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Jeong Y, Park KH, Jeoung JW. Long-term prognosis of acute primary angle closure in an east asian cohort. Jpn J Ophthalmol 2024; 68:302-310. [PMID: 38739252 PMCID: PMC11349775 DOI: 10.1007/s10384-024-01065-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/04/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE To provide an updated analysis of the long-term outcomes of patients with acute primary angle closure (APAC) and to investigate the risk factors for visual field (VF) loss progression. STUDY DESIGN Retrospective, clinical cohort study METHODS: One hundred and forty-six APAC patients with a minimum of 1-year follow-up were included. The presenting features and the treatment utilized were recorded. The visual and intraocular pressure (IOP) outcomes were analyzed. The main outcome measures were the proportion of blindness and IOP at the final visit. A subset of patients with sufficient VF results was divided into a stable and progressive group based on mean deviation (MD) loss rate. Univariate and multivariate logistic regression analyses were performed to identify predictors of progression. RESULTS Nine patients (6.2%) were blind, and 76.0% (111/146) had final decimal visual acuity greater than or equal to 0.5. All patients had normal final IOP, and 65.1% (95/146) were medication-free. 64.4% (94/146) underwent cataract surgery at a median 4 months after their APAC attack. The use of topical hypotensive medications (OR = 8.029, P = 0.012) was the only significant predictor of fast MD loss in the multivariate regression. CONCLUSIONS The long-term outcomes of APAC in recent years have been more promising. All patients maintained normal IOP several years following their APAC attack, and fewer than half required hypotensive agents. The incidence of blindness was low. These findings suggest that current practice patterns in the management of APAC are beneficial.
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Affiliation(s)
- Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Chinnaswamy V, Mohan SG, Ramsamy KM, Tm S. Photocatalytic activity of ZnO doped Nano hydroxyapatite/GO derived from waste oyster shells for removal of Methylene blue. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:41990-42011. [PMID: 38858286 DOI: 10.1007/s11356-024-33894-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
Hydroxyapatite (HAp) stands as an inorganic compound, recognized as a non-toxic, bioactive ceramic, and its composition closely resembles that of bone material. In this study, nHAp was prepared from waste oyster shells, which are biowaste rich in calcium carbonate. nHAp with its unique catalytic property can be used as an adsorbent in various fields, including wastewater treatment. nHAp with an exceptional surface adsorbent with excellent chemical stability, enabling its catalytic function. Nano hydroxyapatite doped with Zinc oxide (ZnO) by wet chemical precipitation and made into a composite with Graphene oxide (GO) by modified hummers method followed by grinding, which was taken as 9:1 ratio (nHAp/ZnO and GO) of weight, enhances its tensile and mechanical strength. The energy band gap of nHAp photocatalyst was evaluated as 3.39 eV and that of the in nHAp/ZnO/GO photocatalyst was narrowed to 1.77 eV. The ternary nanocomposites are very efficient in generating the photogenerated electrons and holes, thereby improving the degradation potential of dye effluents to by-products such as CO2 and H2O. The nanocomposites photocatalyst were characterized by FTIR, XRD, SEM, TEM, EDS, XPS, DRS, and BET techniques. The UV-visible study shows the complete dye degradation efficiency of the prepared nanocomposites photocatalyst. In this study, the prepared nanocomposites nHAp/ZnO/GO have studied their efficiency for the removal of MB dye in a batch process by varying the dosage from 0.1 to 0.5 g, and the effects of dosage variations, pH, kinetic, scavenger study were evaluated at a time interval of 30 min. The removal of dye was found to be 99% at 150 min of 0.3 g dosage and pH = 12 is most favorable as it reached the same percentage at 90 min. The as-prepared nanocomposite nHAp/ZnO/GO fits the kinetic rate constant equation and shows a pseudo-first-order reaction model. This study indicates the suitability for dye removal due to the synergistic effect and electrostatic interaction of the synthesized ternary nanocomposite, which shows the potential, socially active, low-cost-effective, eco-friendly, and safe for photocatalytic degradation of MB from wastewater.
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Affiliation(s)
- Vanitha Chinnaswamy
- PG and Research Department of Chemistry, R.V. Govt. Arts College, Chengalpattu, 603 001, Tamil Nadu, India
| | - Sundara Ganeasan Mohan
- Department of Analytical Chemistry, University of Madras, Guindy Campus, Chennai, 600 025, Tamil Nadu, India
| | - Kuppusamy Muniyan Ramsamy
- PG and Research Department of Chemistry, R.V. Govt. Arts College, Chengalpattu, 603 001, Tamil Nadu, India
| | - Sridhar Tm
- Department of Analytical Chemistry, University of Madras, Guindy Campus, Chennai, 600 025, Tamil Nadu, India.
