Clinical significance of episcleral venous fluid wave in gonioscopy-assisted transluminal trabeculotomy

AIM:To evaluate the clinical significance of checking episcleral venous fluid wave(EVFW)during gonioscopyassisted transluminal trabeculotomy(GATT)in patients with open angle glaucoma(OAG).METHODS:This retrospective case series study comprised 30 patients(45 eyes)with OAG underwent GATT.The location and extent of EVFW were examined and graded after intraoperative compression flushing of the anterior chamber angle during the operation.Patients were followed up for 1y.A complete success for surgery is defined as a postoperative intraocular pressure(IOP)<18 mm Hg without any anti-glaucoma medication.IOP<18 mm Hg with less than two anti-glaucoma medications is defined as qualified success,while the control of IOP requiring three anti-glaucoma medications is considered as unsuccess.RESULTS:The mean IOP was 35.38±7.16 mm Hg before surgery and 15.52±4.22 mm Hg 1y after surgery(P<0.01).The average number of anti-glaucoma medication was 2.8±1.2(2-4)preoperation and 0.6±1.3(0-3)1y postoperation(P<0.01).The success rate of the operation was 93.33%.Complete success rate was 66.67%,qualified success rate was 26.67%,and 6.66%of unsuccessful cases required reoperation.EVFW of all cases was grade 2-4,and the percentages of grade 2,3 and 4 were 33.33%,40.0%and 26.67%,respectively.The distribution and percentage of EVFW were inferior(36%),nasal(28%),superior(20%),and temporal(16%).The EVFW grade of complete success patients was 3.4±0.6(3-4),and that of qualified success patients was 2.6±1.0(2-4).The larger the range of EVFW,the lower the IOP,and the better the IOP reduction effect.CONCLUSION:During GATT surgery,pressurized irrigation of anterior chamber to check EVFW can reduce the outflow resistance of aqueous humor and increase the effect of postoperative IOP.The range of EVFW is negatively correlated with postoperative IOP.Therefore,EVFW may be a valuable prognostic indicator for the success of GATT surgery.

Predicting the prognosis of primary orbital lymphoma by clinical characteristics and imaging features

AIM: To analyze the 5-year disease-free survival(DFS) of primary orbital lymphoma(POL) by clinical characteristics and imaging features.METHODS: A total of 72 patients, 43 males and 29 females, with histologically confirmed POL, were retrospectively recruited between January 2012 and May 2017. The information on clinical characteristics, imaging features, and 5-year DFS was obtained. Univariate and multivariate forward logistic regression analyses were used to identify the variables significantly associated with 5-year DFS. Kaplan-Meier was applied for survival analysis. RESULTS: Univariate analysis revealed that uni-or bilateral orbital involvement, single or multiple lesions, treatment methods, and contrast enhancement pattern on images were significant for 5-year DFS(P=0.022, 0.042, <0.001, and 0.028, respectively), while in multivariate logistic regression analysis, only uni-or bilateral orbital involvement, treatment methods and contrast enhancement pattern on images were significant(r=0.453, 0.897, and 0.556, P=0.038, <0.001 and 0.022, respectively). The survival curves for DFS were obtained. CONCLUSION: The majority of POL are B-cell lymphomas. Unilateral orbital involvement, homogeneous contrast enhancement on images, and the appropriate treatment schemes result to be significant factors for a good prognosis for POL.

慢性泪囊炎患者泪囊长轴与骨性鼻泪管夹角的研究

目的:分析慢性泪囊炎患者患眼和正常眼泪囊长轴与骨性鼻泪管夹角的差异,探讨该夹角与慢性泪囊炎的关系。方法:回顾性收集2016-01/2019-03于我院眼科就诊的四川地区慢性泪囊炎患者218例248眼,所有患者行双侧泪道冲洗后立即进行CT泪道检查,对鼻泪管结构图进行三维重建,于冠状位上观察鼻泪管、泪囊及其周围组织结构,分别测量患眼和正常眼泪囊长轴与骨性鼻泪管夹角。结果:本组患者患眼夹角[23.55°(17.30°,29.90°)]较正常眼[20.05°(15.40°,28.35°)]增大(P<0.05),其中女性患者患眼夹角[24.60°(17.75°,31.00°)]较正常眼[21.15°(15.10°,27.35°)]明显增大(P<0.05),而男性患者患眼夹角与正常眼无明显差异(P>0.05)。此外,41~60岁患者患眼夹角[25.20°(17.90°,33.00°)]较正常眼[21.60°(15.25°,29.05°)]明显增大(P<0.05)。结论:慢性泪囊炎患者泪囊长轴与骨性鼻泪管夹角增大,这可能是中老年妇女慢性泪囊炎发病的因素之一。

