secondary glaucoma

继发性青光眼
  • 文章类型: Journal Article
    目的:比较先天性风疹综合征(CRS)患儿与非风疹性白内障患儿婴儿期白内障术后继发性青光眼的发生率,并探讨相关危险因素。
    方法:回顾性病例对照研究。
    方法:纳入婴儿期接受白内障手术的CRS患儿和因婴儿白内障而接受白内障手术的年龄匹配的婴儿。
    方法:比较两组的青光眼发生率和生存概率。评估青光眼发展的危险因素。最低随访时间为白内障术后1年。
    结果:该研究包括115名儿童的211只眼。CRS组(病例)101眼(58例儿童),非风疹性白内障组(对照)110眼(57例儿童)。两组之间的手术平均年龄没有显着差异(p=0.96)。在整个14年的研究期间,CRS组为32.7%,对照组为24.5%(p=0.19)。CRS组的平均随访时间为5.8±3.7年,非风疹组的平均随访时间为6.4±3.4年。白内障手术后10年无青光眼生存的累积概率存在显着差异(病例0.53与对照组0.8;log秩p-0.034)。两组在继发性青光眼的发病时间上无显著性差异,降低眼压药物的平均数量和手术治疗青光眼的眼睛数量(p>0.05)。在CRS眼中,微角膜与青光眼的发展有关(风险比2.83,95%置信区间1.44-5.57;p=0.002)。
    结论:与接受婴儿白内障手术的婴儿相比,患有CRS的婴儿进行白内障手术后继发性青光眼的发生率没有显着差异。由于CRS患儿无青光眼生存的十年概率明显较低,建议进行更近距离和更长时间的随访,尤其是在具有高危特征的眼睛中.
    OBJECTIVE: To compare the incidence of secondary glaucoma after cataract surgery performed in infancy in children with congenital rubella syndrome (CRS) and children with nonrubella cataracts and to identify associated risk factors.
    METHODS: Retrospective case control study.
    METHODS: Children with CRS who had undergone cataract surgery in infancy and age-matched infants who had undergone cataract surgery for infantile cataracts were included.
    METHODS: Incidence of glaucoma and probability of survival was compared among the 2 groups.
    METHODS: Risk factors for the development of glaucoma were assessed. The minimum follow-up was 1 year after cataract surgery.
    RESULTS: The study included 211 eyes of 115 children. The CRS group (cases) had 101 eyes (58 children) and the nonrubella cataract group (controls) included 110 eyes (57 children). There was no significant difference in the mean age at surgery among the 2 groups (P = 0.96). Cumulative incidence of secondary childhood glaucoma for the entire study period of 14 years was 32.7% in the CRS group and 24.5% in the control group (P = 0.19). Mean follow-up was 5.8 ± 3.7 years for CRS group and 6.4 ± 3.4 years for the nonrubella group. A significant difference in the cumulative probability of glaucoma free survival at 10 years after cataract surgery (cases 0.53 vs controls 0.8; log rank P = 0.034) was present. Both groups had no significant difference in the time of onset of secondary glaucoma, average number of intraocular pressure lowering medications and number of eyes with surgical intervention for glaucoma (P > 0.05). Microcornea was associated with the development of glaucoma (hazard ratio 2.83; 95% confidence interval, 1.44-5.57; P = 0.002) in CRS eyes.
    CONCLUSIONS: There was no significant difference in the incidence of secondary glaucoma after cataract surgery performed in infants with CRS compared with infants who had undergone surgery for infantile cataracts. Because the 10-year probability of glaucoma free survival was significantly less in children with CRS, a closer and longer follow-up is recommended especially in eyes with at-risk features.