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Zhang H, Li Y, Tang Y, Yan X, Geng Y, Li W, Shi K, Tang G, Guo H. Characteristics of optic disc hemorrhage and optic nerve changes following acute primary angle closure. Front Neurol 2024; 15:1333091. [PMID: 38854957 PMCID: PMC11157090 DOI: 10.3389/fneur.2024.1333091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/29/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Acute primary angle closure (APAC) is an emergency ophthalmic presentation and a major cause of irreversible blindness in China. However, only a few studies have focused on the characteristics of optic disc hemorrhage (ODH) during an APAC attack, including its shape, depth, location, scope, and duration after intraocular pressure (IOP) control, along with changes in the optic nerve. This study aimed to analyze the characteristics of ODH and optic nerve changes in patients during their first APAC episode. Methods This retrospective study involved 32 eyes from 32 patients with APAC who received sequential treatment and analyzed the following parameters: the highest IOP and its duration, ODH, retinal nerve fiber layer thickness (RNFLT), and mean deviation (MD). We compared parameters obtained from the affected eye (ODH group) and contralateral unaffected eye (control group), as well as intragroup comparisons. Results The mean IOP in the ODH group was 64.28 ± 10.36 mmHg, with a duration of 4.44 ± 2.35 days. Flame and splinter shapes accounted for 84.38% of the ODH. The mean ODH duration was 4.81 ± 3.25 weeks. ODH during APAC was isolated to one sector in 59.38% of cases, mostly occurring in the temporal superior and temporal inferior (each accounting for 21.88% of the cases). There was a positive correlation between the extent of hemorrhage and the highest IOP duration (p < 0.001). RNFLT was significantly thickened within 72 h post-IOP control but was thinned by 2 weeks. By 6 months, the thinning stabilized, and there was no difference noted between the ODH and control groups at 12 months. MD partly improved at 6 months post-IOP control, and ODH scope significantly affected the MD (p < 0.001). The duration of high IOP was positively correlated to the ODH scope and MD damage. Discussion Timely and effective IOP management is essential for recovering visual function following an APAC attack.
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Affiliation(s)
- Hengli Zhang
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Yawen Li
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Yizhen Tang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaowei Yan
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Yulei Geng
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Weijia Li
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Kuitang Shi
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Guangxian Tang
- Department of Ophthalmology, Shijiazhuang People’s Hospital, Shijiazhuang, China
| | - Hongtao Guo
- Department of Orthopedics, Shijiazhuang People’s Hospital, Shijiazhuang, China
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Hamid S, Matarazzo F, Sun Z, Baboolal S, Muhundhakumar D, Foster PJ. Long-term outcomes after acute primary angle closure: case series from Moorfields Eye Hospital, UK. Br J Ophthalmol 2024:bjo-2023-324748. [PMID: 38740430 DOI: 10.1136/bjo-2023-324748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/14/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND There is limited data regarding the morbidity and progression to primary angle closure glaucoma in those presenting with acute primary angle closure (APAC) in the UK. We aim to report on the vision and intraocular pressure (IOP) outcomes and treatment required after an APAC episode and to identify any risk factors that could predict worse outcomes. METHODS A retrospective observational case series review including 117 consecutive patients (121 eyes) attending Moorfields Eye Hospital, at a tertiary referral unit in the UK, with APAC was performed. RESULTS Most patients (73%) had visual acuities of ≥6/12, meeting the UK driving standard, at the final follow-up. Only 15% (17 eyes) had severe visual impairment, as defined by the WHO, in the affected eye, of which 6.6% (eight eyes) were due to glaucoma. The delayed presentation was linked to a higher need for further medical treatment (OR=2.83, 95% CI 1.09 to 7.40, p=0.03). Patients who underwent phacoemulsification were at lower risk of having blindness in the affected eye (OR 0.18, 95% CI 0.05 to 0.69, p=0.01), having elevated IOP (OR 0.10, 95% CI 0.01 to 0.75, p=0.02) or requiring further medical treatment (OR 0.34, 95% CI 0.12 to 0.99, p=0.04). Older age (OR 1.26, 95% CI 1.08 to 1.48, p<0.01) was associated with worse visual outcomes. CONCLUSIONS APAC causes low long-term visual and treatment morbidity in this largely Caucasian patient group in the UK. Phacoemulsification as a treatment may enhance visual outcomes and reduce the need for further IOP-lowering treatment.
