1
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Yuhas PT, Roberts CJ. Clinical Ocular Biomechanics: Where Are We after 20 Years of Progress? Curr Eye Res 2023; 48:89-104. [PMID: 36239188 DOI: 10.1080/02713683.2022.2125530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular biomechanics is an assessment of the response of the structures of the eye to forces that may lead to disease development and progression, or influence the response to surgical intervention. The goals of this review are (1) to introduce basic biomechanical principles and terminology, (2) to provide perspective on the progress made in the clinical study and assessment of ocular biomechanics, and (3) to highlight critical studies conducted in keratoconus, laser refractive surgery, and glaucoma in order to aid interpretation of biomechanical parameters in the laboratory and in the clinic.Methods: A literature review was first conducted of basic biomechanical studies related to ocular tissue. The subsequent review of ocular biomechanical studies was limited to those focusing on keratoconus, laser refractive surgery, or glaucoma using the only two commercially available devices that allow rapid assessment of biomechanical response in the clinic.Results: Foundational studies on ocular biomechanics used a combination of computer modeling and destructive forces on ex-vivo tissues. The knowledge gained from these studies could not be directly translated to clinical research and practice until the introduction of non-contact tonometers that quantified the deformation response of the cornea to an air puff, which represents a non-destructive, clinically appropriate load. The corneal response includes a contribution from the sclera which may limit corneal deformation. Two commercial devices are available, the Ocular Response Analyzer which produces viscoelastic parameters with a customized load for each eye, and the Corvis ST which produces elastic parameters with a consistent load for every eye. Neither device produces the classic biomechanical properties reported in basic studies, but rather biomechanical deformation response parameters which require careful interpretation.Conclusions: Research using clinical tools has enriched our understanding of how ocular disease alters ocular biomechanics, as well as how ocular biomechanics may influence the pathophysiology of ocular disease and response to surgical intervention.
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Affiliation(s)
- Phillip T Yuhas
- College of Optometry, The Ohio State University, Columbus, OH, USA
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
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2
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Association between Serum Potassium with Risk of Onset and Visual Field Progression in Patients with Primary Angle Close Glaucoma: A Cross-Sectional and Prospective Cohort Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2275171. [PMID: 35783194 PMCID: PMC9246612 DOI: 10.1155/2022/2275171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/04/2022] [Indexed: 12/08/2022]
Abstract
Evidence suggests that ion metabolism may be associated with oxidative stress in the ocular tissue in glaucoma patients. This study is aimed at determining whether serum ion levels are associated with the onset and/or visual field (VF) progression of PACG. A total of 265 PACG and 166 healthy subjects were included in the cross-sectional study. Meanwhile, 265 subjects with PACG were followed up every six months for at least two years in the cohort study. All subjects were evaluated for serum concentrations of ions (calcium, phosphorus, potassium (K+), sodium, and chlorine) and underwent VF examination. Logistic regression analysis was performed to assess the risk factors for PACG. Cox regression analyses and Kaplan-Meier survival analyses were performed to identify factors associated with VF progression in PACG subjects. In the cross-sectional study, the K+ level (4.31 ± 0.39 mmol/L) was significantly higher in the PACG group than in the normal group (4.16 ± 0.35 mmol/L, P < 0.001). Multiple logistic regression showed that the increased K+ level was a risk factor of PACG (OR = 2.94, 95%CI = 1.63–5.32, P < 0.001). In the cohort study, there were 105 PACG subjects with progression and 160 PACG subjects without progression. The progression group had significantly higher baseline serum K+ levels (4.41 ± 0.37 mmol/L) than the no progression group (4.25 ± 0.39 mmol/L) (P = 0.002). The increased level of K+ at baseline was associated with faster VF progression (HR = 2.07, 95%CI = 1.23–3.46, P = 0.006). PACG subjects with higher baseline K+ levels had significantly lower VF nonprogression rates (51.94%) than subjects with lower K+ levels (68.38%, log-rank test P = 0.01). This study found that increased serum K+ level is a risk factor of PACG and is associated with faster VF progression in PACG, which might result from its influence on the oxidative stress process.
