Background: Severe myopia (SM) is commonly defined as a refractive error that exceeds -10.0 diopters (D). To date, however, studies focusing on visual field changes in eyes affected by SM remain scarce. The present study aims to characterize changes to central visual fields in the presence of SM among Chinese individuals and to provide evidence for enabling early diagnosis of primary open-angle glaucoma (POAG) in cases of SM. Methods: The data of 26 cases (44 eyes) involving Chinese individuals with SM were collected using a Humphrey Visual Field Analyzer 750i. The following aspects were identified: types of visual field defects in the probability map of pattern standard deviation, the features of patterns in visual field defects in four quadrants, the frequencies of scotomas, and the proportions of relative scotomas. Results: (I) Among all visual field defects, 95.45% were found to be relevant to selected ocular fundus changes; (II) the proportion of relative scotomas was 65.02%. The two major types of visual field scotomas were the enlargement of the physiologic blind spot (43.20%) and central scotoma (38.64%), while additional types included nasal step defects (18.18%), paracentral scotomas (13.64%), and temporal sector-shaped defects (9.09%). The proportions for scotomas in the four quadrants were: 38.74% (superior temporal quadrant), 25.87% (inferior temporal quadrant), 19.32% (superior nasal quadrant), and 16.07% (inferior nasal quadrant). Conclusions: (I) Visual field analysis should be conducted alongside consideration of fundus changes. The bulk of visual field defects were found to be relative scotomas. (II) Scotomas in SM patients were mainly due to the enlargement of a physiological blind spot and central scotomas, and nasal arch-shaped scotomas presented as arc-shaped damage. (III) Abnormal scotomas were detected most frequently in the inferior temporal quadrant.

Objective To investigate the time relationship of the change,and diagnostic accuracy and sensitivity between retinal light threshold fluctuations (LTF) and retinal nerve fiber layer (RNFL) and ganglion cell complex(GCC) thickness on high-risk primary open-angle glaucoma (POAG).Methods Totally 319 patients (319 eyes) with high-risk in POAG from the First Affiliated Hospital of Kunming Medical Universityand during December 2009 and December 2017,50 healthy individuals (50 eyes) as control were collected in this longitudinal cohort study.Visual field and OCT were reviewed every 6 months on the high-risk group and every 12 months on the control group.High-risk groups inclusion criteria:vertical C/D≥0.6;early visual field defect (according to glaucoma visual field damage GSS2 quantitative grading standards,mean deviation and pattern standard deviation of central field exceeds the border as an early visual field defect);continuous repeatable results.The first field and OCT results in the absence of visual field defects and C/D≥0.6,which were conformed reliability indicators and removed learning effects as a baseline.When patients achieve POAG diagnosis criteria first time which was recorded as a turning point.And they were divided into early group meanwhile were ended of follow-up.After the last follow-up,the inspection data was segmented counted in yearly interval.The changes of LTF,thickness of RNFL and GCC during the follow-up period in the early POAG group and the control group were observed.The loss rate and change rate in each period were compared for the assessment of their trends with time.Followed by calculation of the area under receiver operating curves (AUC) to compare the predicted value of POAG and the sensitivity at 95％ specificity in each period.Results After last follow-up,totally 67 patients 67 eyes (early POAG group,37 males and 30 females) were entered the turning point.The mean follow-up of the early POAG group and the control group were 6.6 and 6.4 years.The average RNFL thickness was 79.05± 8.09 μm,GCC thickness was 71.58 ± 8.41 μm,LTF was -6.05 ± 7.02 dB in early POAG group.The average RNFL thickness was 93.49± 6.24 μrm,GCC thickness was 79.72± 6.32 μm,LTF was-0.31 ± 0.58 dB in the control group.The differences of LTF and the thickness of RNFL and GCC were statistically significant (t=-5.97,-10.42,-5.60;P＜0.001).The AUC of RNFL,GCC thickness and LTF increased with time in the early POAG group.The sensitivity was gradually increased at 95％ specificity:5th year before to at turning point,RNFL thickness AUC was 0.15,0.65,0.71,0.77,0.85,0.92,and sensitivity was 20％,56％,61％,65％,70％,76％,respectively;GCC thickness AUC was 0.12,0.53,0.69,0.74,0.82,0.90,and sensitivity was 14％,53％,69％,74％,82％,90％,respectively;the AUC of LTF was 0.10,0.21,0.33,0.75,0.86,0.91,and sensitivity was 7％,17％,44％,65％,78％,87％,respectively.Conclusions The earliest time of structural functional damage of POAG is at the 4th year before confirmed,simultaneous RNFL diagnosis accuracy and sensitivity are better than GCC and LTF.The earliest time of visual functional damage of POAG is at the 2th year before confirmed,simultaneous LTF diagnosis accuracy and sensitivity are better than RNFL and GCC.

