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Normal tension glaucoma: from the brain to the eye or the inverse? 预览
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作者 Hui-Jun Zhang Xue-Song Mi Kwok-Fai So 《中国神经再生研究:英文版》 SCIE CAS CSCD 2019年第11期1845-1850,共6页
Glaucoma is a chronic, progressive optic neuropathy characterized by the loss of peripheral vision first and then central vision. Clinically, normal tension glaucoma is considered a special subtype of glaucoma, in whi... Glaucoma is a chronic, progressive optic neuropathy characterized by the loss of peripheral vision first and then central vision. Clinically, normal tension glaucoma is considered a special subtype of glaucoma, in which the patient’s intraocular pressure is within the normal range, but the patient experiences typical glaucomatous changes. However, increasing evidence has challenged the traditional pathophysiological view of normal tension glaucoma, which is based only on intraocular pressure, and breakthroughs in central nervous system imaging may now greatly increase our knowledge about the mechanisms underlying normal tension glaucoma. In this article, we review the latest progress in understanding the pathogenesis of normal tension glaucoma and in developing imaging techniques to detect it, to strengthen the appreciation for the connection between normal tension glaucoma and the brain. 展开更多
关键词 nerve REGENERATION normal tension GLAUCOMA open angle GLAUCOMA NEURODEGENERATIVE diseases visual field CEREBROSPINAL fluid pressure IMAGING techniques pathogenesis magnetic resonance IMAGING diffusion TENSOR IMAGING metabolic changes neural REGENERATION
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青光眼引流器Ex-PRESS植入及可调整缝线治疗难治性青光眼
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作者 屈宏波 赵军梅 《中华眼外伤职业眼病杂志》 2019年第8期598-601,共4页
目的评估Ex-PRESS青光眼引流器植入联合可调整缝线治疗难治性青光眼的效果。方法回顾性分析2013年2月至2018年4月难治性青光眼39例(39眼)的临床资料。所有患者行Ex-PRESS青光眼引流器植入联合应用可调整缝线治疗。结果术后6个月,矫正视... 目的评估Ex-PRESS青光眼引流器植入联合可调整缝线治疗难治性青光眼的效果。方法回顾性分析2013年2月至2018年4月难治性青光眼39例(39眼)的临床资料。所有患者行Ex-PRESS青光眼引流器植入联合应用可调整缝线治疗。结果术后6个月,矫正视力提高者12眼,无明显改变者24眼,视力下降3眼。术前平均眼压(47.49±10.16)mmHg(1 mmHg=0.133 kPa)。术后1天、1周、1、3及6个月平均眼压依次为(15.00±5.28)mmHg、(15.64±3.49)mmHg、(16.28±3.03)mmHg、(17.03±2.79)mmHg、(20.08±6.01)mmHg。术后各时间点眼压均低于术前,差异均有统计学意义(均为P=0.000)。结论Ex-PRESS青光眼引流器植入联合可调整缝线是难治性青光眼一种安全有效的治疗手段。 展开更多
关键词 引流器 青光眼 缝线 可调整 青光眼 难治性
青光眼睫状体炎综合征误诊分析并文献复习 预览
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作者 王亮 陈雪 孙红 《临床误诊误治》 2019年第8期13-16,共4页
目的 探讨青光眼睫状体炎综合征的临床特点、诊治措施及误诊原因、防范措施。方法 对曾误诊的青光眼睫状体炎综合征3例的临床资料进行回顾性分析,并复习相关文献。结果 本组误诊率为11.11%。3例分别因左眼眼压升高1周、右眼胀痛12 d、... 目的 探讨青光眼睫状体炎综合征的临床特点、诊治措施及误诊原因、防范措施。方法 对曾误诊的青光眼睫状体炎综合征3例的临床资料进行回顾性分析,并复习相关文献。结果 本组误诊率为11.11%。3例分别因左眼眼压升高1周、右眼胀痛12 d、右眼虹视1 d就诊。就诊初期2例曾误诊为原发性开角型青光眼(误诊时间10 d和1周),1例曾误诊为原发性闭角型青光眼(误诊时间长达5年)。2例误诊原因为发病早期未出现羊脂状角膜后沉着物(keratic precipitates, KP),1例误诊原因为羊脂状KP位于前房角处,但未行前房角镜检查。3例按误诊疾病进行治疗病情均无好转,后均进一步行眼科检查发现羊脂状KP,确诊青光眼睫状体炎综合征。皆给予泼尼松龙滴眼液治疗后眼压降至正常。结论 典型青光眼睫状体炎综合征早期先出现眼压升高,然后才出现羊脂状KP。为了防止青光眼睫状体炎综合征误诊误治,不仅需要对该病有深刻认识,还应该重视病史询问,详细眼部检查,尤其不能忽略前房角镜检查,并需对患者密切随访观察。 展开更多
关键词 青光眼睫状体炎综合征 误诊 青光眼 开角型 青光眼 闭角型
