AIMS:To evaluate the efficacy and safety of intravitreal triamcinolone acetonide (TA) injection at the end of emergency surgery for open globe injury (OGI) to suppress traumatic proliferative vitreoretinopathy (TPVR). METHODS:A single-centre, participant-masked, prospective, randomised controlled clinical trial. A total of 68 globe rupture patients with zone III were randomised to the control group (n=34) or the TA group (n=34) in 1:1 allocation ratio. Patients were treated with 0.1 mL TA in the TA group and 0.1 mL balanced salt solution in the control group at the end of emergency surgery. The primary outcome was the assessment of TPVR during vitrectomy 10±3 days later. Secondary outcomes included visual acuity (VA), retinal attachment rate, macular attachment rate, proliferative vitreoretinopathy (PVR) recurrent rate, side effects 6 months after vitrectomy. RESULTS:During vitrectomy, the TPVR grade of the control group was significantly more severe than the TA group (p=0.028). The TPVR score was significantly better in the TA group (9.30±0.82) than in the control group (6.44±1.06) (p=0.036). The final VA improved in 23 eyes (92%) in the TA group and in 14 eyes (63.64%) in the control group (p=0.008). The retinal attachment rates were 88% and 63.64% in the TA and control group, respectively (p=0.049). The two groups showed no significant difference in macular repositioning and PVR recurrent rate (p=0.215, 0.191). Temporary intraocular pressure elevation occurred in one eye in the TA group after emergency surgery. CONCLUSIONS:Early intravitreal TA injection for OGI effectively reduces TPVR, increases surgical success and improves visual prognosis.

Primary angle closure glaucoma(PACG)is the leading type of glaucoma in Asia, especially in China. PACG still has a high proportion of angle closure after laser peripheral iridectomy(LPI). Plateau iris is one of the non-pupillary blockage factors that cause angle closure. With the wide application of ultrasound biomicroscopy(UBM)in ophthalmology, the understanding of plateau iris has been deepened continually. This paper will elaborate the concept, mechanism, prevalence, relationship with angle closure, diagnostic criteria and the treatment of plateau iris, aiming to have a deeper understanding of the relationship between plateau iris and PACG, and to provide references for the treatment and research of PACG in the future.

Background Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM2.5) on AMD. Methods Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants’ home addresses by latitude and longitude. Participants’ individual PM2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM2.5 on AMD. Results The prevalence of AMD in the study population was 2.6% (95% CI 2.42–2.76%). The average annual PM2.5 level during the study period was 63.1 ± 15.3 µg/m3. A significant positive association was detected between AMD and PM2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM2.5 and atmospheric pressure. Conclusions This study is among the first to characterize the coordinated effects of meteorological factors and PM2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00237.

China faces increasing health risks from climate change. The structure and function of the eye and vision were affected by extreme heat and cold. The study aimed to evaluate the impacts of heatwaves and cold spells on glaucoma. A national cross-sectional study of the Rural Epidemiology for Glaucoma (REG-China) was conducted in ten provinces of China, and 36,081 adults aged 40 years or more were included. Glaucoma signs were assessed via a standard examination. A total of 15 heatwave definitions, based on intensity (95th to 99th percentiles of temperature distribution) and duration (≥2 days, 3 days, and 4 days), were used to quantify heatwave effects, and 6 cold spell definitions were defined based on threshold temperature percentile (5th and 10th) and duration (3 days, 5 days, and 9 days). Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the impacts of heatwaves and cold spells on glaucoma, and the dose-response relationships were assessed using a restricted cubic spline (RCS) model. Subgroup analysis was conducted stratified by gender, age, smoking status, occupation, and family history of glaucoma. The overall prevalence of glaucoma was 2.1% (95% CI 1.94-2.25%). Higher heatwaves were significantly correlated with higher OR of glaucoma, with the OR (95% CI) ranging from 1.014 (1.009, 1.018) to 1.090 (1.065, 1.115) by different definitions. Glaucoma was affected by heatwaves more strongly than by cold spells. The effects of both heatwaves and cold spells were higher in males than females and in smokers than nonsmokers. These results of the present study evoked the attention of prospective research to elucidate the relationship between extreme temperatures and eye diseases.

