Objective To detect the levels of vascular endoth elial growth factor (VEGF) in aqueous humor and vitreous of patients with neovascular glaucoma (NVG) and infer their possible effect on the development of neovascularization of iris. Methods The concentration of VEGF in 22 samples of ocular fluid of aqueous humor and vitreous respectively obtained from 11 patients with NVG undergone intraocular surgery were measured by using enzyme linked immunosobent assay (ELISA) for quantitative analysis. As control, 12 samples of ocular fluid of 6 patients with macular hole were detected by the same methods. Results The mean [AKx-]plusmn;s VEGF concentrations in aqueous humor and vitreous from patients with NVG were [(1.451plusmn;0.247)、(1.610plusmn;0.125) ng/ml] higher than those in the cotrol group [(0.189plusmn;0.038)、(0.201plusmn;0.055) ng/ml], there was a significant difference between the two groups statistically (t=12.007，Plt;0001；t=26.0 57，Plt;0.001). Conclusion The patients with NVG have significantly increased level of VEGF in ocular fluid, and VEGF might fill the role in mediating active iris neovascularization. (Chin J Ocul Fundus Dis, 2001,17:305-306)
Objective To measure optic disc parameters in Mongolian and Han healthy subjects with or without family history of glaucoma, to explore the causes of the differences and their significance in the diagnosis of early glaucoma. Methods Fifteen healthy Mongolian individuals (30 eyes), 30 healthy Han individuals (60 eyes) with a family history of open-angle (30 eyes) or angle-closure (30 eyes) glaucoma, and 45 healthy Han individuals (90 eyes) without a family history of glaucoma were enrolled in this study. The 45 healthy Han individuals without a family history of glaucoma included three age-groups: 20 to 29 years old group, 30 to 39 years old group and 40 to 49 years old group, each group have 15 subjects (30 eyes). Thirteen parameters were measured by Heidelberg retina tomography (HRT) for all subjects, including disc area, cup area, rim area, cup volume, rim volume, cup/disc area ratio, linear cup/disc ratio, mean cup depth, maximum cup depth, cup shape, disc height variation contour, mean retinal nerve fiber layer (RNFL) thickness and optic nerve fiber layer crosssectional area. The results were analyzed and compared between the above groups. Results There was no statistically significant (t=0.791,P=0.132) of the height variation contour between Mongolian and Han without a family history of glaucoma (20 to 29 years old) group. The other parameters of Mongolian were smaller than Han without a family history of glaucoma (20 to 29 years old) group, but the difference was not statistically significant (t=-1.039, -0.799, -0.840,-1.108, -0.956, -0.695, -0.931, -1.099, -1.074, -0.580, -0.204, -1.425; P＞0.05). The parameters in Han with a family history of open-angle glaucoma group were bigger than Han without a family history of glaucoma (30 to 39 years old) group. The differences were statistically significant for disc area, cup area, rim area, cup volume, rim volume, cup area ratio, linear cup/disc ratio, mean cup depth, cup shape measure, nerve fiber layer cross-sectional area (t=4.758, 3.187, 2.544, 2.674, 1.798, 3.676, 2.721, 2.715, 2.510, 2.373; P＜0.05), but were not statistically significant for maximum cup depth, disc height variation contour and mean RNFL thickness (t=1.649, 1.565, 0.767; P＞0.05). Most parameters in Han with a family history of angle-closure glaucoma group were the same as that in Han without a family history of glaucoma (40 to 49 years old) group, including cup area, rim area, cup volume, rim volume, cup/disc area ratio, linear cup/disc ratio, mean optic cup depth, maximum cup depth, cup shape, disc height variation contour, mean RNFL thickness, optic nerve fiber layer cross-section (t=1.201, 1.697, 1.000, 0.516, 0.740, -0.172, -0.070, -0.972, 1.530, -0.390, -0.091, 0.659; P＞0.05); but the difference of disc area between these 2 groups was statistically significant (t=2.224,P＜0.05). Conclusions The family history of glaucoma can change the optic disc parameters of healthy individuals, especially those with a family history of open-angle glaucoma. There is no difference of optic disc parameters between healthy Mongolian and Han subjects.
Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure. Methods Prospective clinical case-control study. A total of 26 patients (30 eyes) with acute primary angle-closure glaucoma (APACG) were in the APACG group, whose intraocular pressure were control after a single episode acute primary angle closure; 30 age-and sex-matched healthy subjects (30 eyes) in the control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm×6 mm macular scanning. The parameters included average thickness of entire CP-RNFL, thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The foveal retinal thickness, center retinal thickness (≤1 mm from the fovea), 4 quadrants of macular inner-ring ( > 1 mm but≤3 mm from the fovea) retinal thickness, 4 quadrants of macular outer-ring ( > 3 mm but≤6 mm from the fovea) retinal thickness, average thickness of macular retinal thickness and macular volume were measured and analyzed. Results The disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22, 4.12, 3.90, 3.00, 3.23; P < 0.05), rim area was smaller than the control group (t=-2.63, P < 0.05). The average thickness (t=-6.68) and the thickness of superior (t=-5.90), temporal (t=-11.64) and inferior (t=-5.06) quadrants of CP-RNFL, center retinal thickness (t=-2.50), 4 quadrants of macular inner-ring retinal thickness (t=-4.91, -4.88, -2.83, -3.59), nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outer-ring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P < 0.05), and the macular volume (t=-2.69) was significantly smaller than the control group (P < 0.05). There was no statistically difference at nasal CP-RNFL (t=-0.11), foveal retinal thickness (t=-0.59), temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P > 0.05). Conclusions In comparison with the healthy subjects, the disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio in APACG eyes were bigger, while rim area was smaller; the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL, fovea, temporal and inferior quadrants of macular outer-ring retinal.
Objective To evaluate the influence of the location of retinal vessel trunk on neuroretinal rim width of inferior and superior sectors of optic disc, and explore its role in the diagnosis of glaucomatous optic nerve lesion. Methods The photographs of ocular fundus from 459 patients with clear location of retinal vessel trunk, including large disc in 131, medium disc in 145, horizontally oval disc in 75, and small disc in 108 were evaluated. Independent-sample t test was used to compare the difference of the superior and inferior rim widths between the higher-vessel group and the lower-vessel group, and to compare the difference of superior and inferior vessel distances between the narrow-superior-rim-width group and the narrow inferior-rim-width group. Results In most of the patients, or the ones with large and small disc, the ratio of superior rim width to summation of superior and inferior rim widths in the higher-vessel group（0.467plusmn;0.051，0.445plusmn;0.040，0.508plusmn;0.056）were less than which in the lowervessel group（0.500plusmn;0.066，0.474plusmn;0.062，0.546plusmn;0.048）, and the differences were significant（P=0.000, 0.045, 0.018）; the ratio of superior vessel distance to summation of superior and inferior vessel distance in the narrow-superior-rim-width group（0.510plusmn;0.051，0.508plusmn;0.055，0.512plusmn;0.036）were less than which in the narrow-inferior-rim-width group（0.528plusmn;0.045，0.533plusmn;0.048，0.534plusmn;0.045）, and the differences were significant（P=0.000, 0.046, 0.022）. Conclusions The position of optic disc vessel trunk influences its superior and inferior rim width. The rim closer to vessel trunk position has narrower width than which comparatively far away from the position. In patients with large, medium, horizontally oval optic disc, glaucoma optic nerve lesion would be considered if the optic disc has the shape of narrower inferior rim, broader superior rim, and vessel location in the superior half of the disc. In the ones with small disc, the optic disc with the shape of narrower superior rim, broader inferior rim, and vessel location in the inferior half of the disc may suggest glaucoma optic nerve lesion. (Chin J Ocul Fundus Dis, 2007, 23: 118-121)