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Modified viscocanalostomy in the Chinese population with open angle glaucoma: a 10-year follow-up results
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作者 Ya Liang Hong Sun +4 位作者 Jie Shuai Kai Xu Fang-Fang Ji Sucijanti Zhi-Lan Yuan 《国际眼科杂志:英文版》 SCIE CAS 2019年第3期429-435,共7页
AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients wit... AIM: To study the long-term efficacy and safety of modified viscocanalostomy in Chinese people with open angle glaucoma(OAG).METHODS: This retrospective study included a total of 100 eyes from 100 Chinese patients with medically uncontrolled OAG. All the patients underwent modified viscocanalostomy with injection of viscoelastic material in the surgically created ostia of Schlemm’s canal(SC). The modifications included peeling of the inner wall of SC and the juxtacanalicular meshwork, use of mitomycin C, and loosely suturing the superficial scleral flap. Intraocular pressure(IOP), visual acuity, number of medications, laser goniopuncture data and complications were recorded. The definition of complete(qualified) success was an IOP equal to or lower than 21, 18, 16 mm Hg without(with or without) anti-glaucoma medications. RESULTS: The mean IOP was 33.5±9.9 mm Hg before surgery, 15.2±3.6 mm Hg(mean IOP reduction of 51%) at 5 y after surgery, and 15.6±2.8 mm Hg(mean IOP reduction of 49.9%) at 10 y after surgery(P<0.001). The number of anti-glaucoma medications dropped from 2.39±0.5 preoperatively to 0.47±0.8 at 5 y and 0.67±0.8 at 10 y postoperatively(P<0.001). The follow-up period was 104.5±37.0 mo. The qualified success rate for an IOP of 21, 18 or 16 mm Hg or less was 84% [95% confidence interval(CI): 0.80-0.88], 73%(95%CI: 0.68-0.78), and 59%(95%CI: 0.52-0.66) after 5 y, and 80%(95%CI: 0.76-0.84), 69%(95%CI: 0.64-0.74), 51%(95%CI: 0.44-0.58) after 10 y, respectively. There was a relationship between age, preoperative IOP and success rate(P<0.01, P<0.05). A total of 31 eyes(31.3%)in 31 patients underwent laser goniopuncture, decreasing the IOP from 22.9±4.3 mm Hg to 16.3±2.5 mm Hg(P<0.01). Neither blebitis nor endophthalmitis occurred.CONCLUSION: Modified viscocanalostomy could be performed to lower IOP, decrease multiple anti-glaucoma drops use as well. It’s a safe procedure with less complications over 10 y in Chinese individuals with OAG. 展开更多
关键词 non-penetrating GLAUCOMA surgery VISCOCANALOSTOMY Schlemm’s CANAL open ANGLE GLAUCOMA laser goniopuncture
局部应用抗青光眼药物致患者干眼症发生的影响因素分析 预览
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作者 王琛 王丽 +1 位作者 武蓓 宫瑞中 《中国药房》 CAS 北大核心 2019年第10期1424-1427,共4页
目的:了解局部应用抗青光眼药物致患者干眼症的发生情况及其影响因素,为青光眼患者干眼症的防治提供参考。方法:选取2015年6月-2018年6月我院就诊的600例接受抗青光眼局部用药治疗的患者作为研究对象,对患者进行眼科检查及问卷调查,对... 目的:了解局部应用抗青光眼药物致患者干眼症的发生情况及其影响因素,为青光眼患者干眼症的防治提供参考。方法:选取2015年6月-2018年6月我院就诊的600例接受抗青光眼局部用药治疗的患者作为研究对象,对患者进行眼科检查及问卷调查,对致干眼症发生的影响因素进行单因素分析及多因素Logistic回归分析。结果:本次共发放调查问卷600份,收回547份,回收率为91.17%。收回问卷的547例患者中有36例拒绝接受进一步检查,19例被剔除,共492例纳入研究。在492例接受抗青光眼局部用药治疗的患者中,干眼症患者为262例,总患病率为53.25%;干眼症状出现频率前3位为干涩感、烧灼感、异物感,分别有182例(69.47%)、159例(60.69%)、106例(40.46%)。单因素分析结果显示,不同性别、年龄、使用视频终端时长、干燥环境、用药时间、用药种类、用药频次以及睡眠质量是否良好、药物有无传统防腐剂、有无翼状胬肉、有无睑板腺功能障碍患者发生干眼症的比例组间比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,患者性别、用药时间、用药种类、药物有无传统防腐剂、睑板腺功能障碍、使用视频终端等为青光眼药物治疗患者干眼症发生的危险因素(OR为1.613~2.477)。结论:接受抗青光眼局部药物治疗的患者干眼症发生率较高,医师应针对性别、用药时间、用药种类、药物有无传统防腐剂、睑板腺功能障碍、使用视频终端等危险因素做好防治措施,最大限度地缓解干眼症患者的眼部不适,从而提高青光眼患者治疗依从性。 展开更多