ObjectiveThis study aimed to investigate the prevalence of glaucoma with associated factors in the rural populations of 10 provinces in China.DesignA population-based cross-sectional study.MethodsAll participants aged 6 years or older from 10 provinces completed visual acuity testing, slit-lamp examination, ophthalmoscopy and non-contact tonometry. Glaucoma suspects underwent fundus photography, Goldmann applanation tonometry, visual field testing and gonioscopy. Glaucoma was determined according to the International Society of Geographical and Epidemiological Ophthalmology classification scheme. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models.ResultsFrom June 2017 to October 2018, 48 398 of 52 041 participants were included in the final analyses. The age-standardised prevalence of glaucoma was 1.7% (95% CI 1.55% to 1.78%) among the participants older than 6 years, which was 2.1% (95% CI 1.93% to 2.23%) in participants aged over 40 years. The constituent ratios of glaucoma were: 44.4% primary angle-closure glaucoma (PACG), 34.7% primary open-angle glaucoma, 2.6% congenital glaucoma and 18.3% other types of glaucoma. Increasing age, smoking, cerebral stroke, type 2 diabetes, higher education (college or more) and higher personal income were significant risk factors for PACG. The unilateral and bilateral blindness rates in the entire study population were 4.692% and 1.068%, respectively. A family history of glaucoma was a significant risk factor for the prevalence of glaucoma and blindness in at least one eye.ConclusionsRural populations have a high prevalence of glaucoma, which should be included in chronic disease management programmes in China for long-term care.

BACKGROUND:A growing body of evidence has confirmed the association between fine particulate matter (PM2.5) and ocular diseases, but little is known on the effect of long-term PM2.5 exposure on glaucoma. METHODS:A national cross-sectional study of the Rural Epidemiology for Glaucoma was conducted in 10 provinces of China, and 33,701 adults aged 40 years or more were included. A satellite-based model at 1-km resolution level was used to estimate PM2.5 concentrations which were assigned to each participant according to geocoded home addresses. Logistic regression model was performed to investigate associations of long-term PM2.5 exposure with glaucoma and its subtypes. RESULTS:Estimated PM2.5 concentrations ranged from 28.0 to 96.4 μg/m3. For each 10 μg/m3 increment in PM2.5, the adjusted odds ratios (ORs) were 1.07 (95% CI: 1.00-1.15) and 1.14 (95% CI: 1.02-1.26) for glaucoma and primary angle-closure glaucoma (PACG), respectively. A positive but non-significant association (OR = 1.05, 95% CI: 0.92-1.18) was detected between long-term exposure to PM2.5 and odds of primary open-angle glaucoma. The middle aged residents and non-smokers were more sensitive to the adverse effects of PM2.5. CONCLUSIONS:Long-term PM2.5 exposure was associated with glaucoma and PACG in Chinese adults, which provided new insights on adverse ophthalmic effect of PM2.5.

Background Vision health is an important aspect of health worldwide. Visual impairment (VI) is associated with poor quality of life and is usually more prevalent in rural areas. To help rural populations obtain vision care, health insurance policies have emerged throughout the world. However, some existing literatures show that health insurance enrollment’s impact on the overall physical health of rural population has been minimal. Focusing on vision health among adults in rural China, our study aims to investigates the impact of health insurance on vision health, heterogeneity of the effect, and the moderating effect of health insurance enrollment on the impact of chronic physical diseases and basic eye diseases on vision health. Methods Primary data were collected through a nation-wide epidemiological survey of vision health conducted in rural China in 2018, with a sample size of 28,787 used in our statistical analysis. Instrumental variables regression and Heckman selection models were conducted to examine the impact of health insurance enrollment and reimbursement ratio adults’ vision health outcomes. Subsample regressions by sex, age, education level, and whether with eye diseases were further conducted to explore the heterogeneity in our results. We then examined whether health insurance enrollment moderates the impact of chronic physical diseases and basic eye diseases on vision health through the method of introducing interaction terms. Results Participating in health insurance reduced the probability of VI by 2.15 %. The reimbursement rate increasing by 1 % point may reduce the probability of worsening VI by 6.12 %. Men (-0.0235, P = 0.0002) benefit more from insurance enrollment than women (-0.0201, P = 0.0082) with respect to vision health. From the young adult group to the oldest group, the marginal effect of health insurance increased from − 0.0068 ( P = 0.0394) to -0.0753 ( P < 0.0001). The marginal effect on VI was most significant in people with lower education levels and weakened with increased education levels. People with basic eye diseases (-0.0496, P = 0.0033) benefit more from participating insurance than the people without basic eye diseases (-0.0196, P = 0.0001) with respect to vision health. The moderating effects of health insurance enrollment on the impacts of cerebral infarction (-0.1225, P < 0.0001), diabetes (-0.0398, P = 0.0245), hyperlipidemia (-0.1364, P = 0.0271), mental illness (-0.1873, P = 0.0010), glaucoma (-0.1369, P = 0.0073), diabetic retinopathy (-0.1560, P = 0.0043), and retinal vein obstruction (-0.2018, P = 0.0155) on vision health were significantly negative. Conclusions The results suggest that participation in health insurance and higher health insurance reimbursement ratios reduced the risk of VI in the sampled adults. Health insurance has the most significant effect in in vulnerable groups. Heath insurance enrollment moderates the impacts of several chronic physical and basic eye conditions on vision health. Our findings have potential implications for reforming health insurance policies to improve vision health conditions in rural areas of developing countries.

