AIM:To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma (JOAG) caused by the Pro370Leu myocilin (MYOC) mutation.METHODS: Fifteen members of a three-generation Chinese family with JOAG were recruited to this study. They all underwent ophthalmic common examinations. Patients suspected to have JOAG got an assessment of visual field and optical coherence tomography. Intraocular pressures (IOPs) of four patients were measured at 8, 10, 12, 14, 17 o’clock respectively after using anti-glaucoma drugs. Mutation screening of all MYOC gene coding exons of the participants was performed by using direct sequencing of PCR products.RESULTS: Clinical examinations and pedigree analysis revealed eight family members were suffered from JOAG. Apparent genetics anticipation phenomenon was observed in this family. Their clinical features included elevated IOP of 35-55mmHg, loss of visual field, thinning of retinal nerve fiber layer, and glaucomatous optic disc damage. Noticeably, their intraocular pressure levels could be controlled within normal range at 8 and 10 o’clock by anti-glaucoma drugs,but their IOPs would elevate >21mmHg after 12 o’clock. Seven patients received trabeculectomy produced thin-walled, pale, and saccate filtering blebs maintaining lower intraocular pressure efficiently. Mutation screening indentified a heterozygous C→T missense mutation in the MYOC gene at position 1 109 in exon 3, corresponding to a substitution of a highly conserved proline to leucine at codon 370 in the olfactomedin domain of MYOC.CONCLUSION: The clinical characteristics of JOAG in this family were 1) genetics anticipation; 2) high IOP; 3) temporay response to anti-glaucoma drugs; 4) filtering surgery produced thin-walled and saccate filtering blebs, helping maintain lower IOP.

Background Reducing ocular surface toxicity induced by topical antiglaucoma medications,and thus improving the therapeutic compliance of glaucomatous patients to treating drug become an urgent issue in the long-term antiglaucomatous therapies.Whether polyethylene glycol,a new type of artificial tear,can play a protective role from ocular surface toxicity induced by topical antiglaucoma medications remains further study.Objective The present study was to investigate the protective effect of polyethylene glycol on ocular surface toxicity induced by prolonged use of benzalkonium chloride-preserved latanoprost eye drops.Methods Thirty adult female New Zealand rabbits were randomly divided into normal control group,phosphate buffer solution (PBS) group and polyethylene glycol eye drops group.PBS with 0.005％ latanoprost was topically administered for consequent 60 days in the PBS group,and 0.005％ latanoprost with polyethylene glycol eye drops was used at the same way in the polyethylene glycol group.Schirmer Ⅰ test,fluorescein and rose bengal staining of cornea and conjunctiva,conjunctiva impression cytology specimens collecting were performed before experiment as well as 31 and 61 days after administration of drug.Histomorphological and ultrastructural changes of cornea and conjunctiva were observed under the light microscopy,scanning and transmission electron microscopy on day 61.Results The score of corneal fluorescine staining was significantly different among the control group,PBS group and polyethylene glycol group (H =25.265,P＜0.001 ;H=29.426,P＜0.001) on day 31 and day 61.Significant difference also was found in the score of rose bengal staining of cornea and conjunctiva (H=26.167,P＜0.001 ;H =29.212,P＜0.001),Schirmer Ⅰ test value (F=4.746,P＜0.05) and conjunctival goblet cell density (F=18.055,P＜0.001).Compared with the control group,corneal fluorescein scores [0(0,1.0) vs.3 (2.0,3.0)] and rose bengal scores [0(0,1) vs.2(2,3)] were significantly increased (both P＜0.001),and Schirmer Ⅰ test value scores and conjunctival goblet cell density were decreased ((5.18±0.46/)mm vs.(9.43±0.57)mm;(53.04±2.98)/HP vs.(87.73±2.34)/HP) (both P＜0.01)on day 61.Impaired microvilli and organelles of the corneal and conjunctival epithelial cells were observed.Compared with PBS-treated group,PEG-treated group showed decrease in fluorescein [3(2.0,3.0) vs.1 (0.5,1.0)] and rose bengal scores [2 (2,3) vs.1 (0,1)] (both P＜0.001),increase in Schirmer Ⅰ test value scores [(7.00±0.71)mm vs.(5.18±0.46) mm,P＜0.05],increase in goblet cell density ((63.88±3.32)/HP vs.(53.04±2.98)/HP,P＜0.05) and improvement of grading scores of conjunctival epithelium on day 61.In addition,complete mierovilli and cell organelles were found in the corneal and conjunctival epithelial cells in the polyethylene glycol group.Conclusions Topical application of polyethylene glycol can decrease the ocular surface toxicity induced by benzalkonium chloride-preserved latanoprost.

