AIMS:To investigate retinal vascular geometric alterations following intraocular pressure (IOP)-lowering surgery in patients with primary angle closure disease (PACD) and determine associations between IOP reduction magnitude and retinal vascular parameters. METHODS:This retrospective, self-controlled study included patients with PACD who underwent IOP-lowering surgery at Beijing Tongren Hospital. Retinal vascular parameters were quantitatively measured from fundus photographs before and after surgery using a validated deep learning-based analysis system. Main outcomes included retinal arteriolar and venular calibre, tortuosity, fractal dimension (FD), segment number (N_seg) and vascular density. Linear mixed-effects models, adjusted for age, follow-up interval and PACD subtype, assessed associations between IOP reduction magnitude and vascular parameter changes. RESULTS:Among 126 eyes (112 patients), surgery decreased IOP from 35.0±9.9 to 16.7±5.7 mm Hg (p<0.001). Venous FD increased from 1.52±0.06 to 1.53±0.05 (p=0.003), N_seg from 123.50 (IQR: 61.75-182.50) to 153.00 (88.50-185.00) (p=0.007), vessel area density (VAD) from 6.13±1.56 to 6.50±1.34 (p=0.006) and vessel skeleton density (VSD) from 1.24±0.35 to 1.35±0.31 (p=0.003). Vessel calibre and tortuosity showed no significant changes. IOP reduction magnitude was independently associated with changes in venous FD (p=0.023), N_seg (p=0.031), VAD (p=0.012) and VSD (p=0.030). CONCLUSIONS:Surgical IOP reduction in PACD patients produces selective retinal venous alterations with increased complexity and density. These pressure-responsive changes may provide complementary, non-invasive information regarding vascular response after surgery.

Purpose:To evaluate retinal vasculometry alterations in successfully treated acute primary angle closure (APAC) eyes versus unaffected fellow eyes. Methods:In this cross-sectional study of 116 patients with unilateral APAC, retinal photographs obtained within two weeks after intraocular pressure (IOP) control were analyzed using deep learning-based software to evaluate retinal vascular parameters. The main outcome included caliber, density, complexity, tortuosity, and branching angle parameters. Results:Compared to fellow eyes, APAC eyes showed larger retinal vein caliber (P < 0.001), increased length-to-diameter ratio in arteries and veins (P < 0.001 and = 0.001), and lower arteriovenous ratio from quantile 4 (AVRQ4) (P < 0.001). Additionally, APAC eyes demonstrated reduced bifurcation densities, fractal dimension (FD), and branching angle for arteries and veins (all P ≤ 0.005). Multivariate analysis identified three independent factors associated with APAC: higher IOP (odd ratio [OR] = 1.073, P = 0.003), lower AVRQ4 (OR = 0.957, P = 0.025), and decreased arterial FD (OR = 0.953, P = 0.028). Conclusions:APAC eyes exhibit significant retinal vasculometry alterations despite IOP control. Longitudinal studies are needed to determine whether these alterations contribute to the development of glaucomatous optic neuropathy. Translational Relevance:The observed changes in artery-to-vein caliber ratio and arterial complexity may help clinicians identify eyes at risk for progressive damage despite normalized IOP. These findings support the development of supplementary monitoring strategies using standard fundus photography in post-APAC management.

PRECIS:Non-pupillary block mechanisms are associated with larger postoperative peripheral anterior synechiae (PAS) extent at 1-year follow-up compared to pupillary block mechanisms in primary angle-closure disease (PACD). PURPOSE:To evaluate the impact of preoperative angle-closure mechanisms on surgical outcomes of phacoemulsification and intraocular lens implantation (PEI) combined with VGP in PACD patients with cataracts. PATIENTS AND METHODS:This prospective cohort study enrolled 56 patients (68 eyes) with PACD and cataracts. Participants were classified into pupillary block (PB) and non-pupillary block (Non-PB) groups based on the anatomical characteristics of angle closure shown in preoperative ultrasound biomicroscopy imaging. Primary outcomes included peripheral anterior synechiae (PAS) extent, intraocular pressure (IOP), and number of IOP-lowering medications over a 12-month follow-up period. RESULTS:Both groups showed significant reductions in PAS extent at the end of surgery compared to the baseline. At 6 and 12 months postoperatively, the Non-PB group exhibited significantly larger PAS extent compared to the PB group (P=0.025 and P=0.017, respectively). Both groups demonstrated significant IOP reduction and decreased use of IOP-lowering medications postoperatively, with no significant differences between groups. The overall complete and qualified success rates at 12 months were 71.6% and 98.5%, respectively, with no significant difference between groups. CONCLUSIONS:Non-PB mechanisms are associated with larger postoperative PAS extent at 1-year follow-up compared to PB mechanisms, emphasizing the importance of comprehensive preoperative angle-closure mechanisms assessment in predicting and potentially minimizing PAS progression for enhanced long-term surgical efficacy in PACD treatment.

