AIM: To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma(JOAG) caused by the Pro370Leu myocilin(MYOC) mutation. ·METHODS: Fifteen members of a...AIM: To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma(JOAG) caused by the Pro370Leu myocilin(MYOC) mutation. ·METHODS: Fifteen members of a three-generation Chinese family with JOAG were recruited to this study. They all underwent ophthalmic common examinations. Patients suspected to have JOAG got an assessment of visual field and optical coherence tomography. Intraocular pressures(IOPs) of four patients were measured at 8,10,12,14,17 o’clock respectively after using anti-glaucoma drugs. Mutation screening of all MYOC gene coding exons of the participants was performed by using direct sequencing of PCR products. ·RESULTS: Clinical examinations and pedigree analysis revealed eight family members were suffered from JOAG. Apparent genetics anticipation phenomenon was observed in this family. Their clinical features included elevated IOP of 35-55mmHg,loss of visual field,thinning of retinal nerve fiber layer,and glaucomatous optic disc damage. Noticeably,their intraocular pressure levels could be controlled within normal range at 8 and 10 o’clock by anti-glaucoma drugs,but their IOPs would elevate 】21mmHg after 12 o’clock. Seven patients received trabeculectomy produced thin-walled,pale,and saccate filtering blebs maintaining lower intraocular pressure efficiently. Mutation screening indentified aheterozygous C→T missense mutation in the MYOC gene at position 1 109 in exon 3,corresponding to a substitution of a highly conserved proline to leucine at codon 370 in the olfactomedin domain of MYOC. ·CONCLUSION: The clinical characteristics of JOAG in this family were 1) genetics anticipation; 2) high IOP; 3) temporay response to anti-glaucoma drugs; 4) filtering surgery produced thin-walled and saccate filtering blebs,helping maintain lower IOP.展开更多
Background: Goniosynechialysis is a surgical procedure that has been shown to slow the progression of glaucoma in oriental eyes with chronic angle closure glaucoma. This procedure was successful in 80% of cases, and t...Background: Goniosynechialysis is a surgical procedure that has been shown to slow the progression of glaucoma in oriental eyes with chronic angle closure glaucoma. This procedure was successful in 80% of cases, and the peripheral anterior syenchiae did not exist until one year later. Nonetheless, there is little evidence of its efficacy in our context. Our study aims to investigate the efficacy of goniosynechialysis during phacoemulsification in patients with primary angle closure disease and concomitant cataract. Methods: This was an observational, prospective study. The intra-ocular pressure, need for anti-glaucoma drugs, visual acuity, the extent of synechiae, anterior chamber depth, surgical success rate, and other indicators were monitored for at least three months following surgery. Results: This study included 114 patients (118 eyes), 61 with chronic angle closure glaucoma (51.69%), 33 with primary angle closure (27.97%), and 24 with acute attack angle closure (20.34%), who were surgically treated with phacoemulsification and goniosynechialysis (Phaco-GSL). The mean intra-ocular pressure had significantly decreased three months after surgery (pre- vs post-op: 22.04 ± 10.86 vs 15.41 ± 6.06 mmHg, p-value p-value p-value p-value p-value Conclusion: Regardless of the type of glaucoma, combined phacoemulsification-goniosynechialysis is effective in lowering pressure, restoring vision, reducing the need for anti-glaucoma drugs, and preventing the synechial recurrence. Success was higher in eyes with less extensive synechiae. Phaco-GSL is safe and effective in the treatment of primary angle closure diseases with co-existing cataract.展开更多
Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life...Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate （SH） on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. Methods： Filly-eight patients （101 eyes）, who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group （56 eyes）, unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group （55 eyes）, phosphate-butTered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index （OSDI） questionnaire, break-up time （BUT） test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were pertbrmed sequentially on days 0 and 91. Results： Compared with the control group, SH-treated group showed decrease in OSDI scores （Kruskal-Wallis test： H = 38.668, P 〈 0.001 ）, fluorescein and rose Bengal scores （Wilcoxon signed-ranks test： z = -3.843, P 〈 0.001, and z = 3.508, P 〈 0.001, respectively）, increase in tear fihn BUT （t-test： t - -10.994, P 〈 0.001 ） and aqueous tear production （t-test： t = -10.328, P 〈 0.001 ） on day 91. The goblet cell density was increased （t-test： t = -9.981, P 〈 0.001）, and the morphology of the conjunctival epithelium were also improved after SH treatment. Conclusions： SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.展开更多
Background:Heliotropium indicum is used as a traditional remedy for hypertension in Ghana.The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H.indicum to manage exper...Background:Heliotropium indicum is used as a traditional remedy for hypertension in Ghana.The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H.indicum to manage experimentally-induced glaucoma.Methods:The percentage change in intraocular pressure(IOP),after inducing acute glaucoma(15 mLkg^(−1) of 5%dextrose,i.v.),in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract(HIE)(30–300 mgkg^(−1)),acetazolamide(5 mgkg^(−1)),and normal saline(10 mLkg^(−1))per os were measured.IOPs were also monitored in chronic glaucoma in rabbits(induced by 1%prednisolone acetate drops,12 hourly for 21 days)after treatments with the same doses of HIE,acetazolamide,and normal saline for 2 weeks.The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour.Glutamate concentration in the vitreous humour was also determined using ELISA technique.Histopathological assessment of the ciliary bodies was made.Results:The extract significantly reduced intraocular pressure(p≤0.05–0.001)in acute and chronic glaucoma,preserved glutathione levels and glutamate concentration(p≤0.01–0.001).Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group.Conclusion:The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive,anti-oxidant and possible neuro-protective effects,which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.展开更多