OBJECTIVE:To investigate the protective effects of sodium hyaluronate on ocular surface toxicity induced by a prolonged use of benzalkonium chloride-preserved Brimonidine eye drops.METHODS:Experimental study. Thirty adult female New Zealand rabbits were divided into three groups with randomized numbers design. Ten rabbits were treated with 0.2% Brimonidine eye drops and PBS (PBS group), the other ten rabbits with 0.2% Brimonidine combined with sodium hyaluronate eye drops (SH group), and control group received no treatment for 60 days. Schirmer test, fluorescein (FL) and Rose Bengal (RB) staining, conjunctival impression cytology specimens collecting were performed on day 0, 31, and 61. Apoptosis of conjunctival epithelium was detected by in situ terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay on day 61. Conjunctival inflammation was observed by hematoxylin eosin staining. Histomorphological changes of cornea and conjunctiva were observed by light microscopy, and scanning and transmission electron microscopy at day 61. Fluorescein and Rose Bengal scores were analysed by Kruskal-Wallis test. Schirmer scores, goblet cell density and inflammatory cells infiltration were analysed by repeated measures analysis of variance.RESULTS:There were significant differences in fluorescein and Rose bengal (H = 22.031, 15.303, P < 0.01) staining among the groups on day 61. Compared with the control group (FL: 0, 0-1, RB: 0, 0-1), fluorescein and Rose Bengal scores were significantly (P < 0.001) increased in PBS group (FL: 1.5, 1-2, RB: 1, 1-2), whereas was significantly (P < 0.001) decreased in SH group (FL:0, 0-1 RB:1, 0-1) when compared to PBS group. There were significant differences in aqueous tear production and goblet cell density (F = 7.980, 14.545, both P < 0.01) among the groups on day 61. Compared with the control group [(9.43 ± 0.57) mm, (87.73 ± 2.34/HP)], Schirmer scores and goblet cell density were significantly (P < 0.01) reduced in PBS-treated group [(6.61 ± 0.38) mm, (68.06 ± 3.61)/HP], but significantly (P < 0.05) increased in SH-treated group [(8.75 ± 0.57) mm, (82.31 ± 1.64)/HP] compared with PBS-treated group. The number of inflammatory cells was significant difference (F = 56.306, P < 0.001) among the groups on day 61. Compared with the control group [(39.89 ± 2.03)/HP], inflammatory cells infiltration was significantly (P < 0.01) increased in both PBS [(73.18 ± 2.17)/HP] and SH groups [(48.79 ± 2.64)/HP], however, SH-treated group was significantly lowered when compared with PBS-treated group. In addition, decrease in apoptosis, complete microvilli and cell organelles were found in the corneal and conjunctival epithelial cells in SH-treated group.CONCLUSIONS:Our results demonstrate that topical application of SH reduces the ocular toxicity and protect the ocular surface in the long term anti-glaucomatous medical therapies and may be considered as a vehicles or neutralizing material for future ocular application.