Circular RNA (circRNA) and microRNA (miRNA) play critical roles in regulating proliferation, apoptosis, and invasion in triple-negative breast cancer (TNBC) cells. To investigate their functional significance, we employed quantitative real-time PCR (qRT-PCR) to assess the differential expression of circ_0000190, miR-301a, and mesenchyme homeobox 2 (MEOX2) between TNBC cell lines and normal breast epithelial cells. Subsequently, we established overexpression and knockdown systems for these molecules to examine their effects on TNBC cell proliferation, apoptosis, migration, invasion, and epithelial-mesenchymal transition (EMT). Additionally, we evaluated the impact of circ_0000190 overexpression on tumor growth using a mouse xenograft model, measuring tumor volume and weight. Our findings revealed that circ_0000190 and MEOX2 expression were significantly downregulated (P<0.05) in TNBC cells compared to normal breast epithelial cells, whereas miR-301a was upregulated (P<0.05). Knockdown of circ_0000190 promoted TNBC cell proliferation, migration, invasion, and EMT, while suppressing apoptosis. Mechanistically, circ_0000190 functioned as a molecular sponge for miR-301a, and its overexpression significantly inhibited miR-301a expression (P<0.001). Notably, miR-301a mimics partially reversed the suppressive effects of circ_0000190 overexpression on proliferation, migration, invasion, and EMT, as well as its pro-apoptotic effects (P<0.001). Furthermore, we identified MEOX2 as a direct target of miR-301a. MEOX2 knockdown attenuated the inhibitory effects of miR-301a silencing on proliferation, migration, invasion, and EMT, while also counteracting its pro-apoptotic function. In vivo experiments demonstrated that circ_0000190 overexpression significantly reduced tumor volume and weight (P<0.001), concomitant with elevated MEOX2 mRNA and protein levels (P<0.001) and decreased miR-301a expression (P<0.001). In conclusion, our study elucidates that circ_0000190 suppresses TNBC progression by downregulating miR-301a and upregulating MEOX2, forming a competitive endogenous RNA (ceRNA) network of circRNA-miRNA-mRNA.

AIM: To compare surgical efficacy based on residual peripheral anterior synechiae (PAS) extent after viscogonioplasty (VGP) combined with phacoemulsification and intraocular lens implantation (PEI) in patients with primary angle-closure disease (PACD) and identify risk factors for extensive postoperative PAS. METHODS: This prospective cohort study included 73 eyes of 61 patients with PACD undergoing PEI with VGP. Patients were divided into Group A (PAS<90°, n=39) and Group B (90°≤PAS≤180°, n=34) based on PAS extent at the end of surgery. PAS progression rates were assessed using a linear mixed-effects model. Logistic regression analyzed risk factors for PAS≥180° at 12mo postoperatively. RESULTS: Both groups showed significant PAS progression at 12mo (P<0.001). Group A had smaller PAS extent than Group B at all time points (P<0.001). PAS progression rates were similar between groups (P=0.335). No significant differences were found in intraocular pressure (IOP), IOP-lowering medications, or surgical success rates (P>0.05). Female [odds ratio (OR)=0.211, P=0.046], preoperative medication number (OR=1.017, P=0.029), and PAS extent at the end of surgery (OR=1.017, P=0.018) were risk factors for PAS≥180° at 12mo. CONCLUSION: Residual PAS extent at the end of surgery predicts postoperative extensive PAS formation but has limited effect on PAS progression rate and IOP control. Female, multiple preoperative IOP-lowering medications, and larger residual PAS extent are independent risk factors for extensive PAS at 12mo postoperatively.

