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.

Experimental study on discharge coefficient of a gear-shaped weir

This study focused on hydraulic characteristics around a gear-shaped weir in a straight channel. Systematic experiments were carried out for weirs with two different gear heights and eight groups of geometrical parameters. The impacts of various geometrical parameters of gear-shaped weirs on the discharge capacity were investigated. The following conclusions are drawn from the experimental study:(1) The discharge coefficient(m_c) was influenced by the size of the gear: at a constant discharge, the weir with larger values of a/b(a is the width of the gear, and b is the width between the two neighboring gears) and a/c(c is the height of the gear) had a smaller value of m_c. The discharge capacity of the gear-shaped weir was influenced by the water depth in the weir.(2) For type C1 with a gear height of 0.01 m, when the discharge was less than 60m^3/h and H_1=P < 1.0(H_1 is the water depth at the low weir crest, and P is the weir height), m_c significantly increased with the discharge and H_1=P; with further increases of the discharge and H_1=P, m_cshowed insignificant decreases and fluctuated within small ranges. For type C2 with a gear height of 0.02 m, when the discharge was less than 60m^3/h and H_1=P < 1.0, m_csignificantly increased with the discharge and H_1=P; when the discharge was larger than 60m^3/h and H_1=P > 1.0, m_c slowly decreased with the increases of the discharge and H_1=P for a=b 1.0 and a=c 1.0, and slowly increased with the discharge and H_1=P for a=b > 1.0 and a=c > 1.0.(3) A formula of m_cfor gear-shaped weirs was established based on the principle of weir flow, with consideration of the water depth in the weir, the weir height and width, and the height of the gear.

Predictors of angle widening after laser iridotomy in Chinese patients with primary angle-closure suspect using ultrasound biomicroscopy

AIM:To assess the predictive value of baseline parameters of ultrasound biomicroscopy(UBM) for angle widening after prophylactic laser peripheral iridotomy(LPI) in patients with primary angle-closure suspect(PACS).METHODS:Angle-opening distance(AOD),trabecular iris angle(TIA),iris thickness,trabecular-ciliary process angle,and trabecular-ciliary process distance were measured using UBM performed before and two weeks after LPI.Iris convexity(IC),iris insertion,angulation,and ciliary body(CB) size and position were graded.Uni-and multivariate regression analyses were used to determine factors predicting the change in AOD(ΔAOD500,calculated as an angle width change before and after LPI) in all quadrants and in subgroup quadrants based on IC.RESULTS:In 94 eyes of 94 patients with PACS,LPI led to angle widening with increases in AOD500 and TIA(P<0.01).Multivariable regression analysis showed that IC(P<0.001),CB position(P=0.007) and iris insertion(P=0.049) were significantly predictive for ΔAOD500.All quadrants were categorized into extreme IC(27.8%),moderate IC(62.3%),and absent IC(9.9%) subgroups.The AOD500 increased by 220% and no other predictive factor was found in the extreme IC quadrants.The AOD500 increased by 55%,and baseline iris angulation was predictive for smaller changes in ΔAOD500 in the moderate IC quadrants.CONCLUSION:In PACS patients,quadrants with greater iris bowing predict substantial angle widening after LPI.Quadrants with a flatter iris,anteriorly positioned CB,and basal iris insertion are associated with less angle widening after LPI.Quadrants with iris angulation as well as a flatter iris configuration predict a smaller angle change after LPI.