关键词 青光眼 抗青光眼药物 干眼症 影响因素
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两种术式治疗犬青光眼的疗效 预览
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作者 董俊 汪琪 +4 位作者 索传广 孙晋睿 王卓乐 明洁 丁一 《动物医学进展》 北大核心 2019年第8期141-144,共4页
旨在探讨小梁切除术与Ahmed青光眼引流阀植入术的治疗疗效。成功建立6只犬的双眼青光眼模型,每只犬双眼分别行小梁切除术和Ahmed青光眼引流阀植入术。两种手术中均联合使用丝裂霉素C。检测术后眼压、前房深度、并发症及眼底变化,评价手... 旨在探讨小梁切除术与Ahmed青光眼引流阀植入术的治疗疗效。成功建立6只犬的双眼青光眼模型,每只犬双眼分别行小梁切除术和Ahmed青光眼引流阀植入术。两种手术中均联合使用丝裂霉素C。检测术后眼压、前房深度、并发症及眼底变化,评价手术治疗效果。结果显示,Ahmed青光眼引流阀植入术和小梁切除术均有较好的降眼压功效,但Ahmed青光眼引流阀植入术较小梁切除术术后眼内压的变化幅度更小,且其眼内操作少,术后并发症发生率低。 展开更多
关键词 青光眼 高眼压模型 Ahmed引流阀植入术 小梁切除术
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不同类型青光眼患者手术前后角膜生物力学变化特征 预览
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作者 王蕊 杨瑾 +2 位作者 尹则琳 田晓峰 李轩 《中华实验眼科杂志》 CAS CSCD 北大核心 2019年第5期382-389,共8页
目的比较不同类型青光眼患者角膜生物力学差异及其相关影响因素,探讨青光眼术后角膜生物力学的变化趋势。方法采用前瞻性病例对照研究。收集2017年1—7月天津市眼科医院收治的急性原发性闭角型青光眼(APACG)(缓解期或慢性期)患者61例61... 目的比较不同类型青光眼患者角膜生物力学差异及其相关影响因素,探讨青光眼术后角膜生物力学的变化趋势。方法采用前瞻性病例对照研究。收集2017年1—7月天津市眼科医院收治的急性原发性闭角型青光眼(APACG)(缓解期或慢性期)患者61例61眼、慢性原发性闭角型青光眼(CPACG)患者94例94眼、原发性开角型青光眼(POAG)患者70例70眼和年龄相关性白内障(ARC)患者64例64眼。采用Corvis ST测量活体角膜的生物力学参数,分析并比较不同类型青光眼患者术前角膜生物力学参数差异以及青光眼手术后的变化,采用多重线性回归分析探讨年龄、矫正后眼压(IOPcc)、中央角膜厚度(CCT)、眼轴长度(AL)、平均角膜屈光力(K)与角膜生物力学参数的关系。结果与ARC组相比,术前CPACG组和POAG组第一压平速度(A1V)、第二压平时间(A2T)较小,差异均有统计学意义(均P<0.05);与ARC组和APACG组相比,术前CPACG组和POAG组第二压平速度(A2V)较大,差异均有统计学意义(均P<0.05)。A1V、A2T、角膜顶点改变的最大垂直距离(DA)及最大压陷时角膜表面未发生改变的两点距离(PD)与IOPcc均呈负相关(r=-0.494、-0.612、-0.652、-0.277,均P<0.05),A2V、第一压平时间(A1T)及最大压陷曲率半径(CCR)与IOPcc均呈正相关(r=0.508、0.960、0.249,均P<0.05);第一压平长度(A1L)及第二压平长度(A2L)与K均呈负相关(r=-0.323、-0.227,均P<0.05),A1V、A2T及DA与K均呈正相关(r=0.214、0.256、0.242,均P<0.05)。与术前相比,CPACG组术后1个月A1T、A2V减小,A1V、A2T、DA增大,差异均有统计学意义(均P<0.05);POAG组术后1个月A1T、A2V减小,A2T、DA增大,差异均有统计学意义(均P<0.05)。与术前相比,APACG组、ARC组术后1个月角膜生物力学指标差异无统计学意义(均P>0.05)。结论CPACG和POAG患眼角膜形变能力较差,青光眼手术后角膜形变能力逐渐恢复;APACG(缓解期或慢性期)由于眼压一过性升高,对角膜形变 展开更多
关键词 青光眼 角膜生物力学 青光眼手术 角膜屈光力
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两种型号青光眼阀植入难治性青光眼的疗效对比
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作者 曾凤 卢亚梅 +3 位作者 周元清 陈永铃 刘佳 周致炎 《中华眼外伤职业眼病杂志》 2019年第7期518-523,共6页
目的比较FP7型与FP8型Ahmed青光眼阀(AGV)植入术治疗成人难治性青光眼的效果。方法回顾性分析2015年5月至2019年2月40例成人难治性青光眼的临床资料。患者随机分为两组,25例(25眼)行FP7 AGV植入术,15例(15眼)行FP8 AGV植入术。术后随访1... 目的比较FP7型与FP8型Ahmed青光眼阀(AGV)植入术治疗成人难治性青光眼的效果。方法回顾性分析2015年5月至2019年2月40例成人难治性青光眼的临床资料。患者随机分为两组,25例(25眼)行FP7 AGV植入术,15例(15眼)行FP8 AGV植入术。术后随访12个月。对比两组术前、术后眼压、视力、成功率、并发症及术后用药情况。结果两组术后各时间点平均眼压明显低于术前(P<0.05)。术后1天,FP7组眼压下降低于FP8组(t=-4.761,P<0.01),余时间点两组间眼压差异均无统计学意义(P>0.05);两组术后各时间点抗青光眼用药数量较术前均明显减少,差异均有统计学意义(P<0.05);术后各时间点两组平均抗青光眼药物数量差异无统计学意义(P>0.05)。两组术后12个月手术成功率、视力提高率和并发症发生率比较,差异均无统计学意义(P>0.05)。结论FP7和FP8 AGV植入术在降低眼压、保护视力、并发症和依赖青光眼药物量等方面效果相似,成功率也相当。在成人结膜下空间不足的情况下使用FP8 AGV是一个安全、有效的选择。 展开更多
关键词 青光眼 难治性 成人 青光眼 Ahmed 疗效
青光眼药物治疗依从性评估工具的适用性 预览
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作者 王晶 陈俊邦 +3 位作者 吴彦霖 胡起维 俞方知 孙昕 《临床眼科杂志》 2019年第2期138-141,共4页
