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1.
Measurements of central cornea thickness (CCT) have a very important value in glaucoma patients; if the central cornea is thinner than it suggests, then the intraocular pressure is falsely low. This study compares the central cornea thickness between patients with pseudoexfoliative glaucoma, open angle glaucoma, angle closure glaucoma and control group. This study included 34 patients with pseudoexfoliative glaucoma, 31 patient with open angle laucoma, 28 patients with angle closure laucoma and 36 normal subjects in a control group. Patients in all groups and also normal subjects in control group had no other corneal disorders, no history of trauma, corneal surgery and were not patients with contacts lens use. Patients with pseudoexfoliative glaucoma and also patients with open angle glaucoma had significantly lower values of central cornea thickness compared with normal subjects in control group. Tomey EM 3000 is a non contact specular microscope which was used to measure central corneal thickness in this study. Pachymetry is an important method for diagnoses of glaucoma and for examination of the intraocular pressure in glaucoma patients, because values of the central corneal thickness affect the exact intraocular pressure readings.  相似文献   

2.

Purpose

To ascertain whether the incidence of ocular dicrotic pulse (ODP) increases with age, it is more pronounced in glaucomatous than in normal eyes and whether it is related to cardiovascular activity.

Methods

261 subjects aged 47 to 78 years were included in the study and classified into four groups: primary open angle glaucoma (POAG), primary angle-closure glaucoma (PACG), glaucoma suspects with glaucomatous optic disc appearance (GODA) and the controls (CG). Additionally, in each group, subjects with ODP were divided into two age subgroups around the median age. A non-contact ultrasonic method was used to measure corneal indentation pulse (CIP) synchronically with the acquisition of electrocardiography (ECG) and blood pulse signals. ODP was assessed from the acquired signals that were numerically processed in a custom written program.

Results

ODP incidence was about 78%, 66%, 66% and 84% for CG, GODA, POAG, and PACG group, respectively. With advancing age, the ODP incidence increased for all subjects (Δ = 12%), the highest being for the PACG and POAG groups (Δ = 30%). GODA group did not show an age-related increase in the incidence of ODP.

Conclusions

The ocular dicrotism, measured with non-contact ultrasonic method, was found to be a common phenomenon in elderly subjects. The increased ODP incidence in PACG and POAG group may correspond to either higher stiffness of glaucoma eyes, biochemical abnormalities in eye tissues, changes in ocular hemodynamics, may reflect the effect of medications or be a combination of all those factors. The results of GODA group suggest different mechanisms governing their ocular pulse that makes them less susceptible to generating ODP and having decreased predisposition to glaucoma.  相似文献   

3.
Chang D  Sha Q  Zhang X  Liu P  Rong S  Han T  Liu P  Pan H 《PloS one》2011,6(11):e27218

Objective

To clarify the presence of oxidative stress in patients with primary angle-closure glaucoma (PACG) and to investigate the relationship between oxidative stress and PACG.

Methods

Fifty patients with primary angle-closure glaucoma and fifty healthy controls of matched age and gender were included in the study prospectively. Serum samples were obtained to detect the oxidation degradation products malondialdehyde (MDA), conjugated diene (CD), 4-hydroxynonenal (4-HNE), advanced oxidation protein products (AOPP), protein carbonyl (PC), ischemia-modified albumin (IMA) and 8-hydroxydeoxyguanosin (8-OHdG).

Results

The concentration of MDA and CD in PACG patients was significantly higher than those of the control subjects (P<0.05, P<0.01). The serum 4-HNE concentrations were increased in PACG patients, but the differences with those of the healthy controls were not statistically significant. Compared to normal subjects, there was significant higher in serum AOPP and PC in PACG patients (P<0.01). PACG patients had higher levels of 8-OHdG in serum with respect to the comparative group of normal subjects (P<0.01). When plasma IMA levels in the PACG group were compared with those in the control group, significant increases in IMA were observed in the former (P<0.05).