PURPOSE:To describe sequential phacoemulsification-intraocular lens (IOL) implantation-posterior capsulorhexis-anterior vitrectomy in the management of phakic malignant glaucoma.METHODS:Twenty consecutive patients (25 eyes) with phakic malignant glaucoma were enrolled at the Zhongshan Ophthalmic Center, Sun Yat-sen University. All patients underwent phacoemulsification, IOL implantation and posterior capsulorhexis together with anterior vitrectomy via a clear corneal paracentesis. Visual acuity, intraocular pressure (IOP), anterior chamber depth (ACD), surgical complications and medications required after the surgery were recorded.RESULTS:After surgery, the mean LogMAR visual acuity and ACD increased significantly (visual acuity from -1.56 ± 1.17 to -0.54 ± 0.81, p < 0.001; ACD from 0.367 ± 0.397 mm to 2.390 ± 0.575 mm, p < 0.001), and mean IOP decreased significantly (from 39.6 ± 10.6 mm Hg to 14.5 ± 4.1 mmHg, p < 0.001). No serious perioperative complications occurred, and only five eyes required topical glaucoma medications after surgery.CONCLUSION:Combined phacoemulsification-IOL implantation-posterior capsulorhexis-anterior vitrectomy surgery is a safe and effective method for treating patients with phakic malignant glaucoma.

Introduction The purpose of this study was to compare the efficacy of tacrolimus, fluorometholone, and saline in the treatment of mild to moderate contact lens-induced papillary conjunctivitis (CLPC). Methods This was a double-masked, randomized pilot study. A total of 18 soft contact lens users ( n = 36 eyes) with mild to moderate papillary conjunctivitis were enrolled. Subjects were randomly assigned into three groups to receive tacrolimus 0.05%, fluorometholone 0.1%, or saline (sodium chloride 0.9%). Drugs were prescribed at the baseline visit (visit 1) and instilled twice daily for 4 weeks. Follow-up visits were taken at week 1 (visit 2), week 2 (visit 3), week 4 (visit 4, drug usage suspended at this visit), and week 6 (visit 5, 2 weeks after interrupting eye drops). Contact lens use was discontinued during the 6 weeks of the study, and variables assessed were symptoms and signs, tear film status, and intraocular pressures. Conjunctival impression cytology was performed at baseline and visit 5 to assess ocular surface status. Results Mean roughness and redness scores decreased significantly from visit 1 to visit 5, but the variation tendency was comparable in all groups ( P = 0.180 and 0.889, respectively). Subjective symptom parameters were improved in all CLPC patients at visit 5, and there was no remarkable difference in symptom reduction in three groups. The mean Schirmer value and mean break-up time (BUT) did not change significantly in the three groups during the study. Ocular surface findings by impression cytology improved significantly after three treatments. Intraocular pressure fluctuation from baseline to 6-week follow-up was not statistically significant in all subjects. No adverse treatment-related event was observed in any study group. Conclusions Tacrolimus 0.05% may be a safe and effective treatment for mild to moderate CLPC and is comparable with fluorometholone 0.1% in efficacy. Contact lens cessation accompanied with saline may also be effective in treating mild to moderate CLPC.

OBJECTIVE:To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) implantation in the early stage of glaucoma secondary to contusion injuries.METHODS:A retrospective case series study. The study was made in 29 consecutive patients with glaucoma secondary to blunt trauma who were uncontrolled by multiple medications and then performed AGV implantations in less than 2 months after the trauma. The duration from injury to IOP elevation was 1 to 30 (6.10 ± 1.13) days. The time from injury to AGV implantation was 16 to 60 (40.03 ± 2.97) days. The patients were followed-up for a period of 6 to 42 (20.75 ± 1.66) months. The main outcome measures included intraocular pressure (IOP), visual acuity (VA), number of glaucomatous medications, intra- and postoperative complications. IOPs were analyzed by repeated measures analysis of variance, numbers of medication assessed by Kruskal-Wallis rank sum test followed by Bonferroni test, and VA comparison was performed using paired Student t-test.RESULTS:The absolute success rate was 86.21% and the conditional success rate was 13.79% after AGV implantation. Compared with pre-operation, the IOP was significantly(F = 124.09, P < 0.05) lowered at the last following-up of post-operation(42.59 ± 1.82)vs (15.12 ± 0.56) mm Hg(1 mm Hg = 0.133 kPa), the numbers of glaucomatous medications were significantly (H = 131.73, P < 0.05) reduced post-operatively (3.93 ± 0.15) vs (0.21 ± 0.12) species, and the VA was significantly (t = -3.466, P < 0.05) improved post-operatively (logMAR 0.40 vs logMAR 0.70). Two cases with shallow anterior chamber and three cases with hyphema were observed in the early stage after the surgery. No persistent hypotony, tube exposure or other serious complications were noted.CONCLUSION:AGV implantation is safe and effective in the management of intractable secondary glaucoma at early stage of contusion injuries.