The Asia-Pacific Glaucoma Society (APGS), in collaboration with the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO), convened a panel of 18 international experts from 10 countries/territories to identify areas of controversy and establish consensus on diagnosing and managing Acute Primary Angle Closure Attack (APACA). APACA is a relatively common and potentially vision-threatening ocular emergency, particularly in Chinese and Asian populations. With timely and appropriate intervention, favorable outcomes could be achieved. However, with the current treatment protocol, two areas need to be improved: 1) more rapid and consistent reduction of intraocular pressure (IOP), and 2) reducing the proportion of patients who develop chronic IOP elevation after resolution of an acute attack and successful laser peripheral iridotomy. The international panel of experts systematically revisited and debated alternative treatments to address the above issues. Consensus was evaluated using a five-point Likert scale (strongly agree, agree, neutral, disagree, and strongly disagree), in which each expert considered and voted anonymously and independently on each consensus statement. A statement consensus is established when the summation of votes for "agree" and "strongly agree" reaches a 75 % threshold. Argon laser peripheral iridoplasty, anterior chamber paracentesis, and laser pupilloplasty are considered appropriate and suitable options for rapid IOP reduction. Earlier phacoemulsification is effective in preventing further retinal ganglion cell loss and disease progression after APACA and is worth considering, provided adequate facilities and expertise are available. Further studies are warranted to evaluate the safety and efficacy of corneal indentation as a rapid and immediate treatment to lower IOP.

To evaluate the efficacy and safety of phacoemulsification combined with glaucoma surgeries based on new criteria of axial length (AL) in nanophthalmos patients with secondary angle closure glaucoma (NSACG). This retrospective study analyzed medical records of NSACG patients, categorized into two groups based on AL. Group 1 (AL: 17–20 mm) underwent phacoemulsification with intraocular lens implantation, viscogonioplasty, and anterior pars plana vitrectomy (PVP), combined with trabeculectomy (Trab) or endoscopic photocoagulation (ECP). Group 2 (AL < 17 mm) underwent PVP combined with trabeculectomy and sclerectomy (PVPTS). A total of 22 patients (31 eyes) with NSACG were enrolled with a mean follow-up of 50.2 ± 26.2 months. Patients with axial length < 17 mm (Group 2) exhibited significantly worse visual acuity (P < 0.05) and required more IOP-lowering medications (P = 0.007) than those with axial length ≥ 17 mm (Group 1). Postoperatively, both groups demonstrated statistically significant reductions in IOP and the number of IOP-lowering medications (All P < 0.05). IOP reduction ≥ 20 What that study adds

Purpose: To evaluate retinal vascular parameters across primary angle-closure disease (PACD) stages and explore their association with glaucomatous optic neuropathy (GON). Design: A cross-sectional, hospital-based study. Participants: We enrolled 638 eyes from 425 participants aged ≥40 years with PACD and further classified them into primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG) groups. Methods: Retinal vascular parameters were measured using the Retinal-based Microvascular Health Assessment System and compared between 3 groups. A multivariable logistic mixed effects model was used to identify factors associated with the presence of GON. Main Outcome Measures: Vessel caliber, tortuosity, complexity, and branching angle parameters. Results: No significant differences in retinal vascular parameters were found between PACS and PAC groups. Eyes in PACG showed significant vascular changes compared to PACS (P < 0.05). Elevated intraocular pressure (odds ratio [OR] = 2.44, P < 0.001), reduced arteriolar curve tortuosity (OR = 0.12, P = 0.002), arteriolar fractal dimension (OR = 0.08, P = 0.027), arteriolar branching angle (OR = 0.16, P = 0.004), and asymmetry ratio (OR = 0.10, P < 0.001 for artery and OR = 0.25, P = 0.023 for vein) were significantly associated with the presence of GON. Conclusions: Retinal “vascular geometric fingerprints” show significant alterations in eyes with PACG compared to PACS and are independently associated with the presence of GON. These findings offer new insights into the vascular changes in GON, and longitudinal studies are needed to determine their prognostic value and clinical utility in managing PACD. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

To assess the long-term outcomes of patients with glaucoma secondary to iridocorneal endothelial syndrome (GS-ICE) who underwent Ahmed glaucoma valve (AGV) implantation combined with phacoemulsification and intraocular lens (IOL) implantation surgery. In this non-comparative retrospective case series study, twelve patients with uncontrolled GS-ICE and cataract underwent Ahmed aqueous shunt combined with phacoemulsification and IOL implantation surgery at Beijing Tongren Eye Center between June 2014 and June 2022. Main medical records included best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications (AGM), corneal status and further surgical interventions. Surgical success was defined as a postoperative IOP ≥ 6mmHg and ≤ 21mmHg without (complete success) or with/without (qualified success) topical AGM and vision of at least light perception during the follow-up period. Twelve eyes of twelve patients were reviewed. Preoperative IOP was decreased from a mean of 38.5 ± 6.7 mmHg on 3.3 ± 0.9 AGM to a mean of 16.3 ± 4.3 mmHg (P<0.001) on 0.6 ± 1.1 medications (P<0.001) at the last follow-up (47.0 ± 24.7 months). Eight eyes (66.7