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 ca...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.展开更多
基金Medical Scientific Research Foundation of Guangdong Province(No.A2013215)
文摘AIM: To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma(JOAG) caused by the Pro370Leu myocilin(MYOC) mutation. ·METHODS: Fifteen members of a three-generation Chinese family with JOAG were recruited to this study. They all underwent ophthalmic common examinations. Patients suspected to have JOAG got an assessment of visual field and optical coherence tomography. Intraocular pressures(IOPs) of four patients were measured at 8,10,12,14,17 o’clock respectively after using anti-glaucoma drugs. Mutation screening of all MYOC gene coding exons of the participants was performed by using direct sequencing of PCR products. ·RESULTS: Clinical examinations and pedigree analysis revealed eight family members were suffered from JOAG. Apparent genetics anticipation phenomenon was observed in this family. Their clinical features included elevated IOP of 35-55mmHg,loss of visual field,thinning of retinal nerve fiber layer,and glaucomatous optic disc damage. Noticeably,their intraocular pressure levels could be controlled within normal range at 8 and 10 o’clock by anti-glaucoma drugs,but their IOPs would elevate 】21mmHg after 12 o’clock. Seven patients received trabeculectomy produced thin-walled,pale,and saccate filtering blebs maintaining lower intraocular pressure efficiently. Mutation screening indentified aheterozygous C→T missense mutation in the MYOC gene at position 1 109 in exon 3,corresponding to a substitution of a highly conserved proline to leucine at codon 370 in the olfactomedin domain of MYOC. ·CONCLUSION: The clinical characteristics of JOAG in this family were 1) genetics anticipation; 2) high IOP; 3) temporay response to anti-glaucoma drugs; 4) filtering surgery produced thin-walled and saccate filtering blebs,helping maintain lower IOP.
文摘Background: Goniosynechialysis is a surgical procedure that has been shown to slow the progression of glaucoma in oriental eyes with chronic angle closure glaucoma. This procedure was successful in 80% of cases, and the peripheral anterior syenchiae did not exist until one year later. Nonetheless, there is little evidence of its efficacy in our context. Our study aims to investigate the efficacy of goniosynechialysis during phacoemulsification in patients with primary angle closure disease and concomitant cataract. Methods: This was an observational, prospective study. The intra-ocular pressure, need for anti-glaucoma drugs, visual acuity, the extent of synechiae, anterior chamber depth, surgical success rate, and other indicators were monitored for at least three months following surgery. Results: This study included 114 patients (118 eyes), 61 with chronic angle closure glaucoma (51.69%), 33 with primary angle closure (27.97%), and 24 with acute attack angle closure (20.34%), who were surgically treated with phacoemulsification and goniosynechialysis (Phaco-GSL). The mean intra-ocular pressure had significantly decreased three months after surgery (pre- vs post-op: 22.04 ± 10.86 vs 15.41 ± 6.06 mmHg, p-value p-value p-value p-value p-value Conclusion: Regardless of the type of glaucoma, combined phacoemulsification-goniosynechialysis is effective in lowering pressure, restoring vision, reducing the need for anti-glaucoma drugs, and preventing the synechial recurrence. Success was higher in eyes with less extensive synechiae. Phaco-GSL is safe and effective in the treatment of primary angle closure diseases with co-existing cataract.
文摘Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate （SH） on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. Methods： Filly-eight patients （101 eyes）, who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group （56 eyes）, unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group （55 eyes）, phosphate-butTered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index （OSDI） questionnaire, break-up time （BUT） test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were pertbrmed sequentially on days 0 and 91. Results： Compared with the control group, SH-treated group showed decrease in OSDI scores （Kruskal-Wallis test： H = 38.668, P 〈 0.001 ）, fluorescein and rose Bengal scores （Wilcoxon signed-ranks test： z = -3.843, P 〈 0.001, and z = 3.508, P 〈 0.001, respectively）, increase in tear fihn BUT （t-test： t - -10.994, P 〈 0.001 ） and aqueous tear production （t-test： t = -10.328, P 〈 0.001 ） on day 91. The goblet cell density was increased （t-test： t = -9.981, P 〈 0.001）, and the morphology of the conjunctival epithelium were also improved after SH treatment. Conclusions： SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.
文摘Background:Heliotropium indicum is used as a traditional remedy for hypertension in Ghana.The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H.indicum to manage experimentally-induced glaucoma.Methods:The percentage change in intraocular pressure(IOP),after inducing acute glaucoma(15 mLkg^(−1) of 5%dextrose,i.v.),in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract(HIE)(30–300 mgkg^(−1)),acetazolamide(5 mgkg^(−1)),and normal saline(10 mLkg^(−1))per os were measured.IOPs were also monitored in chronic glaucoma in rabbits(induced by 1%prednisolone acetate drops,12 hourly for 21 days)after treatments with the same doses of HIE,acetazolamide,and normal saline for 2 weeks.The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour.Glutamate concentration in the vitreous humour was also determined using ELISA technique.Histopathological assessment of the ciliary bodies was made.Results:The extract significantly reduced intraocular pressure(p≤0.05–0.001)in acute and chronic glaucoma,preserved glutathione levels and glutamate concentration(p≤0.01–0.001).Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group.Conclusion:The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive,anti-oxidant and possible neuro-protective effects,which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.
基金Supported by Sichuan Science and Technology Program(No.2021YFS0214).
文摘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.