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3
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Asian Race and Primary Open-Angle Glaucoma: Where Do We Stand? J Clin Med 2022; 11:jcm11092486. [PMID: 35566612 PMCID: PMC9099679 DOI: 10.3390/jcm11092486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 01/27/2023] Open
Abstract
Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by irreversible retinal ganglion cell damage and visual field loss. The global POAG prevalence is estimated to be 3.05%, and near term is expected to significantly rise, especially within aging Asian populations. Primary angle-closure glaucoma disproportionately affects Asians, with up to four times greater prevalence of normal-tension glaucoma reported compared with high-tension glaucoma. Estimates for overall POAG prevalence in Asian populations vary, with Chinese and Indian populations representing the majority of future cases. Structural characteristics associated with glaucoma progression including the optic nerve head, retina, and cornea are distinct in Asians, serving as intermediates between African and European descent populations. Patterns in IOP suggest some similarities between races, with a significant inverse relationship between age and IOP only in Asian populations. Genetic differences have been suggested to play a role in these differences, however, a clear genetic pattern is yet to be established. POAG pathogenesis differs between Asians and other ethnicities, and it may differ within the broad classification of the Asian race. Greater awareness and further research are needed to improve treatment plans and outcomes for the increasingly high prevalence of normal tension glaucoma within aging Asian populations.
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4
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Cheng SM, Zhang JS, Shao X, Wu ZT, Li TT, Wang P, Lin JH, Yu AY. Repeatability of a new swept-source optical coherence tomographer and agreement with other three optical biometers. Graefes Arch Clin Exp Ophthalmol 2022; 260:2271-2281. [PMID: 35171331 DOI: 10.1007/s00417-022-05579-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 01/09/2022] [Accepted: 01/23/2022] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate the repeatability of Anterion and compare the agreement of ocular biometric measurements and predicted intraocular lens (IOL) powers with other three optical biometers. METHODS Flat keratometry (Kf), steep keratometry (Ks), J0 and 45 vectors, central cornea thickness (CCT), anterior chamber depth (ACD), and axial length (AL) from the Anterion, IOLMaster 700, Lenstar LS 900, and OA-2000 were recorded. The IOL powers were calculated with the Hoffer Q, Holladay 1, SRK/T, and Haigis formulas. The repeatability was evaluated using the within-subject standard deviation (Sw), repeatability coefficient (RC), coefficient of variation (COV), and intraclass correlation coefficient (ICC). Inter-device agreement between the four biometers was assessed with the 95% limits of agreement. RESULTS In total, 101 right eyes of 101 participants were enrolled. The Anterion showed good repeatability for all the included biometric parameters with all the CoV ≤ 0.30% and ICC ≥ 0.930 except for J45 with moderate repeatability (ICC was 0.849). Good agreement was found among the four devices for Kf, Ks, J0, J45, ACD, and AL. Generally, wide 95% LoA was found for the predicted IOL powers with the four IOL calculation formulas between the four devices. CONCLUSIONS The Anterion showed good repeatability of biometric measurements for most parameters. Good agreement among the four optical biometers was achieved for all the parameters except for CCT and the predicted IOL power. The AL values exhibited the best repeatability with Anterion and the best agreement among the biometers in our study.
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Affiliation(s)
- Shi-Ming Cheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China.,Ophthalmology Department, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, People's Republic of China
| | - Jia-Sheng Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China
| | - Xu Shao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China
| | - Ze-Tong Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China
| | - Tian-Tian Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China
| | - Po Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China
| | - Jun-Hai Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China
| | - A-Yong Yu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, People's Republic of China. .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, People's Republic of China.