Conclusions

Our study demonstrated that IMA is a new biomarker available for assessing oxidative stress in PCAG. Oxidative stress is an important risk factor in the development of primary angle-closure glaucoma. Increased levels of oxidative stress products may be associated with primary angle-closure glaucoma.  相似文献   

4.
Central corneal thickness is very important measurement in glaucoma treatment because it influences the eye pressure measurements. A thinner cornea gives us artifactually lower intraocular pressure and a thicker cornea gives higher intraocular pressure reading, so it has to be corrected in both cases. The aim of this study is to compare central corneal thickness between congenital glaucoma patients and normal subjects. Prospective study included 27 patients with congenital glaucoma and 35 patients in control group. First group was subdivided in two subgroups: A--8 earlier operated patients, B--19 patients treated with topic therapy. Patients had no other corneal disorders, history of trauma, corneal surgery and they were not contact lens wearers. Measurements were performed by specular microscope Tomey EM 3000 on central corneas. This study showed that patients with congenital glaucoma have lower central corneal thickness than normal subjects. Also, the study showed that antiglaucomatous operation doesn't influence central corneal thickness. Central corneal thickness need to be a routine part of examination measurements because of need to correct intraocular pressure according to it, but also the thinner corneas values can suggest congenital glaucoma diagnosis beside the other parameters.  相似文献   

5.
PURPOSE: To investigate the potential in vivo influence of different topical glaucoma medications on the diameter of the retinal arterioles of healthy volunteers and glaucoma patients. METHODS: The diameter of one pre-selected retinal arteriole per eye was measured using the Retinal Vessel Analyser (RVA), an instrument developed for non-invasive clinical measurement of the diameter of the main retinal vessels. The instrument contains a video system, and the integrated software recognises the boundaries of the retinal vessels by detecting their light-transmission profile. The vessel diameter (in arbitrary units) is plotted against time (seconds) on a separate display screen. In Study I the vessel diameter was measured in 12 eyes of six healthy volunteers (age 21-26 years, mean age 24.0 years) on six occasions each separated by 14 days. In a double-masked fashion, each subject's right eye was treated with one of 5 glaucoma medications (brinzolamide 1%, timolol 0.5%, betaxolol 0.5%, brimonidine 0.2% or latanoprost 0.005%) and the left eye always received balanced salt solution. In Study II, one randomly selected eye of 16 patients (age 50-79 years, mean age 65.2 years) suffering from primary open-angle glaucoma controlled with topical monotherapy was investigated, in an unmasked fashion. Four patients were on betaxolol 0.5% treatment, six subjects were receiving non-selective topical beta receptor blockers and six subjects were being treated with once daily latanoprost 0.005%. RESULTS: The coefficient of variation for the arteriole diameter in the healthy volunteers was less than 12% in each case. No significant post-treatment change of the diameter of the pre-selected arteriole was found for any topical medication investigated, either in the healthy volunteers (Study I) or in the patients suffering from glaucoma (Study II) (p>0.05, paired t-test). In addition, in Study I no difference was observed in the alteration of the arteriole diameter between the baseline and the hour 2 measurements when the values from the drug-treated and placebo treated eyes were compared (p>0.05, two-way ANOVA). CONCLUSION: In the present investigations it was not possible to detect any statistically meaningful change of the arteriole diameter at two hours after the instillation of any of several topical antiglaucoma drugs widely used in clinical practice. Further investigations are necessary to clarify whether the lack of observed change is due to the lack of retinal vascular effects of the drugs investigated, or is due to an inability of the RVA instrument in practice to detect alterations between time-points separated by several hours.  相似文献   

6.

Purpose

We investigated the whole macular choroidal thickness in subjects with glaucoma in order to evaluate the effects of glaucoma and glaucoma visual field damage on the choroidal thickness.

Subjects and Methods

We examined 40 primary open angle glaucoma patients with only superior visual field defects and 48 normal controls. The macular choroidal thickness was measured using swept-source optical coherence tomography according to the three-dimensional raster scan protocol (6×6 mm). We used the choroidal thickness within a 1.0-mm circle measured on ETDRS grids as the central sector and then used a 6×6 rectangular grid to divide the area into six sectors.