目的 探讨视网膜光阈值波动(light threshold fluctuation,LTF)在原发性开角型青光眼(primary open-angle glaucoma,POAG)高危人群中的诊断价值.方法 纵向队列分析.收集POAG高危人群319例(319眼)进行POAG筛查和随访追踪,根据随后是否被确诊为POAG分为确诊组和未确诊组,收集同期来我院体检的健康人群为对照组(50例50眼).研究对象在基线时视野、视盘显示正常,8 a的随访期内每6个月复查一次视野、OCT.当第一次出现具有可重复性的视野早期缺损迹象或视盘垂直杯盘比≥0.6时给予确诊并记录为转点.比较确诊组、未确诊组、对照组从基线到转点的视网膜LTF,探讨影响因素,计算受试者工作曲线下面积,观察随时间推移的变化规律.结果 转点时,确诊组(67眼)与未确诊组(252眼)、对照组的LTF分别为-14 ～3(-6.05±7.02)dB、-4 ～4(-0.53±2.66)dB、-3～3(-0.31±1.58)dB,三组相比差异有统计学意义(P＜0.OO1).确诊组中,LTF与视野指数、平均缺损呈负相关性,与模式标准差、垂直杯盘比呈正相关性(均为P＜0.05).在25～45岁低龄组,视野＞10°～ 20°时视网膜LTF最频繁,占64.9％.在转点前5 a、前4 a、前3 a、前2 a、前1 a及转点的受试者工作曲线下面积分别为0.10、0.21、0.32、0.75、0.86、0.91,95％可信区间敏感度分别为7％、19％、44％、65％、78％、87％.结论 视网膜LTF对POAG早期诊断具有较高价值,LTF可以作为POAG患者尚没有出现视野早期缺损迹象和垂直杯盘比扩大时的早期诊断敏感指标.对POAG高危人群密切关注视野检查的视网膜LTF,可以在POAG患者发生视野或视盘进展的前2 a识别POAG.

SIGNIFICANCE Data regarding the epidemiology of reduced visual acuity (VA) among multiethnic children and adolescents in China are few. Understanding the vision-related health inequalities among different ethnic groups is crucial for health resource allocations and clinical managements for eye diseases. PURPOSE We aim to determine the prevalence, main causes, and health inequalities of reduced VA in multiethnic school students in rural China. METHODS A school-based eye survey including 7681 multiethnic school students aged 5 to 16 years in the southwestern part of China was conducted. Detailed ocular examinations including VA measurements, ocular motility evaluations, bilateral postcycloplegic refractions, and the assessments of the external eye, anterior segment, media, and retinal fundus were carried out by trained research vision professionals. Visual acuity was measured using a logarithm of the minimum angle of resolution E-chart, and reduced VA was defined as a presenting VA of worse than 20/40. Concentration index was initiatively utilized to measure health inequalities among different ethnic groups. RESULTS The prevalence of reduced VA was 11.4 per 100 children (95% confidence interval, 10.7 to 12.1%) based on the worse-seeing eye data. The prevalence of reduced VA increased with increasing age (P < .001 for trend) and was higher among girls compared with boys (P < .0001). Uncorrected refractive error was the principal cause for reduced VA, which accounted for 87.3% of the participants with reduced VA. The concentration index for reduced VA was 0.07 among different ethnic groups. CONCLUSIONS Compared with the estimates reported from previous studies on Chinese children and adolescents, a relatively lower prevalence of reduced VA was observed among multiethnic school students in rural China. Ethnic variations and health inequalities of reduced VA were not significant in this study.