Purpose:This study aimed to investigate the performance of deep learning algorithms in the opportunistic screening for primary angle-closure disease (PACD) using combined anterior segment parameters. Methods:This was an observational, cross-sectional hospital-based study. Patients with PACD and healthy controls who underwent comprehensive eye examinations, including gonioscopy and anterior segment optical coherence tomography (ASOCT) examinations under both light and dark conditions, were consecutively enrolled from the Department of Ophthalmology at the Beijing Tongren Hospital between November 2020 and June 2022. The anterior chamber, anterior chamber angle, iris, and lens parameters were assessed using ASOCT. To build the prediction models, backward logistic regression was utilized to select the variables to discriminate patients with PACD from normal participants, and the area under the receiver operating characteristic curve was used to evaluate the efficacy of the opportunistic screening. Results:The data from 199 patients (199 eyes) were included in the final analysis and divided into two groups: PACD (109 eyes) and controls (90 eyes). Angle opening distance at 500 μm, anterior chamber area, and iris curvature measured in the light condition were included in the final prediction models. The area under the receiver operating characteristic curve was 0.968, with a sensitivity of 91.74 % and a specificity of 91.11 %. Conclusion:ASOCT-based algorithms showed excellent diagnostic performance in the opportunistic screening for PACD. These results provide a promising basis for future research on the development of an angle-closure probability scoring system for PACD screening.

目的 分析原发性闭角型青光眼合并视网膜色素变性患者的临床特征.方法 本研究纳入2013年4月至2017年4月于首都医科大学附属北京同仁医院眼科中心住院治疗的原发性闭角型青光眼(primary angle closure glaucoma,PACG)合并视网膜色素变性(retinitis pigmentosa,RP)患者32例,和同期入院的不合并RP的PACG患者229例.根据青光眼类型将其分为4组,急性闭角型青光眼合并RP组(acute angle closure glaucoma with retinitis pigmentosa,AACG-RP)12例、慢性闭角型青光眼合并RP组(chronic angle closure glaucoma with retinitis pigmentosa,CACG-RP)20例、急性闭角型青光眼不合并RP组(AACG-non RP)94例、慢性闭角型青光眼不合并RP组(CACG-non RP)135例,比较4组患者的发病年龄和眼轴长度等参数.结果 患者平均发病年龄AACG-RP组(39.00±12.07)岁、CACG-RP组(43.85±12.79)岁、AACG-non RP组(66.44±9.40)岁、CACG-non RP组(63.95±10.42)岁,4组之间差异有统计学意义(F=47.70,P<0.05).患者平均眼轴长度AACG-RP组(21.31±1.37)mm、CACG-RP组(22.33±1.09)mm、AACG-non RP组(22.31±1.03)mm、CACG-non RP组(22.47±1.01)mm,4组之间差异有统计学意义(F=19.09,P<0.05).结论 原发性闭角型青光眼患者合并视网膜色素变性患者中,急性闭角型青光眼患者较慢性闭角型青光眼患者发病更早,眼轴更短.原发性闭角型青光眼合并视网膜色素变性患者,尤其是急性闭角型青光眼合并视网膜色素变性患者较无视网膜色素变性者发病年龄更早,且眼轴更短.