Lycium barbarum polysaccharides promotes in vivo proliferation of adult rat retinal progenitor cells

Lycium barbarum is a widely used Chinese herbal medicine prescription for protection of optic nerve.However,it remains unclear regarding the effects of Lycium barbarum polysaccharides,the main component of Lycium barbarum,on in vivo proliferation of adult ciliary body cells.In this study,adult rats were intragastrically administered low-and high-dose Lycium barbarum polysaccharides（1 and 10 mg/kg）for 35 days and those intragastrically administered phosphate buffered saline served as controls.The number of Ki-67-positive cells in rat ciliary body in the Lycium barbarum polysaccharides groups,in particular low-dose Lycium barbarum polysaccharides group,was significantly greater than that in the phosphate buffered saline group.Ki-67-positive rat ciliary body cells expressed nestin but they did not express glial fibrillary acidic protein.These findings suggest that Lycium barbarum polysaccharides can promote the proliferation of adult rat retinal progenitor cells and the proliferated cells present with neuronal phenotype.

Effects of higher-order aberrations on contrast sensitivity in normal eyes of a large myopic population

AIM：To study the relation between higher-order aberrations（HOAs）and contrast sensitivity（CS）in normal eyes among a population of laser in situ keratomileusis（LASIK）candidates.METHODS：In 6629 eyes of 3315 LASIK candidates,CS were measured under dark environment at the spatial frequencies of 1.5,3,6,12 and 18 cycles per degree（c/d）,respectively,using an Optec 6500 visual function tester.Meanwhile,ocular HOAs were measured for a 6.0 mm pupil with a Hartmann-Shack wavefront analyzer.RESULTS：In the study,the subjects with an average spherical equivalent of-4.86±2.07 D were included.HOAs decreased from the third to the sixth order aberrations with predominant aberrations of third-order coma,trefoil and fourth-order spherical aberration.At low and moderate spatial frequencies,CS was negatively correlated with the third-order coma and trefoil aberrations,and decreased with increasing Z31,but increased with increasing Z3-3and Z5-1.At high spatial frequencies,CS decreased with increasing Z3-3and increased with increasing Z5-1.CONCLUSION：At a large pupil size of 6.0 mm,the thirdorder aberrations,but not the total aberrations,are the main factors affecting CS.Vertical coma is negatively correlated with CS.

C-reactive protein and diabetic retinopathy in Chinese patients with type 2 diabetes mellitus

AIM：To investigate the relationship between Creactive protein（CRP）and diabetic retinopathy（DR）in a cohort of Chinese patients with type 2 diabetes mellitus（T2DM）.·METHODS：Community-based observational cohort study.There were 1131 participants recruited from November 2009 to September 2011 in Desheng community in urban Beijing.Patients diagnosed T2DM were recruited and underwent a standardized evaluation consisting of a questionnaire,ocular and anthropometric examinations and laboratory investigation.The presence and severity of DR were assessed by seven fields 30°color fundus photographs.Subjects were then classified into groups with no DR,any DR,or vision-threatening DR.CRP was analyzed from serum of study subjects.·RESULTS：A total of 1007 patients with T2DM were included for analysis,including 408（40.5%）men and 599（59.5%）women.The median CRP level was 1.5 mg/L for women and 1.1 mg/L for men（=0.004,OR 0.37,95%CI0.18-0.74）.After adjusting for possible covariates,higher levels of CRP were associated with lower prevalence of any DR（=0.02,OR 0.55,95%CI 0.35-0.89）,but not associated with vision-threatening DR（=0.62,OR 0.78,95%CI 0.28-2.14）.After stratification by sex,the inverse association between CRP and DR was found to be statistically significant in men（=0.006,OR 0.35,95%CI0.16-0.73）,but not in women（=0.58,OR 0.88,95%CI0.29-1.16）.·CONCLUSION：The data drawn from a Chinese population with T2DM suggest that increasing CRP levels may be inversely associated with development of DR.