Objective: To investigate the effects of type 2 diabetes mellitus on visual field defect, retinal nerve fiber layer thickness and intraocular pressure index in patients with primary open angle glaucoma. Methods: A total of 125 patients (125 eyes) diagnosed with primary open-angle glaucoma in our hospital from April 2016 to September 2017 were enrolled as the research subjects. Patients were divided into case group (70 cases) and control group (55 cases). Patients in case group were diabetic patients combined with primary open-angle glaucoma, while the control group consisted of patients only with primary open-angle glaucoma. Mean defect of visual field, mean light sensitivity in visual field, retinal nerve fiber layer thickness and intraocular pressure index were compared between two groups. Results: Mean defect of visual field in case group was (17.26 ± 3.15 dB), which was significantly higher than that in the control group (P 0.05). Intraocular pressure of case group was (22.75 ± 2.61 mmHg), which was significantly higher than that of control group (P<0.05). Conclusion: Type 2 diabetes can increase defect area of visual field, increase intraocular pressure, reduce retinal nerve fiber layer thickness and promote the progression of the disease in patients with primary open angle glaucoma.

目的 评估原发性慢性闭角型青光眼患者SMS治疗模式("手术-药物-二次手术")和LMS治疗模式("激光周边虹膜切开术-药物-手术")的临床疗效.方法 整群连续选取2013年1月—2014年12月在该院就诊的原发性慢性闭角型青光眼患者312例原发性慢性闭角型青光眼患者(312眼),随机分为两组:A组166眼行SMS治疗模式,B组146眼行LMS治疗模式.随访12个月,比较两种治疗模式下眼压、杯/盘比值及视野的变化情况.结果 首次小梁切除术后6个月眼压控制成功率为84.9％,12个月时为80.1％;而激光周边虹膜切开术后6个月的眼压控制成功率为27.4％,12个月时为17.1％.SMS治疗模式组和LMS模式组的二次手术率分别为10.2％和42.5％,两组比较差异有统计学意义(P<0.01),随访治疗至6个月和12个月时,SMS模式和LMS治疗模式的垂直杯/盘比及视野MD值比较差异无统计学意义(P>0.05).结论 SMS模式和LMS治疗模式治疗原发性慢性闭角型青光眼1年期随访在控制视野及视神经进展方面效果相似,但从控制眼压方面SMS治疗模式的二次手术率明显低于LMS模式.

PURPOSE:The prevalence of primary open-angle glaucoma (POAG) in China has been reported previously, and was lower than that in white and black populations. However, the incidence of POAG in China has not been reported. Therefore, a longitudinal study was conducted to determine the 5-year cumulative incidence and predictors of POAG in China. DESIGN:Population-based cohort study. METHODS:A total of 1520 participants (71.3% of the subjects in the baseline survey) of Bai ethnicity were examined and followed for 5 years. Glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology Classification criteria. Multivariable logistic regression models were fitted to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS:A total of 19 new cases of POAG were detected. The 5-year cumulative incidence of POAG was 1.3% (95% CI, 0.7-1.9). In multivariate analyses, incident POAG was associated with baseline variables including increased age (OR, 4.3; 95% CI, 1.4-13.8; P = .02; 70 years or older vs 50-59 years), elevated IOP (OR, 3.5; 95% CI, 2.0-5.9; P < .001; per 10 mm Hg increase), lower education level (OR, 0.3; 95% CI, 0.1-0.8; P = .02; post-primary education vs no formal education), and the presence of myopia (OR, 3.4; 95% CI, 1.3-8.6; P < .01). CONCLUSIONS:The average annual incidence of POAG in Bai Chinese was lower than that in populations of African descent and white race. The results are important to elucidate the racial/ethnic difference in POAG incidence and for the clinical management and health resource allocation in China.