Triple-negative breast cancer (TNBC) is a highly invasive subtype of breast cancer. This study explored the molecular mechanism and influences of metallothionein 1 J, pseudogene (MT1JP), microRNA-138 (miR-138), and hypoxia-inducible factor-1α (HIF-1α) on TNBC cell proliferation and migration. We confirmed TNBC cases by immunohistochemistry (IHC) staining. The expression of MT1JP in two types of tissue collected from 78 TNBC patients was detected by performing real-time quantitative fluorescence PCR (RT-qPCR). To further evaluate the relationship among MT1JP, miR-138 and HIF-1α, expression vectors of MT1JP and HIF-1α, as well as miR-138 mimic and inhibitor, were delivered into BT-549 cells. We observed that MT1JP was downregulated in TNBC. MT1JP was positively correlated with miR-138 but negatively correlated with HIF-1α in TNBC tissues. In TNBC cells, upregulation of miR-138 and downregulation of HIF-1α were observed after overexpression of MT1JP. In addition, overexpression of miR-138 resulted in downregulation of HIF-1α but did not affect the expression of MT1JP. Decreased proliferation rate of TNBC cells was observed after overexpression of MT1JP and miR-138. HIF-1α increased cell proliferation and migration. HIF-1α also suppressed the role of MT1JP and miR-138 in TNBC cell proliferation and migration. In conclusion, our findings demonstrated that MT1JP inhibited TNBC by regulating the miR-138/HIF-1α axis, indicating that MT1JP might serve as a biomarker or target for TNBC treatment.

先天性葡萄膜外翻为虹膜色素上皮自瞳孔缘向虹膜基质表面过度增生,表现为虹膜表面色素增多,常伴发青光眼,因临床中较为少见,常被误诊、误治,造成视力不可逆性损伤,因此本文对先天性葡萄膜外翻及伴发青光眼的病因、临床特点、发病机制及治疗进展进行综述.

This study aimed to illustrate the efficacy of the combination of lens extraction, trabeculectomy, and anterior vitrectomy in patients with secondary angle-closure glaucoma (ACG) with autosomal recessive bestrophinopathy or Best vitelliform macular dystrophy. This is a retrospective self-controlled case series study. Five patients undergoing a single trabeculectomy in one eye and triple surgery in the other eye were enrolled. All patients underwent a complete ophthalmic examination that included best-corrected visual acuity (BCVA), intraocular pressure (IOP), ultrasound biomicroscopy, and static gonioscopy. Multimodal fundus imaging was performed, including color fundus photography, fundus autofluorescence, and optical coherence tomography. Genetic testing was also analyzed. Among the 10 eyes, the mean IOP was 31.4 ± 4.7 mmHg before surgery. The mean axial length (AL) was 21.53 mm and the anterior chamber depth (ACD) was 2.31 mm. There were no statistically significant differences in preoperative IOP, BCVA, ACD, and AL between the two groups (all P > 0.05). The mean follow-up time was 64.0 months. All five eyes with a single trabeculectomy developed malignant glaucoma (MG). No complications were found in the other five eyes with triple surgery, and the anterior chamber was deepened and stable after surgery until the last visit. The mean IOP at the last visit was normalized to 16 mmHg without using any medications. Triple surgery is superior to single trabeculectomy for patients with ACG and BEST1 mutation, effectively bypassing MG complications. The vitreous may play a vital role in the mechanism of ACG in those patients and the high incidence of MG after filtering surgery.

Abstract Background Prostaglandin analogs (PGAs) are the first-line treatment for primary open-angle glaucoma (POAG) and ocular hypertension (OH). This study aimed to confirm the effectiveness and safety of Tapros® (0.0015% tafluprost eye drops) in Chinese patients with POAG and OH. Methods This phase IV, multicenter, non-comparative, prospective study enrolled patients with POAG and OH in China between 12/27/2017 and 04/15/2020. Patients who were treatment-naïve or untreated within one month (group A) or with unreached intraocular pressure (IOP) target after previous monotherapy of other PGAs (group B) or non-PGA IOP-lowering drugs (group C) were treated with 0.0015% tafluprost for three months. The IOP reduction, response rate, and safety were observed. Results There were 165, 89, and 31 patients in groups A, B, and C, with baseline IOPs of 22.4 ± 4.7, 21.0 ± 3.5, and 22.5 ± 3.2 mmHg, respectively. The least-square means and percentages of IOP reduction at 3 months for groups A, B, and C were 4.7 (19.8%), 1.6 (6.1%), and 4.6 mmHg (20.3%), respectively. A significant reduction in IOP was observed at each visit compared with baseline (all P < 0.05). At the final visit, 57.0% of the participants in group A achieved an IOP reduction of ≥ 20%, while 40.4% and 77.4% in groups B and C achieved an IOP reduction of ≥ 10%. Fifty-eight treatment-related adverse events occurred in 46 participants (15.7%), of which the most common one was conjunctival hyperemia (34/293, 11.6%). Conclusions Tafluprost showed a sustained and significant effect with tolerable adverse events in Chinese patients with POAG and OH who were treatment-naïve or untreated within one month or received prior treatments with unsatisfying outcomes.