目的验证青光眼药物治疗依从性评估工具(中文版)在国内的适用性。方法招募112名开角型青光眼或高眼压症患者,所有患者自行完成青光眼药物治疗依从性评估的问卷调查2次,2次调查之间间隔2个月。采用主成分分析(正交旋转)的方法判断青光眼... 目的验证青光眼药物治疗依从性评估工具(中文版)在国内的适用性。方法招募112名开角型青光眼或高眼压症患者,所有患者自行完成青光眼药物治疗依从性评估的问卷调查2次,2次调查之间间隔2个月。采用主成分分析(正交旋转)的方法判断青光眼治疗依从性评估工具的各模块是否合理;采用克朗巴哈系数(Cronbach's α)来判断各模块的内部一致性信度;采用斯皮尔曼等级相关性判断2次问卷调查的稳定性,采用频度分析天花板和地板效应。我们用单变量线性回归的方法统计一般情况中各项指标与用药依从性的关联度。结果本问卷的47个题目中可以提取出24个题目组成6个模块,所有6个模块的内部一致性信度都在可接受的范围(α≥0.6)。此问卷可重复性也很好,所有的题目都不存在天花板或地板效应。根据线性回归分析结果,发现年龄和婚姻状况与用药依从性相关(P<0.05)。结论青光眼药物治疗依从性评估工具(中文版)适用于在中文环境下的青光眼患者中应用。如果经过适当的精修,研究者和临床医生都可以将这份问卷用于分析影响患者用药依从性的主要因素和验证干预措施的效果。 展开更多
关键词 用药依从性 青光眼 评估工具 青光眼局部药物治疗
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Launching a paradigm for first and redo-surgery in primary congenital glaucoma: institutional experience
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作者 Tharwat H. Mokbel Eman M. El Hefney +5 位作者 Sherein M. Hagras Amani E. Badawi Manal A. Kasem Ahmed A. Al Nagdy Sherief E. El Khouly Walid M. Gaafar 《国际眼科杂志:英文版》 SCIE CAS 2019年第2期226-234,共9页
AIM:To evaluate the outcome of the initial and the redo-surgeries for primary congenital glaucoma(PCG) correlated to its degree of severity. METHODS:A retrospective study involved patients with PCG presented between 2... AIM:To evaluate the outcome of the initial and the redo-surgeries for primary congenital glaucoma(PCG) correlated to its degree of severity. METHODS:A retrospective study involved patients with PCG presented between 2010 and 2018. Medical records were reviewed to assess the degree of the preoperative severity according to the intraocular pressure(IOP), corneal diameter and corneal edema. Success and failure rates were calculated for both first and redo-surgeries at 6 and 12 mo respectively then correlated to the severity of the cases. RESULTS:Complete records were retrieved for 272 eyes(153 patients) with PCG:43 eyes were mild, 136 moderate and 93 severe. Combined trabeculotomy and trabeculectomy(CTT) had the highest success rate in moderate(96.4%) and severe cases(59.3%) while trabeculotomy had the highest success rate in mild cases(96.3%). Medical records of 88 eyes(63 patients) with recurrent PCG were analyzed, most with severe presentation(59 eyes). Ahmed glaucoma valve(AGV) was used in 67(76%) eyes and augmented trabeculectomy in 21(24%) eyes. At 12 mo, there was no statistically significant difference between both surgeries in total success rate(P=0.256). For mild cases, success rate was 100% for both surgeries. Severe cases had higher success rates following AGV(87%) than augmented trabeculectomy(20%). Preoperative severity of the disease was an independent factor affecting the failure rate in secondary trabeculectomy but not in AGV. Patients younger than 24 mo had higher probabilities of failure following both redo-surgeries with hazard ratio =1.325 and 0.37 for augmented trabeculectomy and AGV respectively. CONCLUSION:Preoperative assessment of the severity of eyes with PCG helps in the selecting the optimal primary and secondary surgery. For first surgery, trabeculotomy is more effective in mild cases whereas;CTT and augmented subscleral trabeculectomy(SST) are appropriate for moderate and severe cases. AGV proved to be superior to augmented SST in severe recurrent cases. 展开更多