PURPOSE:We aim to assess the longitudinal association between baseline estimated cerebrospinal fluid pressure (CSFP) and 5-year incident primary open angle glaucoma (POAG) in a population-based sample of Bai Chinese living in rural China.METHODS:Among the 2133 Bai Chinese aged 50 years or older who had participated in the baseline examination of the Yunnan Minority Eye Study, 1520 (71.3%) attended the follow-up examination after five years and 1485 were at risk of developing POAG. Participants underwent comprehensive ophthalmic examinations at both baseline and follow-up surveys. CSFP in mmHg was estimated as 0.55 × body mass index (kg/m2) + 0.16 × diastolic blood pressure (mmHg)-0.18 × age (years)-1.91. Glaucoma was defined using the International Society of Geographical and Epidemiological Ophthalmology Classification criteria. Multivariate logistic regression models were established to determine the association between baseline CSFP and incident POAG.RESULTS:After a mean follow-up time of 5 years, 19 new cases of POAG were detected, with an incidence rate of 1.3% (95% confidence interval, 0.7-1.9%). In multivariate logistic regression analysis, after adjusting for age, gender, education, intraocular pressure, central corneal thickness, hypertension and diabetes, no significant associations, nor any trends, were evident between baseline estimated CSFP and incident POAG. The association between estimated CSFP per mmHg increase in baseline and 5-year incidence of POAG was also non-significant, with adjusted relative risk of 0.96 (P = 0.11) in multivariate analysis.CONCLUSIONS:This longitudinal cohort study does not support previously observed cross-sectional association between estimated CSFP and POAG in population-based studies.

We aimed to describe the ethnic variations in ocular dimensions among three ethnic groups with similar genetic ancestry from mainland of China. We included 2119 ethnic Bai, 2202 ethnic Yi and 2183 ethnic Han adults aged 50 years or older in the study. Ocular dimensions including axial length (AL), anterior chamber depth (ACD), vitreous chamber depth (VCD) and lens thickness (LT) were measured using A-scan ultrasonography. Bai Chinese had longer ALs (P < 0.001), deeper ACDs (P < 0.001) but shallower VCDs (P < 0.001) compared with the other two ethnic groups. There were no ethnic variations in LTs. Diabetes was associated with shallower ACDs and this association was stronger in Bai Chinese compared with Yi or Han Chinese (P for interaction = 0.02). Thicker lenses were associated with younger age ( P = 0.04), male gender ( P < 0.001), smoking history ( P = 0.01), alcohol intake ( P = 0.03), the presence of cataract ( P < 0.001) and the presence of diabetes ( P < 0.001). There were significant differences in ocular dimensions among different ethnic groups with small differences in genetics but large variations in cultures and lifestyles.

PURPOSE:We described the prevalence and associated factors of myopia and high myopia in school children of different ethnicities in a rural community in Yunnan province, China.METHODS:A total of 7681 (93.4%) primary and secondary school students aged 5-16 years in Mangshi participated in this study. Cycloplegic refraction was performed using an auto-refractor. Information regarding demographic factors, socioeconomic status and lifestyle-related exposures were collected using a questionnaire. Multivariate logistic regression models were fitted to estimate the risk factors for myopia and high myopia.RESULTS:The overall prevalence of myopia and high myopia was 39.1% (95% confidence interval [CI]: 38.0, 40.2) and 0.6% (95% CI: 0.4, 0.8) in this study. Myopia prevalence increased significantly with increasing age (p for trend <0.001). Girls were more likely to have myopia compared with boys (p < 0.001). In multivariate analysis, the presence of myopia was associated with increasing height (odds ratio [OR] = 1.02; 95% CI: 1.01, 1.03), computer use (OR = 1.17; 95% CI: 1.03, 1.32), having myopic father (OR = 1.56; 95% CI: 1.24, 1.94), having myopic mother (OR = 1.33; 95% CI: 1.08, 1.63), and increasing time on reading (OR = 1.18; 95% CI: 1.09, 1.28) after adjusting for age, sex and ethnicity.CONCLUSIONS:Nowadays myopia but not high myopia is prevalent among school children in rural China. Significant ethnic differences in myopia prevalence were not observed. A significant 'cohort effect' of myopia previously observed in urban cities had occurred in rural communities in China.

ABSTRACT Purpose: To determine the prevalence and associations of pterygium in a multiethnic adult population in rural China and to examine potential ethnic differences Methods: A total of 6418 adults (2133 ethnic Bai, 2130 ethnic Yi, and 2155 ethnic Han) aged 50 years or older participated in the study. Anterior segment examination was performed without pupil dilation using a slit lamp. Pterygium was defined as a raised fleshy triangular fibrovascular tissue growth of the conjunctiva encroaching onto a clear cornea. Results: Pterygium was least prevalent among adults of Yi ethnicity (29.5%) compared with Bai (39.0%, p < 0.001) or Han (39.5%, p < 0.001) ethnicities. Those of Bai ethnicity were most likely to be affected by severe pterygium (7.5%), while Yi were least likely to be affected (3.8%). Multivariate analysis revealed that increasing age (odds ratio, OR, 1.017), female sex (OR 1.53), lower educational level (OR 1.25), higher blood pressure levels (OR 1.002), and greater time spent outdoors per day (OR 1.09) were significantly associated with a higher prevalence of pterygium, while Yi ethnicity (OR 0.65, comparing Yi with Han) and wearing brimmed hats outdoors (OR 0.82) were protective factors. Conclusion: Ethnicity was significantly associated with prevalence of pterygium. Our findings may be applicable to many other countries located within the “pterygium belt” for health resource allocation among different ethnic groups.