Objective To monitor the release of amino acids of the whole retina during and after experimental glaucoma by increasing the intraocular pressure （IOP）． Methods Experimental glaucoma was induced in one of the two eyes of rabbits by increasing IOP at 120 mm Hg for 45 min under infusion of saline in anterior chamber；then the pressure was released and the needle inserted into the anterior chamber was removed，this state was maintained for another 45 min．Every 15 min during the experiment 5 rabbits were killed and experimental eyes were enucleated．Aliquots（20 μl）of the retinal extracts（see below）were mixed with ophthaldialdehyde reagent and analysed for amino acid content by the HPLC method of Wangwei，using a 150 mm×4.6 mm,5 μm C18 column． Results A large increase in the release of glutamate，but not of the other three amino acids monitored，occurred during initial experimental ocular hypertension．It reached peak value of（111.73±17.46）10-5 mmol/g at 15 min of hypertension．15 min after release of intraocular pressure，again，immediately large and specific increase in the concentration of glutamate was reached to（102.96±51.91）10-5 mmol/g．In eyes subjected to paracentesis of anterior chamber，no difference was found between experimental eyes and controls. Conclusion These results suggest that glutamate is triggered by increasing the IOP，and it releases not only during the period of experimental ocular hypertension，but also afterwards. (Chin J Ocul Fundus Dis, 2002, 18: 146-148)
PURPOSE:To probe the dosage and effect of lasers in panretinal photocoagulation. METHODS:Three kinds of ocular diseases,e, g., neovascular glaucoma(NVG)in 52 eyes ,central retinal vein occlusion(CRVO)in 47 eyes ,and preproliferative and proliferative diabetic retinopathies(PDR)in 231 eyes ,treated with krypton red and argon blue green laser panretinal photocoagulation in ocular clinic of our hospital,were analysed clinically and retropectively. RESULTS:The effetive average numbers of laser burns in panretinal photocoagulation in this series after clinical analysis statistically were found to be 1 500 in NVG,and 1 000 in PDR and CRVO respectively. CONCLUSION:To select the proper laser,its wave length,therapeutic position and volume of laser burns in accordance with the specific circumstances of various retinopthies is of extreme importance in success of laser panretinal photocoagulation. （Chin J Ocul Fundus Dis,1997,13: 195-196）
Through the different image technologies, peripapillary atrophy can be classified into four types: α zone, β zone, γ zone and δ zone. Each type of them has different imaging and histological features. Peripapillary atrophy is a common structure in peoples’ eyes and it is correlated with many factors and diseases such as age, myopia, glaucoma, non-arteritic anterior ischemic optic neuropathy and age-related macular degeneration which bring difficulties to our diagnosis and antidiastole. Classifying and qualifying peripapillary atrophy properly, which can evaluate the changes and degrees, can benefit our studies about their mechanism and offer the clinical biological indictors and research basis.
ObjectiveTo investigate the risk factors for neovascular glaucoma (NVG) after vitrectomy in proliferative diabetic retinopathy (PDR) patients. MethodsThree hundred and one patients (301 eyes) with PDR who underwent vitrectomy between January 2008 and December 2013 in our hospital were retrospectively evaluated. Risk factors for NVG after vitrectomy were identified by multivariate Logistic regression analysis. ResultsTwelve of 301 patients (4.0%) developed postoperative NVG in 2 to 18 months after vitrectomy. The incidence of postoperative NVG peaked in 2 to 6 months after vitrectomy (7 eyes, 58.3%). Logistic regression analysis showed that postoperative retinal detachment was a significant risk factor for postoperative NVG in eyes with PDR (P < 0.001). Eyes with postoperative retinal detachment were more likely to develop NVG after vitrectomy than those without postoperative retinal detachment (OR=17.826). Gender, age, duration of diabetes, preoperative serum creatinine levels, glycated hemoglobin levels, preoperative intraocular pressure, preoperative lens status, combined phacoemulsification surgery and tamponade were not associated with postoperative NVG (P > 0.05). ConclusionPostoperative retinal detachment is a major risk factor for NVG after vitrectomy in PDR.
