:2 and II:4 had pathological changes of anterior chamber angle narrowing.Family members IV:3 and IV:4 were found to have retinoschisis.CONCLUSION:Glaucoma and related pathological changes,such as retinoschisis,in family members are preliminarily considered RP complications caused by RHO mutation.

不同浓度荧光素钠液对检测泪膜破裂时间的稳定性比较

目的:分析不同浓度荧光素钠液对检测泪膜破裂时间(TBUT)的稳定性。方法:回顾性分析2019-08/2021-09来我院干眼门诊配合良好者150例150眼的临床资料,将受试者随机分成0.5%荧光素钠FLS、1.0%FLS、1.5%FLS、2.0%FLS、荧光素钠平行(FLSP)五组,每组30例30眼(均以右眼为受试眼),各组分别滴入对应的荧光素钠液,FLSP组为荧光试纸条检测组。比较不同浓度组裂隙灯图像评分及荧光素钠存活时间,观察各组即时,2、5、10、15、30min的TBUT。结果:0.5%FLS组图像评分明显高于其他四组(t=7.746、21.483、116.190、38.730,均P<0.01),1.0%FLS组图像评分明显高于1.5%FLS组、2.0%FLS组(t=10.742、15.492,均P<0.01)。0.5%FLS组荧光素染色持续时间明显短于其他四组(t=8.226、7.458、9.159、12.347,均P<0.01),1.5%FLS组荧光素存活时间明显长于1.0%FLS组、2.0%FLS组(t=15.428、13.274,均P<0.05)。0.5%FLS组TBUT在2min时明显高于其他四组(t=22.767、22.345、15.494、17.213,均P<0.01),在10min时明显低于其他四组(t=23.266、25.353、10.183、22.025,均P<0.01)。1.5%FLS组平均首次TBUT明显短于其他四组(t=25.236、21.374、19.658、72.341,均P<0.01),FLSP组平均首次TBUT明显长于其他四组(t=22.487、30.267、60.247、40.857,均P<0.01)。TBUT与眼表疾病指数(OSDI)、泪河高度无相关(r=-0.072、0.219,P=0.689、0.112),TBUT与泪液分泌呈正相关(r=0.674,P<0.01)。结论:0.5%FLS图像质量较高,但只适合在5min内观察染色,FLSP组更适合临床较长时间观察角膜荧光染色;1.5%FLS是最为稳定和可靠的浓度和剂量,可用于TBUT的检测。