Dai ethnicity is one of the major Chinese ethnic minorities with a population of about 1.2 million. We aimed to determine the prevalence and potential causes of visual impairment (VI) among ethnic Dai adults aged 50 years or older in a rural community in China. A population-based survey including 2163 ethnic Dai people (80.5%) was undertaken using a random cluster sampling strategy. The detailed eye examination was performed after pupil dilation by trained study ophthalmologists and optometrists. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) was measured using the Early Treatment Diabetic Retinopathy Study logMAR chart and VI was defined as a VA of less than 20/63 in the better-seeing eye. The overall prevalence of presenting blindness and low vision was 3.0% (95% CI, 2.3-3.7) and 13.3% (95% CI, 11.9-14.8), respectively. The prevalence estimates were reduced to 2.1% (95% CI, 1.5-2.8) and 6.7% (95% CI, 5.7-7.8) when BCVA was considered. Men were more likely to be affected by low vision but less likely to be blind compared with women. Cataract accounted for 62.7% of presenting low vision and 68.8% of presenting blindness, respectively. In conclusion, VI was a significant health concern in Dai Chinese in China.

To determine the prevalence, types and awareness of glaucoma in a rural community in China and to examine possible ethnic variations. The Yunnan Minority Eye Study was a multi-ethnic community-based eye survey using random cluster sampling strategies. 2133 Bai, 2205 Han and 2208 Yi Chinese aged 50 years or older participated in this study. Glaucoma including primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG) and secondary glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. The overall age-standardized prevalence of all glaucoma was 2.6

为研究不同人工光源对恒河猴(Macaca mulatta)屈光发育和眼球发育的影响.本研究随机分平均年龄为95 d的12只恒河猴为全光谱组、荧光灯组、白炽灯组、紫光灯组4组,每组3只,对其进行光照(8am～8pm),每天12h,光照前后2、4、6、8、12周分别对其眼球的屈光度、玻璃体腔深度、前房深度、眼轴长度、角膜曲率、晶体厚度等生物学参数进行重复测量,对各指标的变化趋势进行观察.采用重复测量数据的方差分析各时间点数据,有统计学意义的标准为p＜0.05.相关分析结果显示,光照前后各时间点全光谱灯组、荧光灯组、白炽灯组恒河猴的眼球屈光度、眼轴之间的差异均不显著(p＞0.05);紫光灯组恒河猴的眼球眼轴、玻璃体腔长度的增长速度、屈光度下降速度均显著慢于全光谱灯组、荧光灯组、白炽灯组(p＜0.05),但4组恒河猴光照后各时间点的晶体厚度、角膜曲率、前房深度之间的差异均不显著(p＞0.05).从这里我们可以看出,恒河猴眼轴及玻璃体腔在短波长紫光诱导下具有较慢的延长速度及正视化进程速度,短波长紫光诱导恒河猴眼轴及玻璃体腔延长减速,正视化进程减慢.全光谱灯组、荧光灯及白炽灯灯光在短期内(12周)尚未对恒河猴眼球的屈光发育产生明显影响,但是长期影响仍然需要相关医学学者进一步观察.眼球屈光发育在紫光的作用下发生改变的可能机制为视色觉通路信号对比在缺乏全面的光谱的情况下发生异常.