Background: While the relationship between ambient air pollution and diabetes mellitus has recently been reported, data on the association between fine particulate matter (PM2.5) and diabetic complications are limited, especially in microvascular diseases such as diabetic retinopathy. Objectives: To investigate the associations between long-term exposure to PM2.5 and the prevalence of diabetic retinopathy in adult diabetic patients in rural China. Methods: The study population was based on the Rural Epidemiology for Glaucoma in China (REG-China), a national cross-sectional survey conducted in rural China. This analysis selected diabetic patients with or without diabetic retinopathy. A satellite-based spatiotemporal model was used to estimate personal PM2.5 exposure. Logistic regression models were used to investigate the effect of long-term PM2.5 exposure on diabetic retinopathy. Results: The analysis included 3111 diabetic participants, 329 of whom were diagnosed with diabetic retinopathy. The median level of exposure to PM2.5 from 2000 to2016 was 59.9 mu g/m3. For each 10 mu g/m3 increase in PM2.5, the adjusted odds ratio (95% confidence interval) for diabetic retinopathy was 1.41 (1.27, 1.57). In subgroup analyses, the effect of PM2.5 on diabetic retinopathy was significantly stronger in participants who selfreported alcohol consumption. Conclusion: These findings suggest that long-term exposure to high PM2.5 was associated with the risk of diabetic retinopathy among diabetic patients in rural China.

Background: Glaucoma is the commonest cause of irreversible blindness worldwide. The Rural Epidemiology for Glaucoma in China (REG-China) was conducted to investigate the present status of glaucoma in rural China. Methods: The REG-China Study is a cross-sectional study in a nationally representative sample of population aged 6 years or older from ten provinces, autonomous regions, and municipalities in rural areas of China. All participants underwent a comprehensive eye examination, including visual acuity, intraocular pressure, slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Findings: From June to October 2018, 52 041 individuals were invited to participate, of whom 48 398 were included in the final analysis. The overall prevalence of glaucoma was 1·6% (95% CI 1·52–1·77) among the population aged 6 years or older. The prevalence of all types of glaucoma in persons aged 40 years or older was 2·0% (95% CI 1·96–2·85); 58·2%, and 19·8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, marital status, history of cerebral infarction, location areas and family history of glaucoma were significant risk factors for both PACG and POAG. The overall blindness rate of glaucoma was 31·1% (95% CI 25·91%-34·82%). Those who were older, men, and divorced/separated were more likely to become blindness due to glaucoma. Interpretation: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. Funding Statement: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030). Declaration of Interests: The authors declare there are no competing interests. Ethics Approval Statement: The study protocol was approved by the ethics review committee of Tianjin Medical University and other participating institutes. We obtained written informed consent from all study participants.

BACKGROUND: Glaucoma is the commonest cause of irreversible blindness worldwide. Factors associated with the development of glaucoma have been examined in several studies, but not in the Chinese rural population. The China Rural Glaucoma Cohort Study (China-RG Study) was conducted to investigate the present status of glaucoma in China. METHODS: The China-RG Study is a population-based study (June–October 2018) that included 22 rural areas from ten provinces in China and enrolled 52,041 individuals (age >6 years). Participants completed a comprehensive eye examination, including visual acuity, intraocular pressure (IOP), slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models. Disability (YLD) and quality-adjusted life-years (QALYs) were used to express adverse health outcomes of glaucoma; cost-effectiveness analysis was conducted to evaluate the superiority of glaucoma-screening program. FINDINGS: Overall prevalence of glaucoma was 1.6% (95% CI 1.52–1.77%); 58.2%, and 19.8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, history of cerebral infarction, marital status, location, and family history of glaucoma were significant risk factors for both PACG and POAG. Cost–benefit analysis indicated savings of approximately 286,56.57 million yuan in direct medical expenses nationwide by adopting the proposed screening mode. INTERPRETATION: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. The scope and inclusions of basic public health services should be expanded, especially to include ophthalmic diseases. FUNDING STATEMENT: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030)DECLARATION OF INTERESTS: The authors declare there are no competing interests.ETHICS APPROVAL STATEMENT: Ethics approval for study conduct was obtained from the institutional ethics committee of Tianjin Medical University General Hospital; all participants provided written informed consent prior to study participation.