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Affiliation(s)
- Sana Hamid
- Glaucoma Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Francesco Matarazzo
- Glaucoma Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- University of Naples "Federico II", Naples, Italy
| | - Zihan Sun
- NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
- UCL Institute of Ophthalmology, London, UK
| | - Sandika Baboolal
- Glaucoma Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, Norfolk, UK
| | | | - Paul J Foster
- NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
- UCL Institute of Ophthalmology, London, UK
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Xiao H, Guo N, Li J, Jin L, Liu Y, Lin S, Fang L, Liu X, Zuo C. Paracentral Acute Middle Maculopathy Following Acute Primary Angle Closure and Acute Primary Angle Closure Glaucoma. Clin Ophthalmol 2023; 17:3513-3523. [PMID: 38026591 PMCID: PMC10674771 DOI: 10.2147/opth.s437075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose To report the prevalence, clinical characteristics and risk factors for paracentral acute middle maculopathy (PAMM) following acute primary angle closure (APAC) and acute primary angle closure glaucoma (APACG). Methods This retrospective study consecutively recruited patients diagnosed with APAC or APACG. Based on the spectral domain optical coherence tomography characteristics, PAMM eyes were divided into three stages. Characteristics of different stages such as the time from symptoms to treatment (TST), retinal thickness and BCVA improvement were analyzed. The risk factors of PAMM were evaluated by binary logistic regression models. Results A total of 781 eyes of 781 APAC or APACG patients were included, and PAMM was found in 22 (2.9%) of them. Stage III eyes had a significantly longer TST than stage I eyes (P = 0.008) while exhibiting significantly thinner retinal thicknesses (P < 0.0001). The BCVA improvement was significantly worse in the eyes treated in stage III than in those treated in stage I (P = 0.008). Older age, longer axial length and without type 2 diabetes were associated with a lower risk of incident PAMM (OR = 0.95, P = 0.028; OR = 0.52, P = 0.019; OR = 3.92, P = 0.022). Conclusion PAMM can be secondary to APAC or APACG at a rate of 2.9%. Different visual outcomes were observed in patients who received the intervention at different stages of PAMM. Younger patients with a shorter axial length and type 2 diabetes were found to be more susceptible to PAMM.
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Affiliation(s)
- Hui Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Ni Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Junyi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Yuan Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Shufen Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Lei Fang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China
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Zhu Z, Zou H, Li H, Wu X, Wang Y, Li Z, Zhao Y. Repeatability and reproducibility of anterior lens zonule length measurement using ArcScan Insight 100 very high-frequency ultrasound. Expert Rev Med Devices 2023. [PMID: 37300312 DOI: 10.1080/17434440.2023.2223967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aimed to evaluate the intra-examiner repeatability and inter-examiner reproducibility in lens zonular length measurements using very high-frequency digital ultrasound (Insight 100). METHODS Two examiners performed ultrasound imaging independently in each subject. The length of temporal and nasal zonules were then measured with a built-in software. Coefficient of variations (CVs) of the three repeated measurements were used to determine intra-examiner variances. Inter-examiner reproducibility was evaluated using intraclass correlation coefficients (ICCs) and the Bland-Altman method. RESULTS 40 eyes of 40 subjects (14male and 26female; mean age 23.9 ± 2.4 years) were included in the study. The CVs for intra-examiner measurement were 2.74% temporally and 4.32% nasally for Examiner 1, and were 1.96% temporally and 1.75% nasally for Examiner 2. For inter-examiner reproducibility, all ICCs were above 0.9. However, there were significant differences between the two examiners in temporal zonular length measurements (p = 0.001), and the differences mainly came from measuring the zonular length manually (p = 0.001) rather than recording images (p = 0.480). No significant differences were found between two measurements by the same examiner after one month (all p > 0.05, all ICCs>0.8). CONCLUSION The Insight 100 device can be used to measure the length of anterior lens zonule with relatively good repeatability and reproducibility. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov identifier is NCT05657951.
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Affiliation(s)
- Zehui Zhu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
| | - Han Zou
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
| | - Hongzhe Li
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
| | - Xueer Wu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
| | - Yiyi Wang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
| | - Zhangliang Li
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
| | - Yune Zhao
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou, Zhejiang, China
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Characteristics of Anterior Segment in Congenital Ectopia Lentis: An SS-OCT Study. J Ophthalmol 2022; 2022:6128832. [PMID: 35706501 PMCID: PMC9192328 DOI: 10.1155/2022/6128832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate the characteristics of anterior chamber angle parameters in congenital ectopia lentis (CEL) patients and to evaluate the sensitivity and specificity of anterior segment parameters in distinguishing CEL from healthy controls. Setting. Zhongshan Ophthalmic Center, Guangzhou, China. Design Cross-sectional study. Methods 35 CEL patients and 35 age- and sex-matched healthy controls were recruited. Axial length (AL) and anterior segment parameters including anterior chamber width (ACW), angle open distance (AOD), angle recess area (ARA), trabecular-iris space area (TISA), and trabecular-iris angle (TIA) were measured. All the above parameters and the ratio index of angle parameters, which was defined as the angle parameter value of the narrower side to that of the contralateral side, were compared between CEL and controls. Receiver operating characteristic (ROC) curves were also plotted to evaluate the diagnostic performance of anterior chamber angle parameters in CEL patients. Results All angle parameters of the contralateral side to the dislocated lens side were significantly smaller than those of the dislocated lens side in CEL (all P < 0.05). For the diagnostic performance of anterior chamber angle parameters, the ratio index of TIAr500 combined with TIAr750 had the best diagnostic performance for CEL screening (AUC = 0.798), and TIAr500 of 0.887 and TIAr750 of 0.917 were detected to be the optimal cut-off points, representing a sensitivity of 89.8% and specificity of 68.7%. Conclusion The contralateral side to the dislocated lens side in the CEL had a narrower anterior chamber angle. TIAr500 combined with TIAr750 is the optimal combination strategy for ectopia lentis screening.