The effect of increased intra-abdominal pressure on orbital subarachnoid space width and intraocular pressure

In accordance with the trans-lamina cribrosa pressure difference theory, decreasing the trans-lamina cribrosa pressure difference can re- lieve glaucomatous optic neuropathy. Increased intracranial pressure can also reduce optic nerve damage in glaucoma patients, and a safe, effective and noninvasive way to achieve this is by increasing the intra-abdominal pressure. The purpose of this study was to observe the changes in orbital subarachnoid space width and intraocular pressure at elevated intra-abdominal pressure. An inflatable abdominal belt was tied to each of 15 healthy volunteers, aged 22-30 years （12 females and 3 males）, at the navel level, without applying pressure to the abdomen, before they laid in the magnetic resonance imaging machine. The baseline orbital subarachnoid space width around the optic nerve was measured by magnetic resonance imaging at 1, 3, 9, and 15 mm behind the globe. The abdominal belt was inflated to increase the pressure to 40 mmHg （1 mmHg = 0.133 kPa）, then the orbital subarachnoid space width was measured every 10 minutes for 2 hours. After removal of the pressure, the measurement was repeated 10 and 20 minutes later. In a separate trial, the intraocular pressure was measured for all the subjects at the same time points, before, during and after elevated intra-abdominal pressure. Results showed that the baseline mean orbital subarachnoid space width was 0.88 ＋ 0.1 mm （range： 0.77-1.05 mm）, 0.77 ＋ 0.11 mm （range： 0.60-0.94 mm）, 0.70 ＋ 0.08 mm （range： 0.62-0.80 ram）, and 0.68 _＋ 0.08 mm （range： 0.57-0.77 mm） at 1, 3, 9, and 15 mm behind the globe, respectively. During the elevated intra-abdominal pressure, the orbital subarachnoid space width increased from the baseline and dilation of the optic nerve sheath was significant at 1, 3 and 9 mm behind the globe. After decompression of the abdominal pressure, the orbital subarachnoid space width normalized and returned to the baseline value. There was no significant difference in the intraocular pressure before, during and after the intra-abdominal pressure elevation. These results verified that the increased intra-abdominal pressure widens the orbital subarachnoid space in this acute trial, but does not alter the intraocular pressure, indicating that intraocular pressure is not affected by rapid increased in- tra-abdominal pressure. This study was registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-ONRC-14004947）.

Progression rate to primary angle closure following laser peripheral iridotomy in primary angle-closure suspects: a randomised study

AIM:To report the progression rate(PR)to primary angle closure(PAC)following laser peripheral iridotomy(LPI)in PAC suspects(PACS).METHODS:Prospective,randomized controlled interventional clinical trial conducted at the Handan Eye Hospital,China.Totally 134 bilateral PACS,defined as non-visibility of the posterior trabecular meshwork for≥180 degrees on gonioscopy were randomly assigned to undergo LPI in one eye.Gonioscopy and Goldmann applanation tonometry were performed prior to,on day 7 and 12 mo post LPI.RESULTS:Eighty of 134 patients(59.7%)could be followed up at one year.The mean intraocular pressure(IOP)in treated eyes was 15.9±2.6 mm Hg at baseline,15.4±3.0 mm Hg on day 7;16.5±2.9 mm Hg at one month,and 15.5±2.9 mm Hg at 12 mo;the IOP in untreated eyes was similar(P=0.834).One or more quadrants of the angle opened in 93.7%of the LPI treated eyes,but 67.0%(53/79)remained closed in two or more quadrants.The PR to PAC in untreated eyes was 3.75%and one developed acute angleclosure glaucoma(AACG);the PR to PAC in treated eyes was 2.5%and none had developed peripheral anterior synechia(PAS)or AACG.CONCLUSION:LPI can open some of the occludable angle in the majority of eyes with PACS,but 67%continue to have non-visibility of the trabecular meshwork for over 180 degrees.