Results

No significant differences were found in the choroidal thickness values between the glaucoma and normal subjects in any of the sectors after adjusting for the age and axial length (all P>0.4, ANCOVA). According to a stepwise analysis of the glaucoma subjects performed using the parameters of age, axial length, central corneal thickness and mean deviation (MD value) obtained by static perimetry, age was the most predictive and significant factor in all sectors (coefficient  = −3.091 to −4.091 and F value  = 15.629 to 22.245), followed by axial length (coefficient  = −10.428 to −23.458 and F value  = 2.454 to 6.369). The central corneal thickness and MD values were not significant predictive factors in any of the sectors. No significant predictive factors were found for the differences in the choroidal thickness values observed between the superior and inferior field sectors.

Conclusions

Neither the glaucoma-related visual field damage nor glaucoma itself have any apparent associations with the whole macular choroidal thickness.

Trial Registration

Japan Clinical Trials Register (http://www.umin.ac.jp/ctr/ number, UMIN 000012527).  相似文献   

7.
A new technique is described for the determination of cholesterol in skin biopsies which is sensitive, practical and reproducible. The determination of cutaneous cholesterol is of clinical interest, because of its correlation with the degree of atherosclerosis. There was no correlation found between the blood total cholesterol and total triglycerides, and cholesterol and triglycerides determined in the skin biopsies. Determinations were carried out on several normal subjects, 7 long-distance runners, 34 hyperlipidemic patients. There was a significant increase with age of total skin cholesterol in the normal subjects, the values obtained with the long-distance runners had a tendency to be somewhat lower. All the patients investigated had higher cholesterol values than the normal controls or the sportsmen. This technique can be used therefore as a diagnostic tool to detect pathologies of skin lipids, or of tissue lipid metabolism, as for example in normolipidemic patients presenting corneal arcus or xanthelasmas.  相似文献   

8.
Pupillary block is considered as an important cause of primary angle-closure glaucoma (PACG). In order to investigate the effect of pupillary block on the hydrodynamics of aqueous humor (AH) in anterior chamber (AC) and potential risks, a 3D printed eye model was developed to mimic the AH flow driven by fluid generation, the differential pressure between AC and posterior chambers (PC) and pupillary block. Particle image velocimetry technology was applied to visualize flow distribution. The results demonstrated obvious differences in AH flow with and without pupillary block. Under the normal condition (without pupillary block), the flow filed of AH was nearly symmetric in the AC. The highest flow velocity located at the central of AC when the differential pressure between AC and PC was under 5.83 Pa, while it appeared near the cornea and iris surface when the differential pressure was greater than 33.6 Pa. Once pupillary block occurred, two asymmetric vortices with different sizes were observed and the shear stress in the paracentral cornea and iris epithelium increased greatly. It can be concluded that the pupillary block and the elevated differential pressure between AC and PC could change the flow distribution and thus increase the risk of corneal endothelial cells detachment. This study could make a further understanding of the pathogenesis of PACG.  相似文献   

9.

Purpose

To compare the abilities of peripapillary retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting preperimetric glaucoma.

Methods

In a cross-sectional study, 35 preperimetric glaucoma eyes (32 subjects) and 94 control eyes (74 subjects) underwent digital optic disc photography and RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT and GDx ECC to discriminate preperimetric glaucoma eyes from control eyes was compared using area under receiver operating characteristic curves (AUC), sensitivities at fixed specificities and likelihood ratios (LR).

Results

AUC of the global average RNFL thickness of SDOCT (0.786) was significantly greater (p<0.001) than that of GDx ECC (0.627). Sensitivities at 95% specificity of the corresponding parameters were 20% and 8.6% respectively. AUCs of the inferior, superior and temporal quadrant RNFL thickness parameters of SDOCT were also significantly (p<0.05) greater than the respective RNFL parameters of GDx ECC. LRs of outside normal limits category of SDOCT parameters ranged between 3.3 and 4.0 while the same of GDx ECC parameters ranged between 1.2 and 2.1. LRs of within normal limits category of SDOCT parameters ranged between 0.4 and 0.7 while the same of GDx ECC parameters ranged between 0.7 and 1.0.

Conclusions

Abilities of the RNFL parameters of SDOCT and GDx ECC to diagnose preperimetric glaucoma were only moderate. Diagnostic abilities of the RNFL parameters of SDOCT were significantly better than that of GDx ECC in preperimetric glaucoma.  相似文献   

10.