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Chan PP, Tang FY, Leung DY, Lam TC, Baig N, Tham CC. Ten-Year Clinical Outcomes of Acute Primary Angle Closure Randomized to Receive Early Phacoemulsification Versus Laser Peripheral Iridotomy. J Glaucoma 2021; 30:332-339. [PMID: 33769358 DOI: 10.1097/ijg.0000000000001799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/09/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE To compare the 10-year clinical outcomes of eyes with acute primary angle closure (APAC) randomized to receive either early phacoemulsification or laser peripheral iridotomy (LPI). METHODS Sixty-two APAC patients, who underwent either early phacoemulsification (phaco group) or laser peripheral iridotomy (LPI group) in a previous randomized controlled trial, were invited for assessment 10 years after the interventions. The results of the 2 groups were compared. RESULTS Forty of 62 patients (64.5%; 19 in phaco group and 21 from LPI group) were examined. None of them underwent additional glaucoma procedure but 15 (71.4%) patients in the LPI group received lens extraction before this assessment. The mean follow-up duration was 10.7±0.7 years. The phaco group used less medication (0.16±0.37 vs. 0.76±1.09 bottle per eye, P=0.028), had less extensive anterior synechiae (120.0±116.12 vs. 244.3±139.8 degree, P=0.010), and greater mean Shaffer gonioscopy grading (1.79±0.84 vs. 1.40±0.87; P=0.021) than the LPI group. Five eyes had persistent intraocular pressure elevation of >21 mm Hg in 2 consecutive visits and 4 eyes had blindness (best-corrected visual acuity worse than 6/60 and/or central visual field of <20 degree) in the LPI group, compared with none in the phaco group (P=0.022 and 0.045, respectively). There was no significant difference in the mean intraocular pressure, best-corrected visual acuity, and the number of eyes with visual field progression. CONCLUSION At 10 years, APAC eyes that underwent early phacoemulsification required less medication, less peripheral anterior synechiae, lower incidence of intraocular pressure elevation and a lower incidence of blindness compared with APAC eyes that underwent initial LPI.
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Affiliation(s)
- Poemen P Chan
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
- Hong Kong Eye Hospital
| | - Fang Y Tang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
| | - Dexter Y Leung
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong SAR
| | - Thomas C Lam
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
- Hong Kong Eye Hospital
| | - Nafees Baig
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
- Department of Ophthalmology, Caritas Medical Centre
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong, Hong Kong SAR
| | - Clement C Tham
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong
- Hong Kong Eye Hospital
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Shatin
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Zhang H, Cao K, Jia H, Li L, Hu J, Liang J, Song J, Wang H, Zhao A, Duan X, Fan S, Wang F, Su Y, Ha S, Duan X, Yu J, Zhao C, Tang G, Su Y, Cai H, Gao J, Qu Y, Lu P, Xie X, Zhao J, Tang L, Liu D, Liu W, Zhang M, Fang A, Qu B, Dai W, Zhong H, Zhang X, Wu Z, Zhai G, Lyu H, Xie L, Li H, Zheng Y, Li N, Li K, Xie G, Qu H, Yu J, Liang L, Zhu M, Wang X, Ma X, Zeng L, Liu X, Zhang Y, Zhang Y, Yu F, Zhu Y, Cheng S, Yu M, Li J, Zhang Y, Liu P, Wu Z, Zhang X, Kuo D, Wang N, Qiao C. Clinical characteristics, rates of blindness, and geographic features of PACD in China. CANADIAN JOURNAL OF OPHTHALMOLOGY 2021; 56:299-306. [PMID: 33485841 DOI: 10.1016/j.jcjo.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/29/2020] [Accepted: 12/15/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To analyze the rates of blindness with the demographics and clinical characteristics of patients with primary angle-closure disease (PACD) to provide a comprehensive epidemiologic reference in China. METHODS A retrospective analysis was conducted in the Chinese Glaucoma Study Consortium database, which is a national multicenter glaucoma research alliance of 111 hospitals participating between December 21, 2015 and September 9, 2018. The diagnosis of PACD was made by qualified physicians through examination. Comparison of sex, age, family history, subtypes of PACD, and blindness were analyzed. RESULTS A total of 5762 glaucoma patients were included, of which 4588 (79.6%) had PACD. Of PACD patients, 72.1% were female with the sex ratio (F/M) of 2.6, and the average age of patients was 63.8±9.3 years with the majority between 60 and 70 years. Additionally, 30% of these patients had low vision in one eye, 8.8% had low vision in both eyes, 1.7% had blindness in one eye, and 0.3% had blindness in both eyes. There were statistical differences with regards to age between male and female patients with PACD, with male patients being older on average. Primary angle-closure glaucoma was more commonly diagnosed in males (60%) compared to females (35.9%), whereas acute primary angle closure (APAC) was more commonly diagnosed in females (54.3%) compared to males (37.7%). The visual acuity in APAC patients was lower and the rate of low vision and blindness was higher than other subtypes. CONCLUSION PACD was the major type of glaucoma in Chinese hospitals. There were more female patients with PACD, mostly between 60 and 70 years old, with higher rates of APAC in women. APAC resulted in the worst visual outcomes of all PACD subtypes.