关键词 AHMED GLAUCOMA valve AUGMENTED TRABECULECTOMY Egypt primary congenital GLAUCOMA
Dual Scheimpflug imaging as a screening method for occludable angles-a comparison with gonioscopy
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作者 Natalia Maes Bessa Rebeca de Azevedo Souza +2 位作者 Marcony R. Santhiago Haroldo Vieira Moraes Jr Beatriz Fiuza Gomes 《国际眼科杂志:英文版》 SCIE CAS 2019年第2期241-245,共5页
AIM:To evaluate dual Scheimpflug analyzer(Galilei) as a screening method for the diagnostic of gonioscopically narrow anterior chamber angles(ACA). METHODS:In 40 eyes of 40 patients with different ACA range, the ACA, ... AIM:To evaluate dual Scheimpflug analyzer(Galilei) as a screening method for the diagnostic of gonioscopically narrow anterior chamber angles(ACA). METHODS:In 40 eyes of 40 patients with different ACA range, the ACA, anterior chamber volume(ACV) and anterior chamber depth(ACD) were analyzed using the dual Scheimpflug analyzer(Galilei G6 system). Correspondence between these parameters and Shaffer’s classification based on gonioscopy were studied. Receiving operator characteristic(ROC) curves and partition analysis were used to determine the efficacy of the Galilei system in screening for narrow angles. Agreement(Kappa statistics), sensitivity, and specificity for each eye, according to Galilei measures, were also assessed. RESULTS:Shaffer’s grade(from 0 to 4) were significantly associated with each of the measurements(P<0.001). In screening eyes with narrow angles with the Galilei, the area under the ROC curve was largest(0.90) when ACD was used as the reference, and partition analysis demonstrated that those eyes were most adequately partitioned with an ACD of 2.86 mm with 100% sensitivity and 80% specificity. CONCLUSION:The Galilei is a secure, repeatable and noncontact screening method for narrow angles. However it does not provide sufficient information about the ACA anatomy to be considered a substitute for gonioscopy. 展开更多
关键词 GONIOSCOPY narrow ANTERIOR chamber ANGLE screening diagnostic accuracy ANGLE closure GLAUCOMA GLAUCOMA IMAGING
Ex-PRESS implantation for different types of glaucoma
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作者 Meltem Guzin Altinel Ayse Yagmur Kanra +1 位作者 Remzi Karadag Huseyin Bayramlar 《国际眼科杂志:英文版》 SCIE CAS 2019年第8期1290-1297,共8页
AIM: To evaluate the clinical results, efficacy and safety of Ex-PRESS P200 glaucoma shunt implant in different types of medically uncontrolled glaucoma. METHODS: The study included 31 eyes of 31 patients that were un... AIM: To evaluate the clinical results, efficacy and safety of Ex-PRESS P200 glaucoma shunt implant in different types of medically uncontrolled glaucoma. METHODS: The study included 31 eyes of 31 patients that were unresponsive to medical antiglaucomatous therapy in whom Ex-PRESS P200 glaucoma shunt implantation was performed. The demographic characteristics of the patients, type of glaucoma, complete ocular