Sulforaphane modulates TGFβ2-induced conjunctival fibroblasts activation and fibrosis by inhibiting PI3K/Akt signaling

AIM:To examine the effects of sulforaphane on fibrotic changes of transforming growth factor(TGFβ2)induced human conjunctival fibroblast(HCon Fs).METHODS:HCon Fs were cultured and divided into control,TGFβ2(1 ng/m L),sulforaphane and TGFβ2+sulforaphane groups.Cell viability and apoptosis were detected using the MTT and Apo Tox-Glo Triplex assay.Cell migration was detected using scratch and Transwell assay.Real-time quantitative PCR method was used to evaluate m RNA expression of TGFβ2,matrix metalloproteinase-2(MMP2),myosin light chain kinase(MYLK),integrinαV,integrinα5,fibronectin 1 andα-smooth muscle actin(α-SMA).The protein expression ofα-SMA,p-PI3 K,PI3 K,p-Akt,and Akt were detected by Western blot.RESULTS:The proliferation of HCon Fs was significantly(P<0.05)suppressed by sulforaphane compared to control cells with the increase of the concentration and treatment time.Cell proliferation after 48 h incubation was significantly reduced with 100μmol/L sulforaphane treatment by 17.53%(P<0.05).The Transwell assay showed sulforaphane decreased cell migration by 18.73%compared with TGFβ2-induced HCon F(P<0.05).TGFβ2-induced the increasing expression of fibronectin,type I collagen andα-SMA,and the phosphorylation of PI3 K and Akt were all significantly suppressed by sulforaphane pretreatment.CONCLUSION:Sulforaphane inhibits proliferation,migration,and synthesis of the extracellular matrix in HCon Fs,and inhibiting the PI3 K/Akt signaling pathway.Sulforaphane could be a potential therapeutic drug for prevention of scar formation in filtering bleb after trabeculectomy.

Prevalence of cataract and cataract surgery in urban and rural Chinese populations over 50 years old:a systematic review and Meta-analysis

AIM:To summarize the data of epidemiological studies on cataract prevalence over 50 years old in urban and rural areas of China from 2000 to 2020,and to analyze the prevalence of cataract and operation rate in China.METHODS:By searching Pub Med,EMBASE,Web of Science,Wanfang Data and CNKI,Chinese and English literatures on the prevalence of cataract in China were retrieved,and the relevant characteristic data were extracted.Then,Stata v15 SE software was used for Metaanalysis and heterogeneity test.According to the results of heterogeneity,the corresponding effect models were selected to combine the extracted data.RESULTS:A total of 20 studies were included in this study,with a total of 111434 cases.Meta-analysis showed heterogeneity.According to the random effect model,the overall prevalence of cataract in Chinese people over 50 years old was 27.45%,that in rural was 28.79%,and that in urban was 26.66%.The overall coverage rate of cataract surgery was 9.19%.CONCLUSION:The prevalence of cataract is high in China,and there is still room for improvement in surgical coverage,so it is very important to promote cataract screening and prevention.

Longitudinal observation of intraocular pressure variations with acute altitude changes