Purpose

The current study was undertaken to investigate whether glaucoma affects the sleep quality and whether there is any difference between patients with primary glaucoma (primary open angle glaucoma, POAG and primary angle-closure glaucoma, PACG) and healthy subjects, using a validated self-rated questionnaire, the Pittsburgh Sleep Quality Index (PSQI).

Methods

The sleep quality of patients with POAG and PACG was tested against normal controls. Subjects were divided into three sub-groups according to age. Differences in the frequency of sleep disturbances (PSQI score >7) were assessed. The differences of sleep quality within the three groups and within the POAG group depending on the patients’ intraocular pressure (IOP) and impairment of visual field (VF) were also studied.

Results

92 POAG patients, 48 PACG patients and 199 controls were included. Sleep quality declined with age in control and POAG group (tendency chi-square, P<0.05). The prevalence of sleep disturbances was higher in POAG and PACG group than in the control group, the differences were statistically significant. The prevalence of sleep disturbances was higher in patients with PACG, compared to POAG patients in the age interval of 61–80. In POAG group, the ratio of patients with sleep disorders increased with augmented impairment of VF, but the differences were not statistically significant (χ2-test, P>0.05). No significant differences were found in POAG group between patients with a highest IOP in daytime and at nighttime (χ2-test, P>0.05).

Conclusions

The prevalence of sleep disorders was higher in patients with POAG and PACG than in controls. PACG patients seemed to have a more serious problem of sleep disorders than POAG patients between 61 to 80 years old. No correlation was found between the prevalence of sleep disorders and impairment of VF or the time when POAG patients showed a highest IOP.  相似文献   

11.

Main objective

To evaluate the distribution of central corneal thickness (CCT) in a large German cohort and to analyse its relationship with intraocular pressure and further ocular factors.

Design

Population-based, prospective, cohort study.

Methods

The Gutenberg Health Study (GHS) cohort included 4,698 eligible enrollees of 5,000 subjects (age range 35–74 years) who participated in the survey from 2007 to 2008. All participants underwent an ophthalmological examination including slitlamp biomicroscopy, intraocular pressure measurement, central corneal thickness measurement, fundus examination, and were given a questionnaire regarding glaucoma history. Furthermore, all subjects underwent fundus photography and visual field testing using frequency doubling perimetry.

Results

Mean CCT was 557.3±34.3 µm (male) and 551.6±35.2 µm in female subjects (Mean CCT from right and left eyes). Younger male participants (35–44 years) presented slightly thicker CCT than those older. We noted a significant CCT difference of 4 µm between right and left eyes, but a high correlation between eyes (Wilcoxon test for related samples: p<0.0001). Univariable linear regression stratified by gender showed that IOP was correlated with CCT (p<0.0001). A 10 µm increase in CCT led to an increase in IOP between 0.35–0.38 mm Hg, depending on the eye and gender. Multivariable linear regression analysis revealed correlations between gender, spherical equivalent (right eyes), and CCT (p<.0001 and p = 0.03, respectively).

Conclusions

We observed positive correlations between CCT and IOP and gender. CCT was not correlated with age, contact lens wear, positive family history for glaucoma, lens status, or iris colour.  相似文献   

12.
目的 总结兔先天性青光眼的临床特点。方法 对先天性青光眼兔和正常兔进行临床观察,研究其在眼压、眼球结构、视功能方面的变化。结果 青光眼兔的眼压明显升高,角膜直径变大,前房变深,眼轴变长,房角变宽,眼底视乳头损害明显,视觉诱发电位明显异常。结论 兔先天性青光眼的房水排泄障碍部位可能在小梁,兔眼球壁对高眼压的耐受力弱,在高眼压下容易出现眼球扩张,视功能损害。  相似文献   