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5
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Nam M, Kim SW. Changes in Corneal Epithelial Thickness Induced by Topical Antiglaucoma Medications. J Clin Med 2021; 10:jcm10163464. [PMID: 34441760 PMCID: PMC8397015 DOI: 10.3390/jcm10163464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 12/20/2022] Open
Abstract
Corneal thickness measurement is important for assessing intraocular pressure in patients with glaucoma. This study investigated the changes in corneal epithelial thickness (CET) induced by antiglaucoma medications and explored the factors affecting CET measurement. CET was measured over a 9.0 mm diameter area by using Fourier domain optical coherence tomography in 125 patients with primary open-angle glaucoma and 125 age-matched controls without glaucoma. The influence of sex, age, benzalkonium chloride (BAK)-containing instillations, disease severity, and types and numbers of medications was analyzed using simple and multiple regression analyses. CET over 25 sectors was smaller in the glaucoma group than in the control group (mean difference of 4.2 µm in the central 2.0 mm zone; 52.8 ± 3.6 vs. 48.5 ± 3.9, p < 0.001). Simple regression analysis revealed age, use of β-blockers, prostaglandin, carbonic anhydrase inhibitors, total number of medications, and number of daily BAK-containing instillations were associated with a thinner epithelium. Multiple regression analysis revealed β-blockers, prostaglandin, and number of BAK-containing instillations were significant factors. Use of β-blockers and number of BAK-containing instillations were also associated with a thinner epithelium in the monotherapy subgroup analysis. CET was significantly smaller in patients with glaucoma receiving topical medications and was affected by the use of β-blockers, prostaglandin, and BAK.
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6
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Park HM, Choi J, Lee WJ, Uhm KB. Rate of central corneal thickness changes in primary angle closure eyes: long-term follow-up results. BMC Ophthalmol 2021; 21:145. [PMID: 33752630 PMCID: PMC7986557 DOI: 10.1186/s12886-021-01908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT. Methods In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis. Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 μm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 μm/yr (P = 0.034) and that of the surgical trabeculectomy group was − 1.32 ± 0.43 μm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was − 0.81 ± 0.31 μm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 μm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001). Conclusions We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01908-4.
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Affiliation(s)
- Hae Min Park
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.,Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea
| | - Jiin Choi
- Office of Hospital Information, Seoul National University Hospital, Seoul, South Korea
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea. .,Department of Ophthalmology, Hanyang University Seoul Hospital, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.
| | - Ki Bang Uhm
- Department of Ophthalmology, Hanyang University College of Medicine, 222-1, Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea
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7
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Kim WK, Ryu IH, Yoo J, Kim SW. Effect of Gender, Age, and Ocular and Growth-Related Factors on Corneal Epithelial and Stromal Thickness in Children. J Clin Med 2020; 9:jcm9123849. [PMID: 33260816 PMCID: PMC7760657 DOI: 10.3390/jcm9123849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/01/2023] Open
Abstract
Data on corneal epithelial and stromal thickness in school-aged children in relation to gender, age, and ocular and growth parameters are limited. In this retrospective study, we analyzed corneal epithelial and stromal thickness measured with the RTVue system (Optovue, Inc., Fremont, CA, USA) in 122 male and 201 female Korean children (mean age 9.59 ± 2.18 years) with myopia. We used simple and multiple regression analysis to establish the relationships between gender, age, refractive status, axial length, anterior chamber depth (ACD), corneal refractive power, white-to-white corneal diameter (WTW), height, and body weight. Age, body weight, height, and central corneal thickness were positively associated with corneal epithelial thickness, whereas WTW was negatively associated. The multiple regression analysis showed corneal epithelial thickness was affected by sex, body weight, WTW, and central corneal thickness (CCT), while stromal thickness was influenced by age, sex, and WTW. Both corneal epithelial and stromal thickness were significantly greater in male than in female children and were affected by growth. Neither corneal epithelial nor stromal thickness were associated with the severity of myopia, corneal refractive power, or axial length.