BACKGROUND Higher intraocular pressure(IOP)is a major risk factor for developing glaucoma,and the leading cause of irreversible blindness worldwide.High altitude(HA)may be involved in IOP,but the reported results were conflicting.Ascent to HA directly by plane from low altitude regions is an acute,effortless exposure.However,the effects of such exposure to different altitudes on IOP have rarely been reported.AIM To investigate changes in IOP after rapid effortless exposure to HA in stages and compare it with systemic parameters.METHODS Fifty-eight healthy subjects(116 eyes)were divided into three groups:17 lowaltitude(LA)residents[44 m above sea level(ASL)],22 HA residents(2261 m ASL)and 19 very HA(VHA)residents(3750 m ASL).The LA group flew to HA first.Three days later,they flew with the HA group to VHA where both groups stayed for 2 d.Then,the LA group flew back to HA and stayed for 1 d before flying back to 44 m.IOP,oxygen saturation(SpO2)and pulse rate were measured.The linear mixed model was used to compare repeated measurements.RESULTS IOP in the LA group significantly decreased from 18.41±2.40 mmHg at 44 m to 13.60±3.68 mmHg at 2261 m ASL(P<0.001),and then to 11.85±2.48 mmHg at 3750 m ASL(P=0.036 compared to IOP at 2261 m ASL)and partially recovered to 13.47±2.57 mmHg upon return to 44 m.IOP in the LA group at HA and VHA was comparable to that in the local residents(12.2±2.4 mmHg for HA,11.5±1.8 mmHg for VHA).IOP was positively associated with SpO2 while negatively associated with pulse rate.CONCLUSION IOP in the LA group gradually reduced as altitude elevated in stages and became comparable to IOP in local residents.Hypoxia may be associated with IOP,which deserves further study.

空气填充联合内界膜翻转治疗伴有后巩膜葡萄肿的高度近视黄斑裂孔性视网膜脱离

目的:评估空气填充联合内界膜翻转及自体血治疗伴有后巩膜葡萄肿的高度近视黄斑裂孔性视网膜脱离(MHRD)的疗效。方法:回顾性非对照研究分析高度近视眼MHRD患者的治疗效果。玻璃体切割术中使用曲安奈德染色清除玻璃体后皮质,内界膜翻转后应用自体血固定翻转的内界膜后空气填充。记录术后黄斑裂孔闭合率、视网膜复位率及术后最佳矫正视力(BCVA)。结果:研究共纳入高度近视MHRD患者24例24眼。患者随访至少6mo,平均13.58±7.00mo。末次随访时21眼(88%)黄斑裂孔闭合,20眼(83%)视网膜复位。其中17眼(71%)黄斑裂孔闭合且视网膜复位,3眼(13%)黄斑裂孔未闭合但视网膜复位,4眼(17%)黄斑裂孔闭合但仍有视网膜下液。所有病例无需接受二次玻璃体切割手术。末次随访BCVA(LogMAR)较术前显著提高(0.65±0.34 vs 1.36±0.49,P<0.001)。12眼(50%)的BCVA提高大于等于2行。结论:玻璃体切割术联合内界膜翻转、自体血及空气填充是治疗高度近视眼MHRD的有效方法。

Progression on canaloplasty for primary open angle glaucoma

As a non-penetrating glaucoma surgery(NPGS), canaloplasty aims to reconstruct the physiological outflow of aqueous humor by dilating the Schlemm’s canal. Ab interno canaloplasty(ABiC), which can reconstruct the natural outflow pathways of aqueous humor in mild-tomoderate primary open angle glaucoma(POAG) patients, is a new minimally invasive glaucoma surgery(MIGS) procedure improving from traditional canaloplasty. Canaloplasty can reduce intraocular pressure(IOP) with high efficiency and security. There are no complications such as scar formation and encapsulation for this no-bleb canaloplasty.

Development of gene and stem cell therapy for ocular neurodegeneration

Retinal degenerative diseases pose a serious threat to eye health, but there is currently no effective treatment available. Recent years have witnessed rapid development of several cutting-edge technologies, such as gene therapy, stem cell therapy, and tissue engineering. Due to the special features of ocular structure, some of these technologies have been translated into ophthalmological clinic practice with fruitful achievements, setting a good example for other fields. This paper reviews the development of the gene and stem cell therapies in ophthalmology.