13.
PurposeTo study age-related changes in corneal deformation response to air-puff applanation tonometry.MethodsFifty healthy subjects were recruited for a prospective study and divided into two equal age groups (≤ 28 and ≥ 50 years old). Up to three measurements by a corneal deformation analyser based on the Scheimpflug principle were performed on the left eye of each subject. Raw Scheimpflug images were used to extract changes in anterior and posterior corneal profiles, which were further modelled by an orthogonal series of Chebyshev polynomial functions. Time series of the polynomial coefficients of even order exhibited a dynamic behavior in which three distinct stages were recognized. A bilinear function was used to model the first and the third stage of corneal dynamics. Slope parameters of the bilinear fit were then tested between the two age groups using Wilcoxon rank sum test and two-way non-parametric ANOVA (Friedman) test.ResultsStatistically significant changes (Wilcoxon test, P<0.05) between the age groups were observed in the phase of the second applanation dynamics for the posterior corneal profile. In a two-way comparison, in which the corneal profile was used as a dependent variable, statistically significant changes (ANOVA/Friedman test, P = 0.017) between the groups were also observed for that phase.ConclusionCorneal biomechanics depend on age. The changes in corneal deformation dynamics, which correspond to mostly free return of the cornea to its original shape after the air pulse, indicate that the age related differences in corneal biomechanics are subtle but observable with high speed imaging.  相似文献   

14.
PURPOSE: To analyze the corneal endothelial cell density in healthy adult emmetropic subjects. METHODS: We analyzed the corneal endothelial cell density of a group made up of 225 emmetropic subjects (n=225). As age-matched control groups we analyzed two other groups, one made up of myopic subjects (n=209) and the other made up of hyperopic subjects (n=203). We recorded the mean of three consecutive measurements of the corneal endothelial cell density using the Topcon SP-2000P non-contact specular microscope (Topcon Corp., Tokyo, Japan). RESULTS: The mean age was 38.6+/-11.8 years, 40.7+/-12.2 years, and 39.2+/-10.5 years for emmetropic, myopic and hyperopic subjects respectively (p=0.994). No significant differences (p=0.920) in endothelial cell density values were found between emmetropic (2985+/-245 cells/mm2), myopic (2936+/-258 cells/mm2) and hyperopic eyes (2946+/-253 cells/mm2). Lower corneal endothelial cell density values were found in older emmetropic (p<0.001), myopic (p<0.001), and hyperopic subjects (p<0.001). A significant correlation between endothelial cell density and age was found in emmetropic (r=-0.958; p<0.001), myopic (r= -0.954; p<0.001) and hyperopic subjects (r= -0.948; p<0.001). CONCLUSIONS: In healthy emmetropic subjects there is a reduction in corneal endothelial cell density with age although there are no differences in corneal endothelial cell density values between emmetropic, myopic and hyperopic subjects.  相似文献   

15.
Nanophthalmos is an uncommon developmental ocular disorder characterized by a small eye, as indicated by short axial length, high hyperopia (severe farsightedness), high lens/eye volume ratio, and a high incidence of angle-closure glaucoma. We performed clinical and genetic evaluations of members of a large family in which nanophthalmos is transmitted in an autosomal dominant manner. Ocular examinations of 22 affected family members revealed high hyperopia (range +7.25-+13.00 diopters; mean +9.88 diopters) and short axial length (range 17.55-19.28 mm; mean 18.13 mm). Twelve affected family members had angle-closure glaucoma or occludable anterior-chamber angles. Linkage analysis of a genome scan demonstrated highly significant evidence that nanophthalmos in this family is the result of a defect in a previously unidentified locus (NNO1) on chromosome 11. The gene was localized to a 14.7-cM interval between D11S905 and D11S987, with a maximum LOD score of 5. 92 at a recombination fraction of .00 for marker D11S903 and a multipoint maximum LOD score of 6.31 for marker D11S1313. NNO1 is the first human locus associated with nanophthalmos or with an angle-closure glaucoma phenotype, and the identification of the NNO1 locus is the first step toward the cloning of the gene. A cloned copy of the gene will enable examination of the relationship, if any, between nanophthalmos and less severe forms of hyperopia and between nanophthalmos and other conditions in which angle-closure glaucoma is a feature.  相似文献   