examination results, number of antiglaucomatous drugs before and after surgery, early and late complications of surgery, additional surgical and nonsurgical medical interventions, and success rates were investigated from the patients’ files, retrospectively. RESULTS: The mean postoperative follow-up time was 16.4±7.5 mo. The preoperative mean corrected intraocular pressure(IOP) was 28.7±10.3 mm Hg and postoperative mean corrected IOP was 15.3±5.2 mm Hg(P<0.05) at the last visit. The mean IOP reduction was 39.9% when the preoperative and postoperative values of the last visits were compared. The average number of antiglaucomatous drug use decreased from 3.9±0.3 to 1.7±1.7 postoperatively(P<0.05). The use of antiglaucomatous medications at the last visit was more than in other studies in the literature. The most common complication was conjunctival leakage, which was seen in 7 patients. Other early complications were iris touch, intravitreal hemorrhage, hyphema, choroidal effusion, early transient hypotonia and corneal edema. One of the late complications was endophthalmitiswhich was seen in one case 6 mo after the operation, and the other late complication was opacification of the cornea in one patient. Twelve additional surgical operations associated to Ex-PRESS surgery and 3 bleb needling have done. At the last visit, the complete success rate was 32.3% and the qualified success rate was 77.5% in all patients. CONCLUSION: Ex-PRESS P200 glaucoma shunt implantation may be an effective procedure for medically uncontrolled glaucoma with significantly lower use of antiglaucomatous medications. 展开更多
关键词 GLAUCOMA Ex-PRESS IMPLANT GLAUCOMA SURGERY
Xen45 Gel Stent implant: patient reported outcomes
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作者 Faaiq Hassan Luke Thomas Middleton Thomson +1 位作者 Gurpal Toor Qusay Alfahad 《国际眼科杂志:英文版》 SCIE CAS 2019年第9期1503-1506,共4页
Our aim was to report quality of life(QOL) outcomes following Xen45 Gel Stent implantation surgery in patients suffering with primary open angle glaucoma(POAG). A retrospective analysis was performed on all patients w... Our aim was to report quality of life(QOL) outcomes following Xen45 Gel Stent implantation surgery in patients suffering with primary open angle glaucoma(POAG). A retrospective analysis was performed on all patients who had Xen45 implantation surgery during a 2-year period(Jun, 2016-Apr, 2018). Of 52 consecutive patients were included with a total of 58 eyes being operated on. QOL was compared both pre-operatively and 6 weeks postoperatively using the GQL-15 questionnaire. There was an overall improvement in GQL-15 summary scores for our patient group. All item scores showed either no change or some degree of improvement. The Xen45 Gel Stent Implant is a promising new intervention which has shown improved QOL scores in our patient group. Further, higher power studies are now needed to compare the Xen45 to trabeculectomy(TE), which is currently the gold standard. 展开更多
关键词 GLAUCOMA MINIMALLY INVASIVE GLAUCOMA surgery Xen45 GEL STENT IMPLANT