Measurement of macular pigment optical density among healthy Chinese people and patients with early-stage age-related macular degeneration

AIMTo measure the macular pigment optical density (MPOD) in healthy Chinese people and patients with early age-related macular degeneration (AMD).METHODSCross-sectional population based study. Demographic and lifestyle characteristics were ascertained by questionnaire. A food frequency questionnaire was completed for all participants. Participants underwent general physical and ophthalmic examinations and MPOD was measured by heterochromatic flicker photometry. Foveal architecture was measured by optical coherence tomography.RESULTSMPOD of 225 participants (122 healthy and 103 early AMD) was 0.48&#x000b1;0.18. Patients with early AMD (0.52&#x000b1;0.19) tended to have higher MPOD levels than healthy people (0.47&#x000b1;0.17), but the difference was not statistically significant (P=0.06). Participants with carrot or corn oil intake every week tended to have higher levels of MPOD (P=0.002 and 0.008 respectively) while those with corn intake had relatively lower level of MPOD (P=0.01). MPOD increased with the center foveal thickness (P=0.01).CONCLUSIONOur findings show that there is no statistically significant association between MPOD and early AMD in the studied population. MPOD is related to center foveal thickness and diets would influence MPOD levels.

Association between choroidal thickness and anterior chamber segment in eyes with narrow or open-angle

AIM: To investigate the relationship between choroidal thickness and anterior chamber segment in subjects with eyes with narrow or open-angle. METHODS: The subfoveal choroidal thickness was measured with enhanced depth -imaging optical coherence tomography and anterior chamber parameters were measured with ultrasound biomicroscopy in one eye of 23 subjects with open-angle eyes and 38 subjects with narrow-angle eyes. The mean age was 59.52 +/- 7.04y for narrow-angle subjects and 60.76 +/- 7.23y for open angle subjects (P=0.514). Multivariate linear regression analysis was performed to assess the association between choroidal thickness and narrow -angle parameters. RESULTS: There were no differences in subfoveal choroidal thickness between open - and narrow-angle subjects (P=0.231). Anterior chamber parameters, including central anterior chamber depth, trabecular iris angle, iris thickness 500 mu m from the scleral spur (IT500), and ciliary body thickness at 1 mm and 2 mm from the sclera! spur (CBT1, CBT2) showed significant differences between the two groups (P<0.05). Subfoveal choroidal thickness showed negative correlation (beta=-0.496, P=0.016) only with anterior chamber depth in the open angle group and with age (beta=-0.442, P=0.003) and 11500 (beta=-0.399, P=0.008) in the narrow-angle group. However, subfoveal choroidal thickness was not correlated with trabecular iris angle, anterior chamber depth, ciliary body thickness, or central corneal thickness in the narrow-angle group. CONCLUSION: Choroidal thickness does not differ in the two groups and has not correlated with anterior chamber parameters in narrow-angle subjects, suggesting a lack of relationship between choroidal thickness and primary angle-closure glaucoma.

How long is the interval of onsets of bilatera retinoblastoma?

Dear Sir,Iam Dr.Ye Zhang,from Beijing Tongren Eye Center,Beijing Tongren Hospital,Beijing,China.I write to present a case report of bilateral retinoblastoma(Rb)with10-year-interval of onsets.Rb is the most common malignant intraocular tumor of infancy and childhood,with the majority of cases being diagnosed before 5 years of age.It may involve in unilateral or bilateral eye.Studies showed that the interval of the onsets of bilateral Rb is always within three years.So it is very rare

Association of peripheral anterior synechia,intraocular pressure,and glaucomatous optic neuropathy in primary angle-closure diseases