The purpose of this study was to confirm previously reported associations of common variants in or near CDC7/TGFBR3, ZP4, SRBD1, ELOVL5, CAV1/CAV2, TLR4, CDKN2B, CDKN2B-AS1, ATOH7, PLXDC2, TMTC2, SIX1, and CARD10, with primary open angle glaucoma (POAG) in the Afro-Caribbean population of Barbados, West Indies. A total of 437 unrelated subjects from the Barbados Family Study of Open Angle Glaucoma (BFSG), including 272 with POAG and 165 unaffected individuals were included in this study. Eighteen SNPs were genotyped by using the multiplex SNaPshot method. Allelic, genotypic and model-based (dominant, recessive, and additive) associations of the SNPs with POAG were analyzed using Chi-squared tests and logistic regression. SNP rs1063192 (near CDKN2B) was found to be significantly associated with POAG (allelic P = 0.0008, genotypic P = 0.0029), and the minor allele C of rs1063192 was protective against POAG (OR = 0.39; 95%CI = 0.22-0.69). Suggestive association was also noted for rs7916697 (near ATHO7, allelic P = 0.0096, genotypic P = 0.01) with the minor allele being protective (OR = 0.67; 95% CI = 0.50-0.91), although this finding did not withstand correction for multiple testing. However, a significant interactive effect on POAG risk was identified between rs1063192 and rs7916697 (P-interaction = 2.80 × 10(-5)). Individuals with the rs1063192 protective genotype CC or CT and also rs7916697 genotypes GG or GA show a significantly decreased risk of POAG (OR = 0.17, 95%CI: 0.07-0.41). Our study confirms the significant association between SNP rs1063192 (CDKN2B, previously shown to influence vertical cup-to-disc ratio and POAG at 9p21) and POAG in the Afro-Caribbean population of Barbados. The minor allele of rs1063192 interacts with that of rs7916697 (ATOH7)) to reduce POAG risk. Our results also suggest that rs1063912 is a common protective variant for POAG in populations of African as well as European descent.

目的 评价Ahmed青光眼阀植入联合自体巩膜瓣和异体巩膜瓣“双瓣”覆盖术治疗难治性青光眼的临床疗效. 方法 回顾性分析60例(65只眼)难治性青光眼患者应用Ahmed青光眼阀植入联合“双瓣”覆盖术治疗的临床效果,平均随访时间为(14.5±6.9)个月.采用寿命表法统计不同时间点的累积总成功率,并比较手术前后视力、眼压和用药种类. 结果 术后6、12、18、24个月的累积总成功率分别为(92.3±2.6)％、(86.0±4.0)％、(84.2±3.7)％、(80.1±3.6)％.手术前后视力比较差异无统计学意义(x2=2.789,P＞ 0.05),术前平均眼压(39.7±10.7)mmHg,术后末次随访平均眼压(17.3±5.3)mmHg比较,差异有统计学意义(t=15.678,P＜0.05)；手术前用药种类(3.37±0.91)种,术后(1.62±1.12)种,差异有统计学意义(Z=-6.34,P＜0.05).术后无引流管暴露、移位等并发症发生. 结论 Ahmed青光眼阀植入联合自体巩膜瓣和异体巩膜瓣“双瓣”覆盖术是治疗难治性青光眼安全有效的手术方法；“双瓣”覆盖能有效降低引流管暴露的发生率.