    BACKGROUND: The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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  • 文章类型: Journal Article
    目的:评价经半平面入路内镜下睫状体光凝(ECP)治疗难治性青光眼患者的长期疗效设计:单中心,回顾性,纵向,队列研究。
    方法:本研究招募了在北京同仁市眼科中心连续就诊并随访至少5年的ECP患者,中国从2013年1月到2017年12月。所有患者都接受了完整的眼科检查。治疗成功定义为6mmHg≤IOP≤21mmHg,有或没有抗青光眼药物。
    结果:共纳入105名患者的121只眼,包括51名儿童和54名成人。平均随访时间为7.2±1.3年。最常见的青光眼诊断是继发性青光眼(74眼,61.1%)和原发性先天性青光眼(19眼15.7%)。第一次ECP的平均程度为259度。术前33.3±9.0mmHg至术后20.5±7.5mmHg的眼压总体下降38.3%,有统计学意义(P<0.001)。1次及以上ECP手术成功率为65.3%。在适应性爱之后,先前的TCP手术次数和ECP程度,ECP失败与儿童(与成人相比,P=0.028;OR=2.549)和术前IOP较高(P=0.001;OR=1.084)相关.
    结论:ECP是降低难治性青光眼眼压的有效方法,特别是在也是玻璃体视网膜干预的候选人的患者中。因此,青光眼和视网膜专家之间的合作方法对于设计青光眼治疗的最佳管理策略至关重要。
    OBJECTIVE: To evaluate the long-term efficacy of endoscopic cyclophotocoagulation (ECP) via a pars plana approach in a large cohort of refractory glaucoma patients DESIGN: Single-center, retrospective, longitudinal, cohort study.
    METHODS: This study recruited patients who underwent ECP and consecutively visited and were followed up for at least 5 years at Beijing Tongren Eye Center, China from January 2013 to December 2017. All patients underwent a complete ophthalmic examination. Treatment success was defined as 6 mmHg ≤ IOP ≤ 21 mmHg with or without anti-glaucoma medications.
    RESULTS: A total of 121 eyes of 105 patients including 51 children and 54 adults were enrolled. The mean follow-up was 7.2 ± 1.3 years. The most common glaucoma diagnoses were secondary glaucoma (74 eyes, 61.1 %) and primary congenital glaucoma (19 eyes 15.7 %). The mean extent of the first ECP was 259 degrees. There was an overall decrease in IOP of 38.3 % from 33.3 ± 9.0 mmHg preoperatively to 20.5 ± 7.5 mmHg after surgery, which was statistically significant (P < 0.001). The success rate after 1 or more ECP surgery was 65.3 %. After adjusting for sex, number of prior TCP surgeries and the extent of ECP degree, the failure of ECP was associated with being children (as compared with adults; P = 0.028; OR = 2.549) and higher preoperative IOP (P = 0.001; OR = 1.084).
    CONCLUSIONS: ECP is an effective procedure for lowing IOP in refractory glaucoma, particularly in patients who are also candidates for vitreoretinal interventions. Hence, a collaborative approach between glaucoma and retinal specialists is of utmost importance in devising an optimal management strategy for glaucoma treatment.
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  • 文章类型: Observational Study
    To describe the socioeconomic profile, awareness level and reasons for the delay in accessing timely eye care for cataract surgery in patients of lens-induced glaucoma (LIG).
    This cross-sectional observational study included all patients with LIG who presented to a tertiary eye care centre in central rural India between March 2019 to February 2020. Data were collected through a questionnaire.
    Out of the 731 patients included in the study, the majority were females (69.36%). The mean age of the patients at presentation was 62.66 ± 10.37 years. Only a few participants, 193 (26.40%) were aware of LIG. Lower socioeconomic profile, older age, female gender and illiteracy were found to be strongly associated with awareness about LIG (p < .001). Patients waiting for the winter season (58.27%) to get operated was the major reason for delayed presentation to the hospital. Other reasons for the delayed presentation were - need not felt (feeling that intervention was not necessary) due to good vision in other eye (14.36%), financial issues (11.63%), long travelling distance (7.11%), no caretaker (6.89%), medical illness (1.78%) and fear of surgery (0.55%).