Objective To investigate the risk factors associated with neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR). Methods Retrospective study. One hundred and thirty-seven patients (137 eyes) with PDR who underwent PPV were recruited. There were 85 males and 52 females. The average age was (60.1±8.8) years old. The duration of diabetes was (10.2±3.6) years. There were 49 patients with ipsilateral carotid artery stenosis. Fifty-three eyes underwent intravitreal ranibizumab or conbercept injection before PPV. All eyes were treated with 23G standard three-port PPV. The average follow-up time after PPV was 11.5 months. Fundus fluorescein angiography (FFA) was conducted in postoperative 4-6 weeks to observe non-perfused retinal areas. Risk factors, such as ipsilateral carotid artery stenosis, the presence of non-perfusion in retina after PPV and the application of anti-vascular endothelial growth factor (VEGF) drugs before PPV, were identified by logistic regression. Results Twenty of 137 patients (14.6%) developed postoperative NVG after PPV. Ipsilateral carotid artery stenosis [odds ratio (OR) =5.048, 95% confidence interval (CI) 2.057-12.389,P=0.000] and the presence of non-perfusion in retina after PPV (OR=4.274, 95%CI 1.426-12.809,P=0.009) were significant risk factors for postoperative NVG, while the application of anti-VEGF drugs was not (OR=1.426, 95%CI 0.463-4.395,P=0.536). But the time from PPV to the onset of NVG varies significantly between the two groups of injection of anti-VEGF drugs or not (t=−4.370,P=0.000). Conclusions Risk factors associated with NVG after PPV in eyes with PDR included ipsilateral carotid artery stenosis and the presence of non-perfusion in retina after PPV. The application of anti-VEGF drugs before PPV can delay the onset of NVG in PDR eyes after vitrectomy.
ObjectiveTo observe the difference of retinal vessel oxygen saturation in glaucoma and normal eyes. MethodsA cross sectional study design was performed. Fifty eyes of 30 glaucoma patients (glaucoma group) and 41 eyes of 27 age-and sex-matched healthy subjects (control group) were included. Retinal vessel oxygen saturation was measured with a spectrophotometric retinal oximeter in darkness and visual fields were obtained by Humphrey filed analyzer. The glaucoma eyes were divided into two groups: mean defect (MD)<6 dB (28 eyes) and MD≥6 dB (22 eyes) according to mean defect of visual field. ResultsRetinal arteriolar oxygen saturation values in glaucoma group and control group were (94.52±6.51)% and (93.47±6.30)% respectively. No statistical difference was found in retinal oxygen saturation in arterioles (H=-0.949, P=0.343). Retinal venous oxygen saturation values in glaucoma group and control group were (57.57±7.96)% and (52.60±7.70)% respectively. The retinal venous oxygen saturation values in glaucoma group was higher than that in control group (H=-3.318,P=0.001). The retinal arteriovenous difference in glaucoma group and control group were (36.59±4.69)% and (42.41±6.73)% respectively. The retinal arteriovenous difference in glaucoma group was lower than that in control group (H=-4.148,P<0.01). The retinal arteriolar oxygen saturation values in glaucoma eyes with MD<6 dB and MD≥6 dB were (93.38±6.33)% and (95.71±6.54)% respectively, with no statistical difference (H=-1.857,P=0.063). Retinal venous oxygen saturation values in glaucoma eyes with MD<6 dB and MD≥6 dB were (54.83±6.10)% and (61.07±8.79)% respectively. The retinal venous oxygen saturation values in MD≥6 dB glaucoma eyes was higher than that in MD<6 dB glaucoma eyes (H=-2.599, P=0.009). The retinal arteriovenous difference in glaucoma eyes with MD<6 dB and MD≥6 dB were (38.12±4.34)% and (34.64±4.49)% respectively. The retinal arteriovenous difference in MD≥6 dB glaucoma eyes was lower than that in MD<6 dB glaucoma eyes (H=-2.463,P<0.05). ConclusionsCompared with healthy eyes, there is no change in the retinal arteriolar oxygen saturation, but the retinal venous oxygen saturation is higher and the retinal arteriovenous difference is lower. This feature is more obvious in MD≥6 dB glaucoma eyes.