Retinal nerve fiber layer changes based on historic CD4 nadir among HIV positive patients undergoing glaucoma evaluation
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作者 Sarah H.Van Tassel Paul Petrakos +3 位作者 Elizabeth Marlow Elizabeth Mauer Harjot K.Singh Anna M.Demetriades 《国际眼科杂志:英文版》 SCIE CAS 2019年第5期789-794,共6页
AIM: To determine relationships between retinal nerve fiber layer(RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus(HIV) positive patients evaluated for glaucoma suspicion.METHODS: Data were rev... AIM: To determine relationships between retinal nerve fiber layer(RNFL) thickness and nadir CD4 cell count in human immunodeficiency virus(HIV) positive patients evaluated for glaucoma suspicion.METHODS: Data were reviewed for 329 HIV positive patients evaluated for glaucoma suspicion. High-definition optical coherence tomography(OCT) RNFL measurements were obtained at least 6 mo apart. Analyses were performed to identify relationships between nadir CD4 count and RNFL thickness.RESULTS: Totally 110 eyes of 55 patients met inclusion criteria, of which 46 eyes were from subjects with nadir CD4<200 cells/mm~3 and 64 had nadir CD4≥200 cells/mm~3. Patients with nadir CD4<200 cells/mm~3 had significantly thicker superior(119.7±18.6 μm) and temporal(63.8±11.7 μm) quadrants at time of initial OCT compared to the superior(112.8±16.8 μm, P=0.048) and temporal(57.1±11.9 μm, P=0.004) quadrants of patients with higher nadir CD4. This trend toward thicker RNFL among subjects with lower nadir CD4 cell counts persisted at the time of follow up OCT where participants with nadir CD4<200 cells/mm~3 showed average RNFL thickness in the superior and temporal quadrants of 117.9±18.3 μm and 63.8±12.8 μm, respectively, compared to a superior thickness of 110.5±16.9 μm(P=0.034) and temporal thickness of 57.3±11.6 μm(P=0.007) among those with higher nadir CD4. CONCLUSION: Patients with lower nadir CD4 cell counts have thicker RNFL in the superior and temporal quadrants compared to those with higher nadir CD4 counts. RNFL thickness in HIV positive patients may be affected by historic HIV disease control and should be considered when evaluating HIV positive patients for glaucoma. 展开更多
关键词 GLAUCOMA GLAUCOMA SUSPECT human IMMUNODEFICIENCY virus RETINAL NERVE fiber layer
远程眼科会诊对青光眼检出效果影响的研究 预览
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作者 张莉 徐捷 +4 位作者 曹凯 刘含若 孙云晓 李建军 王宁利 《中华眼科医学杂志(电子版)》 2019年第4期206-211,共6页
目的探讨远程眼科会诊平台对青光眼患者检出率的作用。方法回顾性病例系列研究。首都医科大学附属北京同仁医院眼科研究所建立远程眼科会诊中心,收集远程会诊中心患者和基础眼病筛查者。采用Pearson χ^2检验,比较同期在北京进行的基础... 目的探讨远程眼科会诊平台对青光眼患者检出率的作用。方法回顾性病例系列研究。首都医科大学附属北京同仁医院眼科研究所建立远程眼科会诊中心,收集远程会诊中心患者和基础眼病筛查者。采用Pearson χ^2检验,比较同期在北京进行的基础眼病筛查中青光眼的检出率,评价眼科会诊平台对青光眼检出效果的作用,并分析“青光眼”诊断的患者中早期青光眼所占的比例。结果远程会诊平台共收集493 221例患者。其中,检索“青光眼”诊断患者11 538例,占 2.34%;可疑青光眼者2174例,占0.44%;青光眼及可疑青光眼诊断的检出率为2.78%。其中,早期青光眼诊断在所有“青光眼”诊断中的构成比为12.50%。同一时期在北京某机关进行眼病筛查者20 861例,青光眼诊断检出417例,占1.79%;可疑青光眼诊断检出33例,占0.16%;青光眼及可疑青光眼诊断检出率为1.95%。其中,早期青光眼诊断在青光眼诊断中的构成比为33.60%。两种方式青光眼检出率比较,经Pearson χ^2检验结果显示两者差异无统计学意义(χ^2=2.0,P>0.05)。结论应用互联网技术及眼科影像诊断标准,通过远程眼科会诊平台,可实现与基础眼病筛查对青光眼检出等同的效果,且可以实现以信息技术流动代替患者或医师的流动。 展开更多
关键词 远程医疗 青光眼 诊断
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注重儿童抗青光眼手术方式及适应证的选择