目的 探讨眼内窥镜下睫状体光凝术(ECP)治疗外伤性难治性青光眼的安全性和有效性.设计回顾性病例系列.研究对象2013年5月至2020年5月北京同仁医院接受至少一次抗青光眼手术且术后眼压仍＞21 mmHg的外伤性难治性青光眼患者24例(24眼).方法 采用ECP对所有患者进行治疗.术后平均随访(3.6±2.3)年(范围6个月～7年).回顾患者术前、术后1天、术后1周及末次随访时的眼压、视力、降眼压药物使用、术后并发症情况.采用单因素重复测量方差分析(ANOVA)和配对t检验进行数据分析.主要指标眼压、视力、降眼压药物使用情况.结果 术前患者平均眼压(37.8±8.7) mmHg,末次随访时平均眼压为(21.9±6.9)mmHg(P＜0.001),83.3％患者眼压≤21 mmHg.术前使用降眼压药物(2.75±0.79)种,末次随访时为(0.88±1.12)种(P＜0.001).末次随访时87.5％患者视力不变或提高.术中及术后均无严重并发症发生.结论 平均随访3.6年的结果显示,ECP治疗常规抗青光眼手术失败的外伤性青光眼的疗效良好.

73岁女性.左眼2个月前行经巩膜睫状体光凝术.全麻下行左眼超声乳化白内障吸除人工晶状体联合内窥镜下黏弹剂房角分离术.术中前房角分离时出现下方角膜后弹力层脱离,前房注入黏弹剂复位角膜后弹力层,术后降眼压、抗炎治疗,3周后角膜后弹力层复位.

目的:了解儿童罹患青光眼的疾病类型、特点,更好地做到早期发现早期治疗.方法:收集北京同仁医院2014—2019年度834例0～18周岁住院接受抗青光眼手术的患者,回顾性分析患者的人群特点与疾病构成特点.结果:834例患者中,原发青光眼397例(47.6％),继发青光眼429例(51.4％).另有8例无法明确诊断青光眼类型.原发青光眼中以原发先天性青光眼最常见,继发青光眼中以白内障术后继发青光眼为主,两种类型的青光眼占总患者数的50％.结论:儿童罹患青光眼的疾病种类繁多,其中原发先天青光眼与白内障术后继发青光眼最常见,重视婴幼儿先天青光眼的筛查,监测儿童白内障术后眼压有助于早期发现青光眼,并给予治疗,延缓儿童青光眼患者视功能的损害.

目的 评价内窥镜下睫状体光凝(ECP)治疗儿童青光眼的长期疗效和安全性.方法 回顾性系列病例研究.收集2013年8月至2020年5月在首都医科大学附属北京同仁医院眼科中心接受内窥镜下睫状体光凝的儿童青光眼患者.观察指标包括第一次ECP手术时的年龄、青光眼类型、术前与术后最后一次随访时的视力及眼压等.采用配对t检验比较术前及术后末次随访眼压和视力.采用独立样本t检验和卡方检验比较成功组及失败组的各项临床特征.结果 22例(27眼)儿童青光眼患者纳入本研究.其中先天性白内障术后12眼,玻璃体切除视网膜复位联合硅油填充术后10眼,外伤性白内障术后2眼,先天性青光眼3眼.随访时间为6个月至6年(中位数:5年).术前眼压为37.8±8.1 mmHg,ECP平均次数为1.2±0.6次,术后末次随访眼压为22.6±9.8 mmHg,术后眼压下降幅度约40％.末次随访时,19眼眼压控制,7眼眼压失控,1眼眼球萎缩.行1次及以上ECP手术的1年,3年,5年及6年的累积成功率分别为84.4％,71.7％,71.7％,53.8％.手术成功组首次ECP范围(均值:2870)比失败组大(均值:2230).结论 ECP对治疗儿童青光眼,尤其是难治性继发性青光眼是有效的.术后眼压在药物辅助下可以长期稳定.对儿童青光眼长期乃至终身眼压随访是至关重要的.

男性61岁患者,因左眼胀痛2周就诊,眼压25 mmHg,前房浅,激光虹膜切除后散瞳检查,左眼下方及颞侧大球形隆起,伴有脉络膜脱离.眼多普勒B超、脉络膜血管造影及眼眶MRI均显示左眼球内实性占位病变.PET-CT检查示食道癌,并全身广泛转移.