OBJECTIVE To evaluate the changes of anterior segment configuration after surgical peripheral iridectomy (SPI) in patients with primary acute angle closure glaucoma (PAACG) by using anterior segment optical coherence tomography (AS-OCT). METHODS This retrospective self control study consisted of thirty-seven eyes of 37 patients with PAACG who were consecutively recruited in Zhongshan Ophthalmic Center. The peripheral anterior synechiae (PAS) of these patients was less than 5 clock time point. Central anterior chamber depth (ACD), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), anterior chamber width (ACW), anterior chamber volume (ACV), and crystalline lens rise (CLR) were measured using AS-OCT before and one month after SPI. RESULTS After SPI, AOD (0.125 ± 0.072) µm, TISA (0.091 ± 0.041) mm(2), ARA (0.095 ± 0.042) mm(2), ACA (14.230 ± 2.000) mm(2) and ACV (90.074 ± 16.796) mm(3) were significantly increased compared with before SPI AOD (0.088 ± 0.078) µm, TISA (0.050 ± 0.048) mm(2), ARA (0.059 ± 0.057) mm(2), ACA (12.332 ± 2.457) mm(2), ACV (73.131 ± 16.976) mm(3) (t = -8.015 to 1.066, P = 0.001 to 0.044), respectively. There were no significantly changes in ACD, ACW and CLR (t = -1.505 to 0.516, P = 0.102 to 0.609). CONCLUSIONS PAACG can be controlled by SPI resulting in an increase of AOD, TISA, ARA, ACA and ACV, but not ACD or CLR.

PURPOSE:To investigate the efficacy and safety of slit-lamp needle revision with subconjunctival interferon injection in eyes with encapsulated blebs.PATIENTS AND METHODS:We reviewed a series of 25 cases (27 eyes) in which primary needling with 5×105 IFN α-2b injection was performed for bleb encapsulation and analysed the results over a follow-up period of at least 12 months.RESULTS:The mean time to development of encapsulated blebs after the surgery was 23.85 ± 10.66 days (9 to 60 days). The mean IOP decreased significantly from 22.51 ± 5.30 mm Hg at diagnosis of encapsulated blebs to 17.26±7.72 mmHg at the last visit (P = 0.009). Of the 27 eyes, 15 (55.56%) achieved a successful result, 10 (37.04%) were qualified for success and the remaining 2 (7.4%) were considered as failure. The qualified success group took 1.70 ± 0.67 antiglaucoma medications. No serious complications were detected.CONCLUSION:The needling procedure associated with subconjuctival injection of IFN α-2b is a safe and effective method in treating encapsulated blebs.

Objective To compare the difference and repeatability between anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscope (UBM) in measuring central anterior chamber depth (ACD). Methods Twenty-nine patients (32 attacked eyes and 23 unaffected fellow eyes) with acute primary angle closure glaucoma (APACG) and 41 patients (74 eyes) with chronic primary angle closure glaucoma (CPACG) were included in this study. AS-OCT and UBM were used to measure the ACD of these APACG and CPACG subjects. Pair sample t test and correlation analysis were introduced to analyze the difference and correlation of the ACD values between the 2 instruments. ACD of one complete randomly selected eye was measured 10 times by the above 2 instruments, respectively, and the repeatability of 2 instruments was analyzed. Results There was no significant difference in ACD values of attacked eyes of APACG between AS-OCT and UBM. In unaffected fellow eyes and CPACG eyes, the ACD values measured by AS-OCT were deeper than that measured by UBM[ (1.923±0.287) mm vs (1.860±0.243) mm, (2.017±0.054) mm vs (1.913±0.052) mm, both P=0.012]. Positive correlation between AS-OCT and UBM in measuring ACD was found (r=0.928, P<0.001). The coefficient of variation of ACD was 0.66% as measured by AS-OCT, and 0.82% as by UBM. Conclusions The ACD measured by AS-OCT can be deeper than that by UBM. Excellent correlation is found between AS-OCT and UBM measurements. AS-OCT appears to be more repeatable in measuring ACD than UBM.