Vision is mainly limited to the optics of the eye through the anatomy and physiology of the visual system. In this way, vision acuity may be a key clinical measure to show the integrity of visual pathway optical and physiological states of the eyes. Each patient must first have a routine examination of the vision acuity, regardless of the initial visit or follow-up visit. The central vision is the main sign of visual function, especially the far sight, which needs more attention. Whenever possible to use standard visual acuity chart (Snellen, ETDRS): A set of letter is set up, each letter as an integrity which is five times as large as each stroke; for patients who cannot read should use the none text chart (such as E, Landolt C) which is based on the same principles of the Snellen chart; for kindergarten children, use Allen cards, HOTV letters, or E games; for babies, use color objects, toys, or flashlights to determine vision by fixing or following objects.

Purpose: To investigate the correlations between intraocular pressure (IOP) and circulating endothelial progenitor cells (EPCs), retinal ganglion cells (RGC) apoptosis and EPCs, and explore the possible role of EPCs in the elevated IOP-induced RGC apoptosis.Materials and methods: A rat model of IOP elevation was induced by photocoagulation of the limbus vein and episcleral veins using a 532-nm green laser. Twenty rats were randomly assigned to normal control (NC) group, 30 rats were randomly assigned to sham-treated control (STC) group and 50 rats were randomly assigned to laser-treated (LT) group. The IOPs were measured with a Tono-pen XL tonometer. Hematoxylin-eosin staining was performed to observe the effects of IOP elevation on the structure of retina. Retinal apoptotic cells were determined by in situ TUNEL staining, and peripheral blood EPCs (CD34(+)/CD133(+)) were detected by flow cytometry.Results: Compared with the NC group (9.9 +/- 1.2 mmHg), the IOPs in the LT group were 37.4 +/- 1.5, 31.8 +/- 4.1, 25.9 +/- 2.2, 23.1 +/- 3.6 and 22.4 +/- 3.0 mmHg on the third day, seventh day, third week, second month and third month, respectively, after the laser photocoagulation. There were significant differences in IOPs between the groups at the different time points (F = 110.02, p<0.001). TUNEL analysis showed that only few apoptotic RGCs were found on the third and the seventh day after the laser treatment, and then many more apoptotic RGCs were found beginning on the third week after the laser treatment. The EPC counts were 121.3 +/- 22.4, 81.3 +/- 23.7, 46.1 +/- 15.8, 54.4 +/- 19.1 and 54.7 +/- 15.9 /2 x 10(5) mononuclear cells (MNCs) on the third day, seventh day, third week, second month and third month, respectively, after the laser photocoagulation, compared with the NC group (62.1 +/- 13.1)/2 x 10(5) MNCs. There were significant differences in EPC counts between the groups at the different time points (F = 22.09, p<0.001).Conclusions: Elevated IOP-induced RGC apoptosis is associated with the reduced circulating EPC counts.

OBJECTIVE To compare the intraocular pressure (IOP) lowering effect of 0.004% travoprost and 2% carteolol in patients with ocular hypertension (OHT) after laser peripheral iridotomy (LPI) or trabeculectomy in primary angle-closure glaucoma (PACG). METHODS Clinical case control trial. 52 consecutive PACG patients (52 eyes) with IOP > 21 mm Hg (1 mm Hg = 0.133 kPa) after LPI or trabeculectomy were enrolled. 24 patients received topical application of 0.004% travoprost (once daily) and 28 received 2% carteolol (twice daily). IOP lowering effect of travoprost and carteolol before and after treatment was measured by Goldmann tonometer and compared using t-test. The relationship of IOP lowering effect and the degree of angle open was performed by gonioscope and analyzed using Spearman rank correlation. RESULTS Compared with pre-treatment, the IOP was significantly reduced in 24 patients (24 eyes) in 0.004% travoprost group [pre-treatment: (24.67 ± 3.08) mm Hg, post-treatment: (18.58 ± 2.71) mm Hg; t = 6.600, P < 0.05], while significantly reduced in 28 patients (28 eyes) received 2% carteolol [pre-treatment: (23.57 ± 1.60) mm Hg, post-treatment: (19.57 ± 1.60) mm Hg; t = 5.130, P < 0.05]. 0.004% travoprost group is more significant in both quantity and percentage of IOP lowering than 2% carteolol (t = 2.533, 2.532; P < 0.05). There was no correlation between the IOP lowering effect and the degree of angle open in both groups (0.004% travoprost r = 0.145, 0.009; P > 0.05; 2% carteolol r = 0.090, 0.183, P > 0.05). CONCLUSIONS Both of 0.004% travoprost and 2% carteolol reduce IOP in patients with OHT after LPI or trabeculectomy in PACG. 0.004% travoprost is more effective than 2% carteolol in IOP lowering. However, the decrease of IOP is not acted through the alteration of anterior chamber angle in both study groups.