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Affiliation(s)
- Wook Kyum Kim
- B & VIIT Eye Center, Seoul 06615, Korea; (W.K.K.); (I.H.R.)
| | - Ik Hee Ryu
- B & VIIT Eye Center, Seoul 06615, Korea; (W.K.K.); (I.H.R.)
| | - Jeongseo Yoo
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea;
| | - Sun Woong Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea;
- Correspondence:
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8
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Pan CW, Ke C, Chen Q, Tao YJ, Zha X, Zhang YP, Zhong H. Differential metabolic markers associated with primary open-angle glaucoma and cataract in human aqueous humor. BMC Ophthalmol 2020; 20:183. [PMID: 32375707 PMCID: PMC7203853 DOI: 10.1186/s12886-020-01452-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background We aimed to identify metabolic biomarkers and investigate the metabolic alterations in relation to primary open-angle glaucoma (POAG) and cataract in human aqueous humor. Methods Sixteen POAG patients undergoing surgical treatments and 24 patients undergoing cataract surgeries were included in this case-control study. We performed the metabolomic analysis of aqueous humor samples using a non-targeted gas chromatography coupled to time-of-flight mass spectrometer. The area under the receiver operating characteristic curve (AUC) was computed to assess the discrimination capacities of each metabolite marker. Databases including the Kyoto Encyclopedia of Genes and Genomes (KEGG) and MetaboAnalyst were utilized to search for the potential pathways of metabolites. Results Aqueous humor metabolomic profiles could well distinguish POAG from controls. Fourteen metabolic biomarkers were identified as potential aqueous humor biomarkers for POAG, yielding AUC values from 0.62 to 0.86. In pathway analysis, Biotin metabolism was highly impacted, implying that these metabolic markers play important roles in the regulation of this pathway. Conclusions This study identified valuable metabolic biomarkers and pathways that may facilitate an improved understanding of the POAG pathogenesis. The finding holds translational value in the development of new therapeutic measures for POAG.
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Affiliation(s)
- Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China.
| | - Chaofu Ke
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China
| | - Qin Chen
- Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yi-Jin Tao
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Kunming, 650032, China
| | - Xu Zha
- Department of Ophthalmology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuan-Ping Zhang
- Department of Ophthalmology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Kunming, 650032, China.
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9
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Ma R, Liu Y, Zhang L, Lei Y, Hou J, Shen Z, Yi X, Wang Y. Distribution and Trends in Corneal Thickness Parameters in a Large Population-Based Multicenter Study of Young Chinese Adults. ACTA ACUST UNITED AC 2018; 59:3366-3374. [PMID: 30025097 DOI: 10.1167/iovs.18-24332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Ruijue Ma
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University, Tianjin, China
| | - Yuanyuan Liu
- Department of Health Statistics, College of Public Health, Tianjin Medical University, Tianjin, China
| | - Lin Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University, Tianjin, China
| | - Yulin Lei
- Department of Ophthalmology, Jinan Mingshui Eye Hospital, Jinan, China
| | - Jie Hou
- Department of Ophthalmology, Jinan Mingshui Eye Hospital, Jinan, China
| | - Zhengwei Shen
- Ophthalmic Department, Wuhan General Hospital of Guangzhou Military Command of PLA, Wuhan, China
| | - Xianglong Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University, Tianjin, China
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10
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Ahmad SS. Glaucoma suspects: A practical approach. Taiwan J Ophthalmol 2018; 8:74-81. [PMID: 30038885 PMCID: PMC6055310 DOI: 10.4103/tjo.tjo_106_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/14/2018] [Indexed: 12/24/2022] Open
Abstract
Glaucoma suspects are controversial clinical dilemmas. These individuals harbor certain risk factors or demonstrate some clinical features suggestive of an increased probability to develop glaucomatous optic atrophy in the future. These characteristics range from high intraocular pressure; optic disc, visual field, or retinal nerve fiber layer abnormalities; or abnormal angles to a positive family history of glaucoma and other risk factors. Individuals having these characteristics should be assessed diligently before a diagnosis of glaucoma is made. Glaucoma is a chronic, lifelong condition, having a negative impact on the quality of life, with an increased risk of medication-related side-effects, adverse economic impacts, and the need for lifestyle changes in the patient. Overdiagnosis and unnecessary treatment of such individuals is bereft of any advantage. This review aims to provide a practical blueprint for the proper diagnosis and management of such glaucoma suspects.