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Affiliation(s)
- Hui Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab
| | - Kai Cao
- Beijing Institute of Ophthalmology
| | - Hongyan Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab
| | - Liang Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab
| | | | - Jing Liang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Song
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hui Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab
| | | | - Xiaoming Duan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab
| | - Sujie Fan
- Handan City Eye Hospital, Handan, China
| | - Feng Wang
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ying Su
- The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shaoping Ha
- Department of Ophthalmology, Ning Xia Eye Hospital, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Xuanchu Duan
- The Second Xiangya Hospital of Central South University, Changsha, China
| | | | | | - Guangxian Tang
- The First Hospital of Shijiazhuang City, Shijiazhuang, China
| | - Yufang Su
- Baotou Chaoju Ophthalmic Hospital, Baotou, China
| | | | - Jianlu Gao
- Liaocheng People's Hospital, Liaocheng, China
| | - Yanbing Qu
- Yuncheng City Eye Hospital, Yuncheng City, China
| | - Peng Lu
- Lanzhou University Second Hospital, Lanzhou, China
| | - Xiaobin Xie
- Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | | | - Li Tang
- West China Hospital, Sichuan University, Chengdu, China
| | - Danyan Liu
- The Second Hospital of Heibei Medical University, Shijiazhuang, China
| | - Wei Liu
- The Second People's Hospital of Jinan, Jinan, China
| | - Min Zhang
- Dongguan People's Hospital, Dongguan, China
| | - Aiwu Fang
- The Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bo Qu
- The 4th Affiliated Hospital of China Medical University, the Eye Hospital of China Medical University, Shenyang, China
| | - Weijia Dai
- Xuanwu Hospital, Capital Medical University
| | - Hua Zhong
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xueling Zhang
- The First People's Hospital of Xuzhou, Xuzhou, China
| | | | | | - Hongbin Lyu
- The Affiliated Hospital of Southwest Medical University, Chongqing, China
| | - Lin Xie
- The Third Medical Center of Chinese PLA General Hospital
| | - Haijun Li
- The Third Medical Center of Chinese PLA General Hospital
| | - Yajuan Zheng
- The Second Hospital of Jilin University, Changchun, China
| | - Ning Li
- Jinzhou Central Hospital, Jinzhou, China
| | | | | | | | | | | | - Min Zhu
- The First People's Hospital of Foshan, Foshan, China
| | - Xuemei Wang
- Harbin Ophthalmology Hospital, Harbin, China
| | - Xiang Ma
- Liuzhou People's Hospital, Liuzhou, China
| | - Liuzhi Zeng
- ChengDu First People's Hospital, Chengdu, China
| | | | - Yong Zhang
- Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yuyan Zhang
- Huashan Hospital of Fudan University, Shanghai, China
| | - Fanglei Yu
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yihua Zhu
- The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | | | - Min Yu
- Mian Yang Central Hospital, Mianyang, China
| | - Jingmin Li
- The Second Hospital of Dalian Medical University, Dalian, China
| | | | - Ping Liu
- Taian Central Hospital, Taian City, China
| | - Zhihong Wu
- The Third Medical Center of Chinese PLA General Hospital, Beijing, China
| | | | - Debbie Kuo
- Palo Alto Medical Foundation, San Francisco, the United States
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab; Beijing Institute of Ophthalmology
| | - Chunyan Qiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Institute of Ophthalmology.
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10
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Li S, Tang G, Fan SJ, Zhai G, Lv J, Zhang H, Lu W, Jiang J, Lv A, Wang N, Cao K, Zhao J, Vu V, Mu D, Pan X, Feng H, Hsia YC, Han Y. Factors associated with blindness three months following treatment for acute primary angle glaucoma. Br J Ophthalmol 2020; 105:502-506. [PMID: 32769077 DOI: 10.1136/bjophthalmol-2020-316259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/20/2020] [Accepted: 05/10/2020] [Indexed: 11/04/2022]
Abstract
AIMS To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness. METHODS In this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of ≤1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point. RESULTS The rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of ≤1% was 4.6 hours. CONCLUSIONS AND RELEVANCE Education level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC.