Background Laser peripheral iridotomy(LPI) can break the pupillary block,and is an effective method of treating acute primary angle closure (APAC).However,a part of APAC eyes may gradually develop a formation and extension of peripheral anterior synechia(PAS) and increased intraocular pressure(IOP) after LPI.Objective To investigate the relationship between appositional angle closure and darkroom provocative test(DRPT) in the fellow eyes with APAC after LPI. Methods Fellow eyes of APAC without PAS after LPI were studied.Ultrasounic biomicroscopy(UBM) were performed in darkness to observe whether appositional angle closure occurred and compare the relationship between the quadrants with appositional angle closure and the results of DRPT.Results Fifty-four patients were included in the study.Appositional angle closure was observed in at least one quadrant in 20(37.0％ ) of the 54 fellow eyes with APAC after LPI.Fifty-one patients were given DRPT and positive result in 9 patients( 17.6％ ).According to the quadrants with appositional angle closure,there were 5 patients with DRPT positive results in 46 patients with appositional angle closure 0 to 2 quadrants,and 4 patients with DRPT positive results in 5 patients with appositional angle closure 3 to 4 quadrants ( P =0.003 ).Bivariate correlation analysis indicated a positive correlation between the value of the increased IOP in DRPT and the number of quadrants with appositional angle closure in darkness( r =0.397,P =0.004). Conclusions A certain proportional fellow eyes of APAC appeared appositional angle closure in darkness and DRPT positive result after LPI.The more the quadrants of appositional angle closure after LPI,the greater the likelihood of a positive DRPT.It suggests that the APAC fellow eyes and attack eyes with the same anatomical configuration still have the possibility of angle closure after LPI,and need follow-up and treatment for a long time.

Background The circulating endothelial progenitor cells (EPCs)play an important role in postnatal vasculogenesis and restoration of endothelial injury.Previous investigation illustrated that a reduced ocular blood flow and vascular dysfunction caused by endothelial dysfunction plays a role in the pathogenesis of glaucoma.However,endothelial system accommodation is accomplished with the circulating EPCs. Objective The present trail was to investigate EPCs change in patients with primary acute angle-closure glaucoma (PACG)and explore the role of EPCs in the pathogenesis of PACG. Methods A prospective cohort study was designed.Thirty patients with PACG were enrolled in Tianjin Medical University General Hospital as PACG group,and 20 normal subjects served as control group.Periphery blood samples were obtained from all the patients and then stained with saturating concentrations of monoclonal antibodies,FITC-conjugated anti-CD34 and CD133 mAb.EPCs identified by CD34,CD133 were enumerated by flow cytometry,and the correlation between EPCs change and its relative factors was analyzed.Informed consent was obtained from each subject before any medical procedure. Results No significant differences were found in age,gender,vascular-related risk factor,blood biochemical indicators between PACG group and normal contol group(P＞0.05 ),but a higher intraocular pressure( IOP)was displayed in PACG group compared with normal control group ( P =0.00 ).The numbers of EPCs were ( 48 ± 22 ) cells/ml in PACG group and ( 65 ± 20 )cells/ml in normal control group with a significant difference between them (P=0.004).In PACG group,the numbers of EPCs were(60± 19 )cells/ml and (34 ±7 )cells/ml respeetively in phase 1 and phase 3 of optical nerve damage (Z=-3.015,P=0.002 ).There was a negative correlation between EPCs numbers and baseline IOP within a certain range( r=-0.835,P＜0.05 ).However,no obvious correlations were seen between EPCs numbers and blood lipid Level,blood glucose level or glaucoma course ( r =0.343,P =0.227 ; r =-0.203,P =0.419 ; r =0.198,P =0.610 ).The EPCs numbers in PACG patients with cardiovascular disease were(56±22)cells/ml and that of without PACG were (35± 15 ) cells/ml( P =0.005 ). Conclusions The numbers of EPCs decrease in PACG patient.These results imply that EPCs might play role during the restore of the optical nerve damage in PACG eye.