16.
The corneal epithelium represents one of the main structures that undergo degenerative alterations due to antiglaucomatous therapy. Chronic glaucoma therapy containing benzalkonium chloride induces epithelial cellular changes and inflammatory infiltration that in turn causes ocular surface changes resulting in ocular discomfort. Also, age‐related changes can involve the tear film stability and the corneal epithelium surface with reduction of microvilli. The objective of this study is to gain insights about the changes in corneal epithelium in glaucomatous patients divided according to age, type and duration of therapy using anterior‐segment optical coherence tomography (AS‐OCT). This study evaluated a total of 81 eyes of 42 patients for whom corneal epithelium thickness (CET) was measured in different sectors of the cornea. Our results showed no significant differences in CET among patients divided according to type and duration of treatment, while younger patients showed a thinner CET in comparison with older patients. AS‐OCT results demonstrated that the physiological age‐related alterations contributed to corneal epithelium changes in patients undergo chronic antiglaucoma therapy.  相似文献   

17.
The endothelial cells are one of the most important structures in a donor cornea. Morphology and concentration of endothelial cells must be carefully evaluated with a specular microscope before transplantation. The aim of this study is to evaluate the status of corneal endothelium in glaucoma patients. Prospective study included 50 patients suffering from glaucoma and 50 patients in control group. Patients had no corneal disease, ocular inflammation, previous trauma or ocular surgery. Patients were not contact lens wearers. They were also analyzed in groups according to type of glaucoma. Specular microscopy was performed on central corneas. This study showed that patients with glaucoma have lower central corneal endothelial cell density than those without glaucoma of the same age group. Also, patients with pseudoexfoliative glaucoma had lower values of central endothelial cell density comparing to patients with open angle or angle closure glaucoma.  相似文献   

18.
It was generally observed that welders in Calabar, Nigeria did not always wear their protective goggles during welding. Since chronic exposure to welding light can impair vision this study was done to assess the effect of exposure to welding light on ocular function of welders in Calabar, Nigeria. There were 195 subjects comprising 110 welders (test) and 85 control subjects. Both groups were all male and had similar age range. The tests employed were clinical examination for ocular disorders, assessment of visual acuity, and opthalmoscopy. Test questionnaire was also used to record information on length of service, precautionary measures at work place, age and past ocular illnesses. The study also compared incidence of ocular disorders between the two groups of welders (arc and carbide welders). The mean ages of the welders and their control were not significantly different (27.53 +/- 10.0 vs 27.78 +/- 8.5 yrs respectively). There was a significantly [P < 0.01] higher incidence of pingueculum, cataract, allergic conjunctivitis, corneal opacity, and keratoconjunctivitis (arc eye) in welders than in their control subjects. However, visual acuity, incidence of pterygium and glaucoma were similar. Between the two groups of welders, the incidence of pterygium, corneal opacity and keratoconjunctivitis was significantly [P < 0.01] higher in arc welders than carbide welders. The incidence of pingueculum and glaucoma were however, similar. In conclusion, chronic exposure to welding light without adequate precaution may cause ocular disorders. Arc welding is more dangerous to ocular function than carbide welding. Length of service and age are predisposing factors to ocular disorders in the welding business.  相似文献   

19.
目的:探讨超声乳化手术治疗慢性闭角型青光眼合并白内障的临床效果。方法:慢性闭角型青光眼合并白内障64例(64眼)根据治疗方法的不同分为治疗组与对照组各32例,对照组采用传统小梁切除手术,治疗组采用超声乳化手术。结果:(1)两组术前视力对比无明显差异,治疗后视力情况都明显改善,同时组间对比有明显差异(P0.05)。(2)两组术前眼压比较无显著性差异,术后两组组间与组内对比都有明显差异(P0.05)。(3)两组术前前房深度比较无显著性差异,治疗后都有明显上升(P0.05),同时组间对比差异明显(P0.05)。(4)两组患者术中与术后都无严重并发症发生。结论:对于慢性闭角型青光眼合并白内障患者行超声乳化手术具备加深前房、控制眼压、提高视力的作用,同时安全性好,可作为标准治疗选择。  相似文献   

20.
The incidence and seasonal variations of acute primary angle-closure glaucoma (APACG) was studied. It was based on a retrospective chart review of 121 hospital patients in Split, Croatia for the fifteen-year period from 1985 through 1999. The average incidence was 4.1 cases per 100,000 per year in the total population and 7.1 per 100,000 in those aged 30 years and older. APACG affects women almost twice more often than men. The incidence rate increased with age. No seasonal variations in the occurrence of APACG and no correlation with the mean duration of light exposure per season were found.  相似文献   

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