    Delayed reporting for eye healthcare in patients of LIG is found to be multifactorial. Most patients preferred waiting for the winter season to get their eyes operated, which throws light on the mindset and ignorance of the patients in this part of central rural India. We further emphasize on strengthening the education and counseling efforts in the community to enable patients to access services in a timely fashion.
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  • 文章类型: Journal Article
    UNASSIGNED: To investigate the outcomes of transscleral cyclophotocoagulation (TSCPC) after Ahmed glaucoma valve (AGV) implantation failure in patients with familial amyloidotic polyneuropathy (FAP) secondary glaucoma.
    UNASSIGNED: In this retrospective study, all patients with secondary FAP glaucoma who underwent AGV implantation between 2010 and 2019 in our tertiary center were assessed. Among all, those patients who needed TSCPC to control intraocular pressure (IOP) after AGV were selected. Demographic data, value of IOP, best-corrected visual acuity (BCVA), number of antiglaucomatous medications, surgical complications, and need for retreatment were collected.
    UNASSIGNED: From a total of 124 eyes submitted to AGV implantation, 13 eyes (10.48%) needed TSCPC to control IOP. The median age at TSCPC was 49.50 years (43; 55.75), and the median period between AGV implantation and TSCPC was 1.63 years (1.00; 3.65). There was a significant decrease of IOP after the procedure, from 24.33 ± 4.76 to 11.33 ± 2.90 mm Hg at last visit (p < 0.001). A reduction in the number of antiglaucomatous medications was also noticed, from 3.92 ± 0.29 to 1.25 ± 1.42 (p < 0.001). There was no difference in BCVA (p = 0.502). After the procedure, there was an exuberant anterior chamber (AC) reaction in two eyes (16.7%), and one case developed a neurotrophic ulcer (8.3%). There was no need for re-treatment.
    UNASSIGNED: Ahmed glaucoma valve implantation is a promising surgical procedure to treat patients with PAF secondary glaucoma, showing good results. For refractory cases, TSCPC seems to be effective and safe to control IOP.
    UNASSIGNED: There are only a few studies in current literature that address amyloid secondary glaucoma, maybe because it is a rare pathology worldwide. However, it has a high incidence in certain regions, including the north of Portugal. For the record, this is the first study describing the tool of cycloablative procedures in this type of glaucoma.
    UNASSIGNED: Vieira R, Marta A, Figueiredo A, et al. Transscleral Cyclophotocoagulation in Familial Amyloidotic Polyneuropathy Secondary Glaucoma after Ahmed Valve Implantation: A Case Series Study. J Curr Glaucoma Pract 2021;15(1):32-35.
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  • 文章类型: Journal Article
    青光眼在严重之前无症状,表明受影响的个体的实际数量可能高于被诊断的个体。
    研究沙特阿拉伯东部省青光眼病例的临床模式。
    这项回顾性研究是在大学法赫德国王医院进行的,Al-Khobar,和Dhahran眼科专科医院,达兰,沙特阿拉伯。对2015年1月至2018年12月在这些医院就诊的所有青光眼患者的病历进行了严格审查。有关患者人口统计学特征的数据,收集和分析临床资料及其内科和外科管理技术。
    共纳入999名患者,其中52.9%是男性,94.8%是沙特,平均年龄为58.8岁。在82.3%的病例中观察到双侧受累。原发性开角型青光眼(POAG)是最常见的青光眼类型(27.7%),其次是继发性青光眼(26.7%),原发性闭角型青光眼(PACG)(18.2%),原发性先天性青光眼(2.7%),和青少年开角型青光眼(2.2%),这是最常见的青光眼亚群。
    研究人群受POAG影响最大,继发性青光眼和PACG。有关青光眼患病率的知识对于计划服务很重要,分配资源,防止失明。
    UNASSIGNED: Glaucomas remain asymptomatic until severe, indicating that the actual number of affected individuals may be higher than those diagnosed.