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Affiliation(s)
- Shuning Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Guangxian Tang
- Department of Ophthalmology, 1st Hospital of Shijiazhuang, Shijiazhuang, China
| | - Su Jie Fan
- Department of Ophthalmology, Handan 3rd Hospital, Handan, Hebei, China
| | - Gang Zhai
- Department of Glaucoma, Fushun Eye Hospital, Fushun, China
| | - Jianhua Lv
- Department of Glaucoma, Hebei Eye Hospital, Xingtai, Hebei, China
| | - Hengli Zhang
- Department of Ophthalmology, 1st Hospital of Shijiazhuang, Shijiazhuang, China
| | - Wensheng Lu
- Department of Glaucoma, Hebei Eye Hospital, Xingtai, Hebei, China
| | - Jing Jiang
- Department of Glaucoma, Fushun Eye Hospital, Fushun, China
| | - Aiguo Lv
- Department of Ophthalmology, Handan 3rd Hospital, Handan, Hebei, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China.,Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Jing Zhao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Vivian Vu
- Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Dapeng Mu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Xiaohua Pan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Hui Feng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Yen C Hsia
- Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Ying Han
- Ophthalmology, University of California San Francisco, San Francisco, California, USA
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11
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Xing X, Huang L, Tian F, Zhang Y, Lv Y, Liu W, Liu A. Biometric indicators of eyes with occult lens subluxation inducing secondary acute angle closure. BMC Ophthalmol 2020; 20:87. [PMID: 32138781 PMCID: PMC7059282 DOI: 10.1186/s12886-020-01355-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the anterior biometrics in eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), misdiagnosed as acute primary angle closure (APAC) at the first visit with APAC, chronic primary angle closure glaucoma (CPACG), and cataract. METHODS This retrospective case study included 17 eyes with angel closure due to occult LS, who were misdiagnosed as APAC on their first visit, 56 APAC eyes, 54 CPACG eyes, and 56 cataract eyes. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of ocular biometrics. RESULTS The ASAC-LS patients had a longer ocular axial length than APAC and CPACG patients. Central corneal thickness of the ASAC-LS patients was not significantly different from APAC patients, but was significantly different from CPACG and cataract patients. The APAC patients had the smallest ACD, while the ASAC-LS patients had the smallest AD. The ASAC-LS patients had the largest lens thickness. According to ROC curve analysis, RLP, ACD, AD, CLP, LP had high power of discrimination. CONCLUSIONS This study revealed that LS secondary PAC patients had a shallower AD, thicker CCT comparing to those of APAC, CPACG and cataract patients. For patients with acute angle-closure glaucoma, it is necessary to exclude lens zonula relaxation. TRIAL REGISTRATION NCT03752710, retrospectively registered.
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Affiliation(s)
- Xiaoli Xing
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China.
| | - Liangyu Huang
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Fang Tian
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Yan Zhang
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Yingjuan Lv
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Wei Liu
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Aihua Liu
- Tianjin Medical University Eye Hospital, Tianjin Medical University Optometry College, Tianjin Medical University Eye Institute, 251 Fukang Road, Nankai District, Tianjin, 300384, China
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12
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Sihota R, Angmo D, Ramaswamy D, Dada T. Simplifying "target" intraocular pressure for different stages of primary open-angle glaucoma and primary angle-closure glaucoma. Indian J Ophthalmol 2018; 66:495-505. [PMID: 29582808 PMCID: PMC5892050 DOI: 10.4103/ijo.ijo_1130_17] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/10/2018] [Indexed: 11/25/2022] Open
Abstract
Lowering of intraocular pressure is currently the only therapeutic measure for Glaucoma management. Many longterm, randomized trials have shown the efficacy of lowering IOP, either by a percentage of baseline, or to a specified level. This has lead to the concept of 'Target" IOP, a range of IOP on therapy, that would stabilize the Glaucoma/prevent further visual field loss, without significantly affecting a patient's quality of life. A clinical staging of Glaucoma by optic nerve head evaluation and perimetric parameters, allows a patient's eye to be categorized as having - mild, moderate or severe Glaucomatous damage. An initial attempt should be made to achieve the following IOP range for both POAG or PACG after an iridotomy. In mild glaucoma the initial target IOP range could be kept as 15-17 mmHg, for moderate glaucoma 12-15 mmHg and in the severe stage of glaucomatous damage 10-12 mmHg. Factoring in baseline IOP, age, vascular perfusion parameters, and change on perimetry or imaging during follow up, this range may be reassessed over 6 months to a year. "Target" IOP requires further lowering when the patient continues to progress or develops a systemic disease such as a TIA. Conversely, in the event of a very elderly or sick patient with stable nerve and visual field over time, the target IOP could be raised and medications reduced. An appropriate use of medications/laser/surgery to achieve such a "Target" IOP range in POAG or PACG can maintain visual fields and quality of life, preventing Glaucoma blindness.