INTRODUCTION We studied the automated intraretinal segmentation on Fourier domain optical coherence tomography (OCT). MATERIALS AND METHODS Thirty eyes from 30 normal subjects were studied using the RTVue-100. Both radial and raster scan protocol were performed 3 times on each subject. The OCT software performs automated intraretinal segmentation and provides macular thickness measurements. RESULTS Both scanning protocols provide reproducible inner, outer and full retinal thickness measurements. The inner, outer and full retinal thicknesses at the foveal central subfield were 67.31 +/- 12.27 microm, 151.67 +/- 12.96 microm, 219.33 +/- 23.19 microm, respectively by the raster scan, and 63.27 +/- 10.37 microm, 147.07 +/- 14.54 microm, 209.89 +/- 21.80 microm, respectively by the radial scan. Macular regional variations were consistently observed. The raster scan protocol gives greater retinal thickness measurements than the radial scan protocol (P <0.05), but the latter yields slightly more reproducible results. CONCLUSIONS Fourier domain OCT equipped with the ability to perform automatic intraretinal segmentation is a convenient tool in studying diseases that may differentially affect various parts of the retina. However, the establishment of normative values can be complicated by different scanning protocols, devices used, methods of data presentation and definition of intraretinal boundaries.

Objective To evaluate the safety and efficacy of cyanoacrylate tissue adhesive in surgical repair of filtering bleb in glaucoma. Methods A study was conducted in 10 patients (10 eyes)diagnosed at the Zhongshan Ophthalmic Center, Sun Yat- sen University, between January 2007 and December 2009. Seven out of the 10 patients underwent partial resection of filtering blebs with the corneoscleral incision sealed by cyanoacrylate tissue adhesive instead of sutures, while the remaining 3 patients underwent surgical repair of filtering bleb for glaucoma in which the leakage was directly treated with cyanoacrylate tissue adhesive without suture. The vision acuity, intraocular pressure, anterior chamber depth, status of cyanoacrylate tissue adhesive, wound leakage or inflammation were observed during the follow-up for 6 to 18 months. Results In the 10 patients, the single-eye intraocular pressure was less than 6 mm Hg (1 mm Hg＝0.133 kPa) and the mean intraocular pressure was (11.2±4.1 ) mm Hg before surgery,compared with over 8 mm Hg for single-eye intraocular pressure and (11.6±2.8) mm Hg for mean intraocular pressure at one month after surgery. At the end of postoperative follow-up, a mean intraocular pressure ( 11.5±3.5) mm Hg was recorded, with no significant difference as compared with the preoperative data (P＞0.05).The cyanoacrylate-sealed wounds were free of leakage after surgery. On day 7 to 20 when the cyanoacrylate adhesive normally fell off, the wounds were fully healed, the filtering blebs were found scarless, and there was no inflammatory reactions in the anterior chamber. Among patients with overhanging bleb, the depth of anterior chamber was not significantly changed after surgery, except for 2 patients in whom the anterior chamber was deepened compared to the shallow one previously due to filtering bleb leakage. Conclusion Cyanoacrylate tissue adhesive may be a safe and effective alternative for sutures in partial resection and repair of filtering blebs.

PURPOSE:To observe the changes of ocular fundus and to describe the image features of optical coherence tomography (OCT) in patients with laser-induced maculopathy.METHODS:Four patients (4 eyes) with decreased visual acuity due to laser injury were recruited into the study between April 2002 to December 2009. All patients underwent routine check-up for eyes.RESULTS:The four cases presented with different clinical characteristics from each another. In the first case, OCT showed lamella macular hole, with partially remained outer sensory retina. The signals of inner segments/outer segments (IS/OS) band and RPE band were disrupted. The choroidal band was distorted with increased reflection. Perimacular epiretinal membrane and vitreous hemorrhage were also observed. The second case had a full-thickness macular hole with retina edema surrounding the hole. The third case presented local serous sensory retinal detachment in macula. The fourth case presented hyper-reflection of the inner retina in macula which indicated hemorrhage.CONCLUSION:There are various patterns of laser-induced maculopathy. OCT is a useful noninvasive diagnostic tool to delineate the layer, extent and configuration of the damage on retina.