Objective To assess the prevalence and causes of ocular diseases in the ethnic Han, Dai, Bai and Yi populations aged 50 years or older in Yunnan Province, China. Methods Random cluster sampling strategies were adopted in a population-based and epidemiological investigation of ophthalmopathy from January 2010 to January 2015. All the subjects underwent detailed eye examinations, a general examinations and a face-to-face questionnaire interview. Ocular examinations included measurements of visual acuity (VA), direct ophthalmoscopy, intraocular pressure (IOP), slit lamp examination, fundus photography and so on other assessments. Results Of the 10 845 individuals people eligible for the Yunnan Minority Eye Study (YMES), 8 696 (80.18%) subjects participated in the study. The Prevalence was around approxiamtely 7.8% for myopia, 1.6% for high myopia in ethnic Yi;3.0% for blindness, 13.3% for visual impairment in ethnic Dai; 2.2% for glaucoma in ethnic Bai;39.5% for pterygium in ethnic Han and 4.6% for cataract surgery in ethnic Bai. Conclusion These data from the YMES project will provide key information about major causes of blinding eye diseases in the rural ethnic regions of Southwest China and which can be used for planning a reasonable distribution of medical resources and the strategies for the prevention and treatments of blindness in China.

Glaucoma, a type of optic neuropathy, is characterized by the loss of retinal ganglion cells. It remains controversial whether c-Jun N-terminal kinase (JNK) participates in the apoptosis of retinal ganglion cells in glaucoma. This study sought to explore a possible mechanism of action of JNK signaling pathway in glaucoma-induced retinal optic nerve damage. We established a mouse model of chronic ocular hypertension by reducing the aqueous humor followed by photocoagulation using the laser ignition method. Results showed significant pathological changes in the ocular tissues after the injury. Apoptosis of retinal ganglion cells increased with increased intraocular pressure, as did JNK3 mRNA expression in the retina. These data indicated that the increased expression of JNK3 mRNA was strongly associated with the increase in intraocular pressure in the retina, and correlated positively with the apoptosis of retinal ganglion cells.

PURPOSE To determine the prevalence of myopia and ocular biometry in population-based samples of ethnic Yi and Han people living in an inland rural community in China. METHODS A random cluster sampling strategy was used to select ethnic Han and Yi adults aged 50 years or older living in Yunnan. Refractive error was determined by subjective refraction and ocular biometric parameters, including axial length (AL), anterior chamber depth (ACD), vitreous chamber depth (VCD), and lens thickness (LT), which were measured using an Echoscan. RESULTS Adults of Yi ethnicity had lower prevalence of myopia (10.3% vs. 8.1%; P = 0.02) and high myopia (2.3% vs. 1.6%; P = 0.10) than their counterparts of Han ethnicity. The prevalence of myopia increased with age (P for trend < 0.05), whereas the mean AL did not differ significantly among age groups in both ethnic groups (both P for trend > 0.05). In multivariate analysis, time spent outdoors was associated with myopia (P = 0.003) and AL (P < 0.001) but not high myopia (P = 0.33). No interaction effect was detected between ethnicity and other risk factors on myopia (all P > 0.05). Adjustment for lens nuclear opacity score reduced the excess prevalence of myopia in Han ethnicity by 37.5%. CONCLUSIONS There was little evidence showing that ethnic disparities existed in the prevalence and risk factors between the major and minor ethnic groups living in the same communities in rural China. The "cohort effect" on myopia observed in many other populations was not seen in this study.

Background Hypertension is an important public health issue in China, but there are few studies examining hypertension in ethnic groups in Yunnan, China. This study, Yunnan Minority Eye Study (YMES), was initially designed to determine the prevalence and impact of eye diseases, including hypertension and diabetes mellitus. As a part of YMES, the prevalence, awareness, treatment, and control of hypertension and the associated risk factors among the Yi ethnic population in rural China are reported. Methods A population-based survey was conducted in 2012 with adult participants over 50 from rural communities in Shilin Yi Autonomous County, Yunnan Province, located in southwest China. A random cluster sampling method was used to select a representative sample. The participants’ blood pressure, height, weight, and waist circumference were measured. Hypertension was defined as mean systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of antihypertensive medications. Results A total of 2208 adults were assessed. The prevalence of hypertension was 38.5%, and the age- and gender-adjusted prevalence was 37.0%. The proportion of patients who were aware of their hypertension among those diagnosed with hypertension was 24.8%. Of those aware of having hypertension, 23.6% took antihypertensive drugs. Among all hypertensive patients, only 7.2% had controlled their hypertension (<140/90 mmHg). Risk factors for hypertension were older age, smoking, alcohol consumption, family history of high blood pressure, overweight, and obesity. Protective factors included being slim and higher education. Conclusions Hypertension was highly prevalent among this population of the Yi ethnic group in China. The ratio of awareness, treatment, and control of hypertension were considerately low. Hypertension education and screening programs in rural China are recommended to improve the health status of this population.