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作者 王宁利 王怀洲 《中华眼科杂志》 CAS CSCD 北大核心 2019年第5期321-324,共4页
儿童青光眼致盲率高,手术难度大,手术成功率低,对家庭和社会造成沉重负担。目前对于儿童抗青光眼手术方式的选择尚无统一的标准和共识。房角手术和小梁切开术,尤其微导管引导的全周小梁切开术,对儿童青光眼均具有良好的治疗效果。本文... 儿童青光眼致盲率高,手术难度大,手术成功率低,对家庭和社会造成沉重负担。目前对于儿童抗青光眼手术方式的选择尚无统一的标准和共识。房角手术和小梁切开术,尤其微导管引导的全周小梁切开术,对儿童青光眼均具有良好的治疗效果。本文通过分析目前临床儿童抗青光眼手术存在的问题及其原因,强调统一儿童抗青光眼手术适应证和手术方式的必要性,提出应制定共识,推广普及新手术新技术,提高儿童青光眼的手术成功率。 展开更多
关键词 青光眼 小梁切开术 选择性外科手术 儿童
动机性访谈对青光眼患者随访依从性及自我管理行为的影响 预览
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作者 金露 兰琼 +1 位作者 谯雪 肖娅 《医药高职教育与现代护理》 2019年第2期121-124,共4页
目的探讨动机性访谈对青光眼患者随访依从性及自我管理能力的影响。方法选取达州市中西医结合医院2017年2月至2018年4月收治的青光眼患者100例为研究对象,按照随机数字表分为对照组和观察组,各50例。对照组给予常规健康教育,观察组在常... 目的探讨动机性访谈对青光眼患者随访依从性及自我管理能力的影响。方法选取达州市中西医结合医院2017年2月至2018年4月收治的青光眼患者100例为研究对象,按照随机数字表分为对照组和观察组,各50例。对照组给予常规健康教育,观察组在常规健康教育基础上进行动机性访谈,比较两组出院后1周和1、3、6个月时的随访依从性,观察干预前后两组自我管理行为改变情况。结果出院后1周时,观察组随访依从率为100%,对照组为94.0%,两组比较差异无统计学意义(P>0.05);出院后1、3、6个月时,观察组随访依从率均在90%以上,对照组明显低于观察组(P<0.05);干预后观察组自我管理行为问卷各项得分及总分明显高于干预前且高于对照组(均P<0.05)。结论动机性访谈可显著提高青光眼患者的随访依从性及自我管理能力,有较高的临床价值。 展开更多
关键词 自我管理行为 随访依从性 动机性访谈 青光眼
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手术治疗晶状体悬韧带异常所致青光眼临床观察 预览
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作者 张彦坤 刘晓静 《河北医药》 CAS 2019年第16期2466-2468,2472共4页
目的探讨晶状体悬韧带异常所致青光眼手术治疗方法及效果。方法术前估计悬韧带可能异常的象限,选择手术切口位置,尽量避开悬韧带异常象限。18例患者均行青光眼手术,鼻上切口7眼,颞上切口8眼,颞侧切口3眼。合并白内障患者有6眼联合白内... 目的探讨晶状体悬韧带异常所致青光眼手术治疗方法及效果。方法术前估计悬韧带可能异常的象限,选择手术切口位置,尽量避开悬韧带异常象限。18例患者均行青光眼手术,鼻上切口7眼,颞上切口8眼,颞侧切口3眼。合并白内障患者有6眼联合白内障囊外摘除术+人工晶体植入术。结果18眼均完成青光眼小梁切除术。6眼联合白内障囊外摘除术+人工晶体植入术除1眼因悬韧带断裂后囊翻卷范围较大未植入人工晶体,另外2眼人工晶体攀植入睫状沟内。余均植入囊带内。术后眼压控制满意,视力有不同程度的提高。1例合并前房出血。结论晶状体悬韧带异常所致青光眼患者术前应详细检查,正确选择手术时机,手术方法,切口位置,术中细节的处理是保证手术成功的关键。 展开更多
关键词 晶状体悬韧带异常 青光眼 手术治疗
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年龄与青光眼视神经损害进展的关联性分析
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作者 高峰 樊冬生 赵勇 《中华眼外伤职业眼病杂志》 2019年第6期445-449,共5页
目的分析年龄及随诊时间与青光眼患者视神经损害进展的关联性。方法回顾性分析2015年3月至2017年3月青光眼592例(990眼)的资料,将患者基线立体眼底照片与随诊眼底照片通过计算机图像软件进行对比,观察青光眼视神经病变的进展情况。结果... 目的分析年龄及随诊时间与青光眼患者视神经损害进展的关联性。方法回顾性分析2015年3月至2017年3月青光眼592例(990眼)的资料,将患者基线立体眼底照片与随诊眼底照片通过计算机图像软件进行对比,观察青光眼视神经病变的进展情况。结果单因素分析显示,年龄、随诊时间、眼压升高、青光眼分期、视网膜血管变化、盘周萎缩弧扩大均为青光眼视神经损害进展的影响因素(P<0.05),而性别与青光眼视神经进展关联不密切(P>0.05)。多因素分析显示,不同年龄段、随诊时间和基线青光眼分期3个因素是导致青光眼视神经损害进展的危险因素。年龄<39岁及50~59岁段青光眼视神经损害进展比例较高,分别为63.28%及63.20%。随诊5年内患者青光眼视神经进展为39.36%,随诊10年以上患者青光眼视神经进展为73.47%,组间比较,差异有统计学意义(P<0.05)。早期发生青光眼视神经损害进展者为75.18%,而中、晚期进展者分别为45.19%和32.84%,组间比较,差异有统计学意义(P<0.05)。结论视网膜血管变化、随诊时间、基线青光眼分期、年龄及盘周萎缩弧扩大均为青光眼视神经进展的影响因素。 展开更多
关键词 青光眼 年龄 随诊时间 视神经损害
建立“治未病”思想指导下的中西医结合青光眼防治体系的思考 预览
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作者 张丽霞 倘孟莹 《中国中医眼科杂志》 2019年第5期343-346,共4页
青光眼是发病率为首位的不可逆性致盲性眼病,其以特征性视神经萎缩和视野缺损为共同特征,病理性眼压增高是其主要危险因素之一。如何降低青光眼致盲率、致残率,提高青光眼患者生存质量一直是眼科学界共同关注的研究热点和难点。现代医... 青光眼是发病率为首位的不可逆性致盲性眼病,其以特征性视神经萎缩和视野缺损为共同特征,病理性眼压增高是其主要危险因素之一。如何降低青光眼致盲率、致残率,提高青光眼患者生存质量一直是眼科学界共同关注的研究热点和难点。现代医学和中国传统医学是两个不同的医学体系,在维护人类健康方面各自发挥着不可替代的作用。本文旨在归纳总结现代医学在青光眼领域所取得的新进展,阐述中医在青光眼不同发展阶段的优势和特色,探讨建立“治未病”思想指导下的中西医结合青光眼防治体系。 展开更多
关键词 中医 青光眼 中医药学 中西医结合 治未病
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