    UNASSIGNED: To study the clinical patterns of glaucoma cases in the Eastern Province of Saudi Arabia.
    UNASSIGNED: This retrospective study was conducted at King Fahd Hospital of the University, Al-Khobar, and Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. The medical records of all patients with glaucoma who visited these hospitals from January 2015 to December 2018 were critically reviewed. Data regarding patients\' demographic characteristic, clinical data and their medical and surgical management techniques were collected and analyzed.
    UNASSIGNED: A total of 999 patients were included, of which 52.9% were males, 94.8% were Saudi, and the mean age was 58.8 years. Bilateral involvement was observed in 82.3% of cases. Primary open-angle glaucoma (POAG) was the most prevalent type of glaucoma (27.7%), followed by secondary glaucomas (26.7%), primary angle-closure glaucoma (PACG) (18.2%), primary congenital glaucoma (2.7%), and juvenile open-angle glaucoma (2.2%), which were the most frequent glaucoma subsets.
    UNASSIGNED: The study population was most affected by POAG, secondary glaucomas and PACG. Knowledge regarding prevalence of glaucoma is important to plan services, allocate resources, and prevent blindness.
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  • 文章类型: Journal Article
    目的:评估接受全身或局部类固醇治疗的青光眼患者的特征。
    方法:从2011年8月至2017年10月在我们的青光眼三级转诊中心的4256例患者中选择接受类固醇治疗的患者。从临床记录中提取受试者的临床特征。评估影响观察期间最高眼压(max-IOP)或在第一次和最后一次就诊时视野的平均偏差(MD)的因素,使用广义估计方程进行单变量和多元回归分析.
    结果:这项研究纳入了196例患者的三百八十二只眼。作为类固醇治疗原因的最常见疾病是特应性皮炎(58眼),其次是自身免疫性疾病。特应性皮炎患者明显年轻(38.0±11.2岁,p<0.001),MD较低(首次就诊时-9.3±9.1dB,p=0.01;-上次就诊时10.6±9.2dB,p=0.004)比患有其他疾病的人。在多元回归分析中,初次就诊时的年龄和MD,max-IOP,特应性皮炎在最后一次就诊时与MD相关。
    结论:本研究的结果表明,特应性皮炎患者即使在年轻人中也存在不可逆性视野丧失的风险。为了早期检测到高眼压,应建议在治疗特应性皮炎时加强眼科筛查。
    OBJECTIVE: To assess the characteristics of glaucoma patients who received systemic or topical steroid treatment.
    METHODS: Patients who received steroid treatment were selected from a total of 4256 patients at our tertiary referral center of glaucoma management between August 2011 and October 2017. Clinical characteristics of the subjects were extracted from clinical records. To evaluate the factors influencing highest intraocular pressure during observation (max-IOP) or mean deviations (MDs) of visual field at the first and last visits, univariate and multivariate regression analyses were performed using a generalized estimating equation.
    RESULTS: Three hundred and eighty-two eyes of 196 patients were included in this study. The most frequent disease as the reason for steroid treatment was atopic dermatitis (58 eyes) followed by autoimmune diseases. The patients with atopic dermatitis were significantly younger (38.0 ± 11.2 years old, p < 0.001) and had lower MD (- 9.3 ± 9.1 dB at first visit, p = 0.01; - 10.6 ± 9.2 dB at last visit, p = 0.004) than those with other diseases. In multivariate regression analysis, age and MD at first visit, max-IOP, and atopic dermatitis were correlated with MD at last visit.
    CONCLUSIONS: The results of the present study suggest that patients with atopic dermatitis carry the risk of irreversible visual field loss even in youth. For earlier detection of high intraocular pressure, reinforcement of ophthalmological screening in management of atopic dermatitis should be recommended.
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