有研究表明,视神经损伤可以引起视网膜干细胞标志物表达增多[1,2].为进一步了解视神经损伤激活视网膜干细胞情况,我们应用液压冲击颅脑损伤仪(FPI)建立视神经损伤动物模型.观察胚胎视网膜十细胞同源转录因子(Chx10)和神经干细胞标志物巢蛋白(nestin)的表达,现将结果报道如下. 1 材料和方法

患者女,54岁.因头痛9 d伴左眼视力下降3 d,右眼视力下降1 d就诊.患者9 d前无明显诱因出现搏动性头痛,就诊于某神经科专科医院,MRI检查结果显示,小脑扁桃体下疝<5 mm,伴脊髓空洞,给予降压治疗未见明显好转;3 d前出现双眼肿胀,左眼视力下降,1 d前右眼视力下降就诊于外院,检查见双眼前房浅,右眼眼压15.8 mm Hg(1 mm Hg=0.1 66kPa),左眼眼压37.7 mm Hg,诊断为急性闭角型青光眼急性发作,给予口服醋甲唑胺,毛果芸香碱点眼,未见缓解,于2010年1月8 日到我院就诊.

Objective:To explore the prevalence of primary glaucoma in 1 592 over 40 years old persons in a University in Tianjin.Methods:Cases and family histories of glaucoma were taken.Shallow anterior chambers were determined by hand-holding slit lamp microscope.Glaucomatous cup were assessed by ophthalmoscope according to ISNT rule combined with Spaeth DDSL.Tomometry,gonioscopy,perimetry and UBM were performed in suspect cases.Results:The incidence of primary glaucoma was 3.53% in people older 40 years in University which included 17 cases of POAG,and 39 cases of PACG included 31 cases of chronic angle closure glaucoma.The ratio of POAG vs PACG was 0.43.Conclusion:There is an increasing trend in the incidence of primary glaucoma and the ratio of POAG vs PACG in China.

PURPOSE:To investigate the frequency of appositional angle closure and related anatomic characteristics in fellow eyes of Chinese subjects with acute primary angle closure (APAC) after laser peripheral iridotomy (LPI). DESIGN:Cross-sectional study. PARTICIPANTS:Consecutive subjects with APAC presenting from April 2006 to September 2006 at the Glaucoma Service of Peking University Eye Center, Peking University Third Hospital. METHODS:Under dark conditions, fellow eyes were divided into 2 groups based on the detection of appositional angle closure by ultrasound biomicroscopy (UBM). For all subjects, UBM parameters were measured to evaluate the different anatomic features between the 2 groups. Darkroom provocative tests (DRPTs) and gonioscopy were performed to investigate the relationship between angle closure and intraocular pressure. MAIN OUTCOME MEASURES:Central anterior chamber depth (ACD); angle opening distance(500) (AOD(500)); angle recess area(750) (ARA(750)); trabecular-iris angle (T-I angle); trabecular-ciliary process distance (TCPD); peripheral iris thickness (IT(1)); iris-zonule distance (IZD); and the position of the iris insertion. RESULTS:Thirty-four post-LPI fellow eyes of 34 patients with APAC (8 men, 26 women; mean +/- standard deviation age 66.3+/-7.2 years, range 54-83) were included. Peripheral anterior synechiae (PAS) were not observed in any subject. Appositional angle closure was observed in at least 1 quadrant in 13 (38.2%) of the 34 patients. Compared with eyes without appositional closure, eyes with appositional closure showed significantly lower AOD(500), ARA(750), and T-I angle in 4 quadrants; shorter TCPD in the inferior and temporal quadrants; and thicker IT(1) in the superior and nasal quadrants (P<0.05). The DRPT results were positive in 3 (11.1%) of 27 eyes with appositional closure in 0 to 2 quadrants and in 3 (75.0%) of 4 eyes with appositional closure in 3 to 4 quadrants (P = 0.0164). CONCLUSIONS:Under dark conditions, more than one third of fellow eyes of APAC showed appositional angle closure after LPI. The anatomic findings indicate a narrower angle, a more anterior position of the ciliary body, and a thicker peripheral iris in fellow eyes of APAC after LPI may be associated with an increased risk for progressive angle closure.