目的 探讨特发性脱髓鞘性视神经炎(IDON)患者视盘周视网膜神经纤维层(RNFL)厚度与视野缺损变化的关系,评估结构损害与视功能损害和恢复的相关性.方法 前瞻性对入院诊断为单眼IDON的65例患者的患眼和对侧眼,分别在糖皮质激素冲击与序贯治疗前和治疗后3、6、12个月进行Humphrey视野计标准自动视野检查,相干光断层扫描(OCT)视盘周各位点方向的RNFL厚度.将视野缺损计分与不同位点神经纤维层厚度分别进行对比,研究IDON患者结构和功能损害的特点,同时将结构与功能损害进行相关性分析.结果 ①治疗前患眼与对侧眼平均RNFL厚度组间差异无统计学意义(P =0.759),发病后3、6、12个月,患眼的平均RNFL及上、下、鼻、颞侧RNFL均进行性变薄(P＜0.05),而对侧眼的RNFL未见显著改变(P＞0.05).随访12个月后,患眼各钟点位出现RNFL受损比例不同,以视盘的上、下极纤维束区受损最为严重.②患眼视野计分在治疗前与治疗后3、6、12个月相比,差异有统计学意义(P＜0.05);而随访的3、6、12个月间差异无统计学意义(P＞0.05).③随访3、6、12个月的视野计分与下方RNFL厚度呈负相关(P＜0.05);6、12个月视野计分与平均RNFL呈负相关(P＜0.05);12个月时视野计分与上方RNFL呈负相关(P＜0.05).视野计分与鼻侧和颞侧RNFL变化均无相关性(P＞0.05).12个月后,视野计分与12、1、5、6、7的5个钟点位呈负相关(P＜0.05),其余各钟点位与视野计分无相关性(P＞0.05).视盘与视野损害在早期具有较高的一致性.④按照Garway-Heath视盘与视野分区对应关系,12个月时视盘与视野损害较一致性的区域以第Ⅵ和第Ⅰ区最多见,其次是第Ⅱ和第Ⅲ区,视野损害在乳斑束对应区及早期发生损害的区域有明显改善.结论 ①IDON患者在发病后RNFL进行性变薄,尤以3个月内变薄最明显,视盘上、下极偏颞侧最先出现可检测的RNFL损害,且下极先于上极出现损害,而视野的损害以中心暗点及偏上方的缺损为早发.RNFL的损害与视野缺损以神经纤维束性损害为主,两者损害存在结构-功能的良好对应关系.②治疗后视野可有幅度逐渐变小的改善,以3个月内最为明显.虽然RNFL在进一步变薄,但到12个月时视野改善幅度最大的区域可见于乳斑束对应区及早期发生视野改变的区域.

Purpose:To determine the 5-year cumulative incidence of pterygium and its associated predictors in the Bai Chinese population in a rural community.Methods:This population-based study included 2133 subjects aged 50 years or older in 2010 and was repeated in 2015 with 1520 subjects (71.3%) participating in the follow-up examination. Participants with pterygium in either eye in 2010 were excluded from the analysis related to incidence. Anterior segment examination was performed without pupil dilation using a slit lamp, and pterygium was defined as a raised fleshy triangular fibrovascular tissue growth of the conjunctiva encroaching onto the clear cornea.Results:The 5-year cumulative incidence of pterygium was 6.8% [95% confidence interval (CI), 5.2-8.4] and was significantly higher in women compared with men (8.8% vs. 3.8%; P = 0.003). The age-specific incidence was 7.7%, 6.5%, and 5.6% in those aged 50-59, 60-69, 70 years, or older at the baseline, respectively. Outdoor occupation was the only predictor, which remained to be significantly associated with a higher incidence of pterygium in multivariate analysis (odds ratio = 2.52, 95% CI, 1.27-4.95). The predictive effect of outdoor occupation on incident pterygium was moderate with an area under the curve in the receiver operating characteristic analysis of 0.59 (95% CI, 0.53-0.66).Conclusions:The incidence of pterygium in this rural cohort was higher compared to a previous report in Chinese in urban areas. The findings are important for health policy makers to project future burden of pterygium and make proper decisions on health resource allocation.