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Affiliation(s)
- Ramanjit Sihota
- Glaucoma Research Facility & Clinical Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Dewang Angmo
- Glaucoma Research Facility & Clinical Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Deepa Ramaswamy
- Glaucoma Research Facility & Clinical Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tanuj Dada
- Glaucoma Research Facility & Clinical Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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13
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Associated factors of acute primary angle closure glaucoma in a sub-group of Chinese people: comparison between attack eyes and normal controls. Sci Rep 2017; 7:14885. [PMID: 29097742 PMCID: PMC5668270 DOI: 10.1038/s41598-017-14685-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/10/2017] [Indexed: 01/18/2023] Open
Abstract
Acute primary angle closure glaucoma (APACG) is an ophthalmic emergency that may lead to irreversible blindness. Although efforts were made to control intraocular pressure, disease progression still existed. Anterior segment optical coherence tomography (AS OCT) may provide a new insight into mechanism of APACG. In order to seek out associated factors by AS OCT, We compared anterior segment parameters between 74 APACG and 48 normal eyes. Analysis of variance, principle component analysis and logistic regression were used. APACG group had more women (75.7% vs 47.9%, p = 0.002), smaller anterior chamber (anterior chamber depth, ACD; anterior chamber area, ACA; all p = 0.001), narrower angle (AOD500, AOD750, angle opening distance at 500um and 750um; TISA500, TISA750, trabecular-iris space area at 500um and 750um; ARA500, ARA750, angle recess area at 500um and 750um; all p < 0.001), thinner iris (iris thickness at 750um, IT750; maximum of iris thickness, ITMAX; all p < 0.001), larger iris area (IA, p < 0.001) and lens vault (LV, p = 0.005). Principle component extracted were AOD500, AOD750, TISA500, TISA750, ARA500, ARA750, IA, PD (pupillary diameter), ACD, ACA and IT750. After adjusting for confounding factors, AOD750 (b = 12.40 ± 2.56, p < 0.001), IT750 (b = 10.50 ± 3.45, p = 0.002) and IA (b = −1.56 ± 0.77, p = 0.044) were significantly associated with occurrence of APACG.
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14
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Fea AM, Dallorto L, Lavia C, Pignata G, Rolle T, Aung T. Long-term outcomes after acute primary angle closure of Caucasian chronic angle closure glaucoma patients. Clin Exp Ophthalmol 2017; 46:232-239. [DOI: 10.1111/ceo.13024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/09/2017] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Antonio Maria Fea
- Dipartimento di Scienze Chirurgiche; Università degli Studi di Torino; Turin Italy
| | - Laura Dallorto
- Dipartimento di Scienze Chirurgiche; Università degli Studi di Torino; Turin Italy
| | - Carlo Lavia
- Dipartimento di Scienze Chirurgiche; Università degli Studi di Torino; Turin Italy
| | - Giulia Pignata
- Dipartimento di Scienze Chirurgiche; Università degli Studi di Torino; Turin Italy
| | - Teresa Rolle
- Dipartimento di Scienze Chirurgiche; Università degli Studi di Torino; Turin Italy
| | - Tin Aung
- Singapore National Eye Center; Singapore Singapore
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15
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Zhao Y, Fu JL, Li YL, Li P, Lou FL. Epidemiology and clinical characteristics of patients with glaucoma: An analysis of hospital data between 2003 and 2012. Indian J Ophthalmol 2015; 63:825-31. [PMID: 26669333 PMCID: PMC4730693 DOI: 10.4103/0301-4738.171963] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 10/27/2015] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess demographic and clinical characteristics of glaucoma patients in an Ophthalmologic Hospital of Jinan, China from 2003 to 2012. MATERIALS AND METHODS Medical charts of patients with primary open-angle glaucoma (POAG), primary angle closure glaucoma (PACG), and secondary glaucoma (SG) were reviewed. The main outcome measures of patients with glaucoma included basic demographic data (age at presentation, gender, and residence), clinical characteristics (admission date, intraocular pressure, and naked vision), and previous history (injury, cardiovascular disease, diabetes mellitus, hypertension, smoking, and alcohol consumption). RESULTS Data from 1458 glaucoma patients were reviewed, of which PACG and SG patients accounted for 45.40% and 47.19%, respectively. The average age of all patients with glaucoma increased from 56.05 years in 2003 to 57.83 years in 2012, and the proportion of patients from rural areas rose from 46.43% to 59.13% during 10-year period. Female gender, cardiovascular disease, and hypertension were associated with PACG. POAG was related to smoking and alcohol consumption. There was positive correlation between SG and history of injury and diabetes mellitus. CONCLUSION PACG and SG are the major types of glaucoma. Gender, injury, diabetes mellitus, cardiovascular disease, hypertension, smoking, and alcohol consumption were associated with different types of glaucoma.