【Objective】 To investigate the role of nocturnal intraocular pressure (IOP) monitoring in the diagnosis of primary open angle glaucoma (primary open angle glaucoma, POAG). 【Method】 Fifty-night eyes from 30 out-patients with glaucomatous optic nerve damage and diurnal IOP monitoring ≤21 mmHg were included. Nocturnal IOP monitoring, optical coherence tomography (OCT), Heidelberg retina tomography (HRT) and Humphrey visual field were performed to all of the included subjects. 【Result】 In nocturnal IOP monitoring, the IOP was more then 21 mmHg in 14 patients (28 eyes, 46.7%), who were classified into hypertension open angle glaucoma group (HPG). Another 16 patients (31 eyes, 53.3% ) with IOP still under 21 mmHg were classified into normal pressure glaucoma group (NPG). The peak of IOP occurred at 5: 00 am and 2: 00 am in HPG and NPG groups, respectively. Compared with the NPG group, the base line of IOP (P = 0.033 ～ 0.000) and the amplitude of IOP fluctuation (P = 0.011) were significantly higher in HPG group. There were no significant differences in parameters of OCT and HRT, and visual field defects. 【Conclusion】 IOP is the most important factor in identifying HPG and NPG, and nocturnal IOP monitoring is influential in the diagnosis of POAG.

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.

Purpose To determine whether the polymorphisms of calcitonin receptor-like receptor gene (CALCRL) are associated with primary angle closure glaucoma (PACG) in a southern Chinese population. Methods A total of 207 individuals with acute and chronic PACG and 205 ethnically matched controls were recruited in the current study. A tag-single nucleotide polymorphism approach was used to investigate this gene. Alleles were determined by PCR restriction fragment length polymorphism. Results The results show a nominal association between rs1157699 and acute PACG (uncorrected p=0.024 and 0.028 for alleles and genotypes, respectively). Haplotype Trs840617Crs6759535Trs1157699 frequency is significantly higher in acute PACG patients than in controls (corrected p=0.012), whereas haplotype Trs840617Crs6759535Crs1157699 frequency is significantly lower in acute PACG patients compared with controls (corrected p=0.02). However, no significant difference was detected between chronic PACG and CALCRL tag single nucleotide polymorphisms. Conclusions The study suggests a possible role of CALCRL in the pathogenesis of acute PACG but not chronic PACG. A replication of this study with a larger sample size as well as on different populations will be helpful in confirming this finding.

Purpose: To study the association of the single nucleotide polymorphisms (SNPs) rs17576 and rs2250889 in the extracellular matrix metalloprotease-9 (MMP-9) gene with primary angle closure glaucoma (PACG) in southern Chinese patients.Methods: DNA samples were obtained from 211 adult patients with PACG and 205 control subjects to study the relationships between SNPs in MMP-9 and PACG. Polymorphism analyses of rs17576 and rs2250889 in MMP-9 were performed using the polymerase chain reaction, restriction fragment length polymorphism (RFLP), and direct DNA sequencing techniques. The association between genetic polymorphisms and the risk of PACG were estimated by chi 2 test and logistic regression.Results: Genotyping of the MMP-9 site (rs2250889) was significantly different between the two groups (P = 0.004), and the odds ratio was OR = 1.76 (95% CI: 1.264-2.449). The frequencies of the G/G genotype in the PACG and control groups were 9% and 2.9%, respectively. However, there were no significant differences between these two groups in the frequencies of the genotypes and alleles for rs17576 in MMP-9.Conclusion: The SNP rs2250889 located in MMP-9 might be associated with PACG among southern Chinese people, and people with the G/G genotype are likely more susceptible to PACG. In contrast, the SNP rs17576 in MMP-9 might not be related to PACG in the same population.

本研究通过实时荧光定量PCR(RTQ-PCR)技术定量分析转化生长因子β受体Ⅰ,(TβR-Ⅰ)和受体Ⅱ(TβR-Ⅱ)基因在正常成年大鼠视网膜中的表达,探讨TGF-β及其受体在维持正常视网膜稳态和视网膜增生性病变中的作用机制。