BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)fo...BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia.METHODS Visual values(contrast sensitivity,color vision,and best-corrected visual acuity)in three groups,patients with high myopia in Group A,patients with high myopia and glaucoma in Group B,and patients with high myopia suspicious for glaucoma in Group C,were compared.Optic disc parameters,retinal nerve fiber layer(RNFL)thickness,and ganglion cell layer(GCC)thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic(ROC)test performance curves of the RNFL and GCC for high myopia and glaucoma.RESULTS Of a total of 98 patients admitted to our hospital from May 2018 to March 2022,totaling 196 eyes in the study,30 patients with 60 eyes were included in Group A,33 patients with 66 eyes were included in Group B,and 35 patients with 70 eyes were included in Group C.Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma.The area under the ROC curve was greater than 0.7,indicating an acceptable diagnostic value.CONCLUSION The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.展开更多
Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour inter...Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour intervals for 48 h. Based on the results of the serial lOP measurements, optic disc changed and visual field defected, the patients were diagnosed as primary OAG （ POAG ）, normal tension glaucoma （NTG）, ocular hypertension （ OHT） , or physiologic cup （PC）. Results After the serial lOP measurements, 16. 7% of the suspected OAG patients were diagnosed as POAG, 32. 4% as NTG, 24. 5% as OHT, and 26. 4% as PC. The highest percentages of the POAG group had peak lOP at 8 AM （19. 4% ） and their trough lOP at 10 PM （27. 8% ） ; the NTG group had peak lOP at 12 AM （18. 6% ） and their trough lOP at 12 PM （22. 9% ） ; the OHT group had peak lOP at 4 AM （22. 6% ） and their trough lOP at 10 PM （26. 4% ） ; and the PC group had peak lOP at 4 AM （ 21. 1% ） and their trough lOP at 12 PM （ 21. 1% ）. The percentages of peak lOP outside clinic （ 8 AM - 4 PM） in the POAG, NTG, OHT and PC groups were 55. 6%, 50. 0%, 58. 4% and 45. 7%, respectively. The mean magnitude of variance was 5. 1 - 6. 7 mmHg in those suspected OAG patients. There was a strong positive correlation in lOP between both eyes at each time point of measurement and the variation curves of the right and left eyes had parallel profiles in those suspected OAG patients. Conclusion Serial measurement of lOP is still needed, in order not to miss the peak and the trough lOP readings in suspected OAG patients, which helps in better management of glaucoma.展开更多
AIM: To determine relationships between retinal nerve fiber layer(RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus(HIV) positive patients evaluated for glaucoma suspicion.METHODS: Data were rev...AIM: To determine relationships between retinal nerve fiber layer(RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus(HIV) positive patients evaluated for glaucoma suspicion.METHODS: Data were reviewed for 329 HIV positive patients evaluated for glaucoma suspicion. High-definition optical coherence tomography(OCT) RNFL measurements were obtained at least 6 mo apart. Analyses were performed to identify relationships between nadir CD4 count and RNFL thickness.RESULTS: Totally 110 eyes of 55 patients met inclusion criteria, of which 46 eyes were from subjects with nadir CD4<200 cells/mm^3 and 64 had nadir CD4≥200 cells/mm^3. Patients with nadir CD4<200 cells/mm^3 had significantly thicker superior(119.7±18.6 μm) and temporal(63.8±11.7 μm) quadrants at time of initial OCT compared to the superior(112.8±16.8 μm, P=0.048) and temporal(57.1±11.9 μm, P=0.004) quadrants of patients with higher nadir CD4. This trend toward thicker RNFL among subjects with lower nadir CD4 cell counts persisted at the time of follow up OCT where participants with nadir CD4<200 cells/mm^3 showed average RNFL thickness in the superior and temporal quadrants of 117.9±18.3 μm and 63.8±12.8 μm, respectively, compared to a superior thickness of 110.5±16.9 μm(P=0.034) and temporal thickness of 57.3±11.6 μm(P=0.007) among those with higher nadir CD4. CONCLUSION: Patients with lower nadir CD4 cell counts have thicker RNFL in the superior and temporal quadrants compared to those with higher nadir CD4 counts. RNFL thickness in HIV positive patients may be affected by historic HIV disease control and should be considered when evaluating HIV positive patients for glaucoma.展开更多
AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to...AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performance of GC-IPL thicknesses is comparable to that.展开更多
目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1...目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1;就诊年龄7~30岁;仅1例有家族史;14例(25.93%)患者伴有眼部症状。所有患者中单纯高眼压型[眼压>21 mm Hg(1 mm Hg=0.133 kPa)]占53.70%(29/54),单纯杯盘比(C/D)异常占18.52%(10/54),两者兼有占27.78%(15/54);近视69眼(63.89%);全部房角开放;视野异常29眼(26.85%);OCT异常39眼(36.11%);排除青光眼21例(38.89%),确诊为开角型青光眼8例(14.81%)。结论年轻可疑青光眼患者发病隐匿,绝大部分症状不典型或无症状,合并近视的患者较多,年轻患者一定要重视眼压和眼底的检查,特别对于屈光不正、视力下降和有危险因素的患者不要忽视行视野和OCT进行详细的排查和密切随访。展开更多
AIM： To assess the refractive status, anterior chamber depth （ACD） and axial length （AL） of patients with primary angle-closure disease （PACD）. METHODS： Retrospective cohort. Data was collected from charts of...AIM： To assess the refractive status, anterior chamber depth （ACD） and axial length （AL） of patients with primary angle-closure disease （PACD）. METHODS： Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics, PACD type, refractive status （spherical equivalent）, ACD and AL were studied. RESULTS： The median age of 137 subjects [53 with primary angle-closure suspects （PACS）, 27 with primary angle- closure （PAC） and 57 with primary angle-closure glaucoma （PACG）] was 68y （range 21-88y）. The majority was Chinese （n=68; 49.6%） and most of them were women （n=75; 54.7%）. The distribution of myopia （n=51; 37.2%） and hyperopia （n=49; 35.8%） was similar. The ACD was shallower in myopes compared to hyperopes （P=-0.02） and emmetropia （P=-0.049） but the AL was not significantly different between groups. There were no patients blind from PACG. CONCLUSION： Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes, the AL was not different between groups.展开更多
文摘BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia.METHODS Visual values(contrast sensitivity,color vision,and best-corrected visual acuity)in three groups,patients with high myopia in Group A,patients with high myopia and glaucoma in Group B,and patients with high myopia suspicious for glaucoma in Group C,were compared.Optic disc parameters,retinal nerve fiber layer(RNFL)thickness,and ganglion cell layer(GCC)thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic(ROC)test performance curves of the RNFL and GCC for high myopia and glaucoma.RESULTS Of a total of 98 patients admitted to our hospital from May 2018 to March 2022,totaling 196 eyes in the study,30 patients with 60 eyes were included in Group A,33 patients with 66 eyes were included in Group B,and 35 patients with 70 eyes were included in Group C.Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma.The area under the ROC curve was greater than 0.7,indicating an acceptable diagnostic value.CONCLUSION The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.
文摘Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour intervals for 48 h. Based on the results of the serial lOP measurements, optic disc changed and visual field defected, the patients were diagnosed as primary OAG （ POAG ）, normal tension glaucoma （NTG）, ocular hypertension （ OHT） , or physiologic cup （PC）. Results After the serial lOP measurements, 16. 7% of the suspected OAG patients were diagnosed as POAG, 32. 4% as NTG, 24. 5% as OHT, and 26. 4% as PC. The highest percentages of the POAG group had peak lOP at 8 AM （19. 4% ） and their trough lOP at 10 PM （27. 8% ） ; the NTG group had peak lOP at 12 AM （18. 6% ） and their trough lOP at 12 PM （22. 9% ） ; the OHT group had peak lOP at 4 AM （22. 6% ） and their trough lOP at 10 PM （26. 4% ） ; and the PC group had peak lOP at 4 AM （ 21. 1% ） and their trough lOP at 12 PM （ 21. 1% ）. The percentages of peak lOP outside clinic （ 8 AM - 4 PM） in the POAG, NTG, OHT and PC groups were 55. 6%, 50. 0%, 58. 4% and 45. 7%, respectively. The mean magnitude of variance was 5. 1 - 6. 7 mmHg in those suspected OAG patients. There was a strong positive correlation in lOP between both eyes at each time point of measurement and the variation curves of the right and left eyes had parallel profiles in those suspected OAG patients. Conclusion Serial measurement of lOP is still needed, in order not to miss the peak and the trough lOP readings in suspected OAG patients, which helps in better management of glaucoma.