AIM:To investigate the association of peripheral anterior synechiae(PAS)with intraocular pressure(IOP)and glaucomatous optic neuropathy(GON)in primary angle closure(PAC)and primary angle-closure glaucoma(PACG).METHODS:Totally 355 eyes(238 PAC and 117 PACG)of 181 patients were included in this retrospective analysis of baseline data from a randomized clinical trial.All patients had undergone a comprehensive ophthalmic examination.The extent of PAS in clock hours as determined on gonioscopy was documented.The independent effect of the extent of PAS on IOP and the prevalence of GON were determined using multivariable generalized estimating equation(GEE)models.RESULTS:The frequency of GON increased with the extent of PAS and a higher IOP.PAS were more extensive(8 vs 1 clock hour,P<0.001)and IOP higher(28.01 vs 18.00 mm Hg,P<0.001)in PACG compared to PAC.The prevalence of GON among the PAS quartiles were 10.2%(PAS<0.5 clock hours),16.9%(PAS≥0.5 and PAS<3 clock hours),29.6%(PAS≥3 and PAS<7 clock hours),and 74.4%(PAS≥7 clock hours),respectively.After adjusting for IOP,age,gender,spherical equivalent,average Shaffer score and number of medications,the odds ratio(OR)for GON was 4.4(95%CI:1.5-13.0;P=0.007)with PAS≥3 clock hours and 13.8(95%CI:4.3-43.6;P<0.001)with PAS≥7 clock hours as compared to eyes with PAS<0.5 clock hours.The frequency of GON increased linearly with the extent of PAS.Extent of PAS was also associated with higher IOP.Eyes with both PAS≥6 clock hours and IOP≥21 mm Hg had the highest risk of GON compared to eyes with both PAS<6 clock hours and IOP<21 mm Hg(OR=18.0,95%CI:7.5-43.4;P<0.001).CONCLUSION:The extent of PAS in PAC and PACG is an important predictor of higher IOP and is linearly associated with GON independent of IOP,suggesting other factors related to PAS formation may be involved in the development of GON in PACG.

Effect of 0.01%atropine eyedrops on intraocular pressure in schoolchildren:a randomized clinical trial

·AIM:To assess the effect of 0.01%atropine eye drops on intraocular pressure(IOP)in myopic children.·METHODS:A placebo-controlled,double-masked,randomized study.Totally 220 children aged 6 to 12 y with myopia ranging from-1.00 to-6.00 D in both eyes were enrolled.Children were randomized in a 1:1 ratio to either 0.01%atropine eye drops or a placebo group using generated random numbers.All participants underwent the examination of IOP and cycloplegic refraction at baseline,6 and 12 mo.The change of IOP and the proportion of subjects with increased IOP in atropine and placebo groups were compared.·RESULTS:Of 220 children,117 were boys(53.2%).A total of 159(72.3%)participants completed the follow-up at the 1-year study.At baseline,the mean IOP was 15.74 mm Hg(95%CI,15.13 to 16.34 mm Hg)for the 0.01%atropine group and 15.59 mm Hg(95%CI,15.00 to 16.19 mm Hg)for placebo group(mean difference,0.14 mm Hg;P=0.743)after adjusting for central corneal thickness at baseline.At one year follow-up,the mean change of IOP was 0.16 mm Hg(95%CI,-0.43 to 0.76 mm Hg)for the 0.01%atropine group and-0.11 mm Hg(95%CI,-0.71 to 0.50 mm Hg)for placebo group(mean difference,0.27 mm Hg;P=0.525)after adjusting for central corneal thickness.The 51.4%of children have increased IOP in the 0.01%atropine group,compared with 45.9%in the placebo group(P=0.511).·CONCLUSION:The 0.01%atropine eye drops do not significantly affect the risk of elevated IOP.It is relatively safer to use in the studies that try to minimize myopia progression.However,a further long-duration study is required to be validated.

Establish Albumin-creatinine Ratio Reference Value of Adults in the Rural Area of Hebei Province

Objective To establish albumin-creatinine ratio(ACR) reference value of the rural population in Hebei province.Methods This study enrolled 5154 participants.By excluding subjects with hypertension,diabetes,dyslipidemia,cardiovascular and cerebrovascular diseases,kidney diseases,and overweight condition,as well as those with an estimated glomerular filtration rate(eGFR)<60 ml/(min·1.73 m^2),apparently healthy subjects(1168) were selected.Urine albumin was measured by using the immunoturbidimetic method,serum creatinine was measured by using Jaffe's kinetic method on a morning spot-urine sample,and ACR was calculated.The 95 th percentile of ACR in the healthy subjects was used as the normal upper limit.Results The normal upper limit of ACR was 28.71 mg/g(3.25 mg/mmol) for males and 31.85mg/g(3.60 mg/mmol) for females.Based on this ACR reference value,the age-gender standardized prevalence of albuminuria in the rural areas of Hebei province was 12.9%.Conclusion The ACR reference value in the rural of Hebei province is higher than that of the Western population.