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Affiliation(s)
- Yang Zhao
- Nursing Faculty, Tianjin Medical College, Tianjin, China
| | - Jia-Li Fu
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yu-Li Li
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Ping Li
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Feng-Lan Lou
- School of Nursing, Shandong University, Jinan, Shandong, China
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16
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Andreatta W, Elaroud I, Nightingale P, Nessim M. Long-term outcomes after acute primary angle closure in a White Caucasian population. BMC Ophthalmol 2015; 15:108. [PMID: 26286533 PMCID: PMC4541724 DOI: 10.1186/s12886-015-0100-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/31/2015] [Indexed: 11/25/2022] Open
Abstract
Introduction Very limited data is available on the morbidity and progression to primary angle closure glaucoma (PACG) in White Caucasian individuals following acute primary angle closure (APAC). Our aim is to identify the number of eyes who developed PACG following an APAC attack and to determine the risk factors for PACG development in a White Caucasian population in the United Kingdom (UK). We assessed the rate of blindness and visual impairment in the affected eye as defined by the World Health Organisation. Methods Retrospective observational study including 48 consecutive eyes of 46 White Caucasian subjects who presented with APAC to a tertiary referral unit in the United Kingdom. Eyes affected by glaucomatous optic neuropathy at presentation were excluded. We included in our analysis socio-demographic variables, ophthalmic findings, investigations and treatment. Results The mean final follow up period was 27 months ± 14 standard deviation (SD). Seven (15 %) eyes developed PACG. Statistical analysis showed that the following factors were linked to a higher risk of progression: length of symptoms before presentation and time taken to break the attack. The intraocular pressure (IOP) was significantly higher in the group who developed PACG at the one- and six-month visit compared to the group which did not develop the disease. At the final visit 3 (6 %) eyes were blind while 5 (10 %) were visually impaired. PACG was responsible for visual impairment in 2 (4 %) eyes but not for any case of blindness. Conclusions Delayed presentation, length of time taken to break the attack and poor IOP control can result in PACG development and visual impairment. APAC causes a low long-term visual morbidity in White Caucasians.
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Affiliation(s)
- Walter Andreatta
- Birmingham & Midland Eye Centre, Glaucoma Services, Birmingham, UK. .,University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. .,Queen Elizabeth Hospital, Birmingham, B15 2TH, UK.
| | - Ibrahim Elaroud
- Birmingham & Midland Eye Centre, Glaucoma Services, Birmingham, UK.
| | - Peter Nightingale
- Wellcome Trust Clinical Research Facility, Queen Elizabeth Hospital, Birmingham, UK.
| | - Maged Nessim
- Birmingham & Midland Eye Centre, Glaucoma Services, Birmingham, UK. .,Honorary Senior Clinical Lecturer, University of Birmingham, Birmingham, UK.
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17
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Lee JWY, Woo TTY, Yau GSK, Yip S, Yick DWF, Wong J, Wong RLM, Wong IYH. Cross-sectional study of the retinal nerve fiber layer thickness at 7 years after an acute episode of unilateral primary acute angle closure. Medicine (Baltimore) 2015; 94:e391. [PMID: 25590844 PMCID: PMC4602553 DOI: 10.1097/md.0000000000000391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The purpose of this article is to investigate the long-term retinal nerve fiber layer (RNFL) status and determinants of RNFL thinning after an episode of unilateral primary acute angle closure (AAC). This cross-sectional study analyzed the medical records of consecutive patients with a single episode of unilateral AAC from 1999 to 2009 in Hong Kong. The peripapillary RNFL thickness was correlated with age, gender, presenting intraocular pressure (IOP), time to laser iridotomy, time to cataract extraction, follow-up duration, as well as the last IOP, vertical cup-to-disc ratio (CDR), and vision. The fellow uninvolved eye was used as a proxy comparison of RNFL loss in the attack eye. In 40 eligible patients, the mean age was 68.3 ± 8.7 years with a male-to-female ratio of 1:7. The mean presenting IOP was 49.2 ± 14.0 mm Hg and the time from presentation to laser iridotomy was 6.7 ± 6.9 days. Forty percent of subjects received a cataract extraction at 3.2 ± 2.9 years after the attack. The last IOP, CDR, and LogMAR vision were 16.0 ± 3.8 mm Hg, 0.6 ± 0.2, and 0.6 ± 0.6 LogMAR units, respectively, at 7.9 ± 2.4 years. The RNFL thickness in the attack eye (69.2 ± 19.1 μm) was 25.2 ± 17.9% thinner than the fellow eye (93.0 ± 17.8 μm) at 7.5 ± 2.9 years post-AAC. Using univariate analysis, the last vertical CDR (odds ratio [OR] = 17.2, P = 0.049) and LogMAR visual acuity (VA) (OR = 6.6, P = 0.03) were the only significant predictors for RNFL thinning whereas none of the other covariates showed significant associations (P > 0.1). At 7.5 years following unilateral AAC, the RNFL thickness was 25% thinner than the fellow eye. CDR enlargement and poor VA were the only significant predictors for RNFL loss.
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Affiliation(s)
- Jacky W Y Lee
- From the Department of Ophthalmology (JWYL, TTYW, GSKY, DWFY), The Department of Ophthalmology, Caritas Medical Centre (JW); Department of Applied Mathematics (SY), The Hong Kong Polytechnic University; Department of Ophthalmology and Visual Sciences (RLMW), Hong Kong Eye Hospital; and Department of Ophthalmology (IYHW), The University of Hong Kong, Hong Kong SAR, People's Republic of China
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