文摘AIM: To determine relationships between retinal nerve fiber layer(RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus(HIV) positive patients evaluated for glaucoma suspicion.METHODS: Data were reviewed for 329 HIV positive patients evaluated for glaucoma suspicion. High-definition optical coherence tomography(OCT) RNFL measurements were obtained at least 6 mo apart. Analyses were performed to identify relationships between nadir CD4 count and RNFL thickness.RESULTS: Totally 110 eyes of 55 patients met inclusion criteria, of which 46 eyes were from subjects with nadir CD4<200 cells/mm^3 and 64 had nadir CD4≥200 cells/mm^3. Patients with nadir CD4<200 cells/mm^3 had significantly thicker superior(119.7±18.6 μm) and temporal(63.8±11.7 μm) quadrants at time of initial OCT compared to the superior(112.8±16.8 μm, P=0.048) and temporal(57.1±11.9 μm, P=0.004) quadrants of patients with higher nadir CD4. This trend toward thicker RNFL among subjects with lower nadir CD4 cell counts persisted at the time of follow up OCT where participants with nadir CD4<200 cells/mm^3 showed average RNFL thickness in the superior and temporal quadrants of 117.9±18.3 μm and 63.8±12.8 μm, respectively, compared to a superior thickness of 110.5±16.9 μm(P=0.034) and temporal thickness of 57.3±11.6 μm(P=0.007) among those with higher nadir CD4. CONCLUSION: Patients with lower nadir CD4 cell counts have thicker RNFL in the superior and temporal quadrants compared to those with higher nadir CD4 counts. RNFL thickness in HIV positive patients may be affected by historic HIV disease control and should be considered when evaluating HIV positive patients for glaucoma.
文摘AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performance of GC-IPL thicknesses is comparable to that.
文摘目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1;就诊年龄7~30岁;仅1例有家族史;14例(25.93%)患者伴有眼部症状。所有患者中单纯高眼压型[眼压>21 mm Hg(1 mm Hg=0.133 kPa)]占53.70%(29/54),单纯杯盘比(C/D)异常占18.52%(10/54),两者兼有占27.78%(15/54);近视69眼(63.89%);全部房角开放;视野异常29眼(26.85%);OCT异常39眼(36.11%);排除青光眼21例(38.89%),确诊为开角型青光眼8例(14.81%)。结论年轻可疑青光眼患者发病隐匿,绝大部分症状不典型或无症状,合并近视的患者较多,年轻患者一定要重视眼压和眼底的检查,特别对于屈光不正、视力下降和有危险因素的患者不要忽视行视野和OCT进行详细的排查和密切随访。
文摘AIM： To assess the refractive status, anterior chamber depth （ACD） and axial length （AL） of patients with primary angle-closure disease （PACD）. METHODS： Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics, PACD type, refractive status （spherical equivalent）, ACD and AL were studied. RESULTS： The median age of 137 subjects [53 with primary angle-closure suspects （PACS）, 27 with primary angle- closure （PAC） and 57 with primary angle-closure glaucoma （PACG）] was 68y （range 21-88y）. The majority was Chinese （n=68; 49.6%） and most of them were women （n=75; 54.7%）. The distribution of myopia （n=51; 37.2%） and hyperopia （n=49; 35.8%） was similar. The ACD was shallower in myopes compared to hyperopes （P=-0.02） and emmetropia （P=-0.049） but the AL was not significantly different between groups. There were no patients blind from PACG. CONCLUSION： Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes, the AL was not different between groups.