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Affiliation(s)
- Syed Shoeb Ahmad
- Department of Ophthalmology, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
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11
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Belovay GW, Goldberg I. The thick and thin of the central corneal thickness in glaucoma. Eye (Lond) 2018; 32:915-923. [PMID: 29445115 DOI: 10.1038/s41433-018-0033-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 11/09/2022] Open
Abstract
Central corneal thickness (CCT) is an important parameter in the assessment of any potential glaucoma patient. While it affects prognosis in ocular hypertension, its value in patients diagnosed with glaucoma is less certain. There are several biological factors and genetic components that may influence glaucoma progression, which have been associated with thinner CCT. The CCT itself can be affected by several factors including ethnicity, age, sex, glaucoma medications, genetics, and the subtype of glaucoma. Besides, there is variability in the measurement of CCT between difference types of devices. These factors need to be considered in the evaluation of glaucoma patients' CCT and its effect on interpretation of intraocular pressure levels and risk stratification.
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Affiliation(s)
| | - Ivan Goldberg
- Glaucoma Unit, Sydney Eye Hospital, Sydney, Australia.,Discipline of Ophthalmology, University of Sydney, Sydney, Australia.,Eye Associates, Sydney, Australia
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12
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Jonas JB, Aung T, Bourne RR, Bron AM, Ritch R, Panda-Jonas S. Glaucoma. Lancet 2017; 390:2183-2193. [PMID: 28577860 DOI: 10.1016/s0140-6736(17)31469-1] [Citation(s) in RCA: 754] [Impact Index Per Article: 107.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 04/11/2017] [Accepted: 04/26/2017] [Indexed: 12/28/2022]
Abstract
Glaucoma is a heterogeneous group of diseases characterised by cupping of the optic nerve head and visual-field damage. It is the most frequent cause of irreversible blindness worldwide. Progression usually stops if the intraocular pressure is lowered by 30-50% from baseline. Its worldwide age-standardised prevalence in the population aged 40 years or older is about 3·5%. Chronic forms of glaucoma are painless and symptomatic visual-field defects occur late. Early detection by ophthalmological examination is mandatory. Risk factors for primary open-angle glaucoma-the most common form of glaucoma-include older age, elevated intraocular pressure, sub-Saharan African ethnic origin, positive family history, and high myopia. Older age, hyperopia, and east Asian ethnic origin are the main risk factors for primary angle-closure glaucoma. Glaucoma is diagnosed using ophthalmoscopy, tonometry, and perimetry. Treatment to lower intraocular pressure is based on topical drugs, laser therapy, and surgical intervention if other therapeutic modalities fail to prevent progression.
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Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
| | - Tin Aung
- Singapore Eye Research Institute, Singapore; Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rupert R Bourne
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - Alain M Bron
- Department of Ophthalmology, University Hospital, Dijon, France; Eye and Nutrition Research Group, Bourgogne Franche-Comté University, Dijon, France
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Songhomitra Panda-Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
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13
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Chiam N, Baskaran M, Li Z, Perera S, Goh D, Husain R, Khor CC, Cheng CY, Aung T, Vithana EN. Social, health and ocular factors associated with primary open-angle glaucoma amongst Chinese Singaporeans. Clin Exp Ophthalmol 2017. [PMID: 28621876 DOI: 10.1111/ceo.13008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
IMPORTANCE There is limited literature on lifestyle and health factors related to primary open-angle glaucoma amongst Asians. BACKGROUND This study evaluated the association of primary open-angle glaucoma with smoking, health and ocular factors amongst Chinese Singaporeans. DESIGN Case-control study. PARTICIPANTS The study used 711 primary open-angle glaucoma patients from a Singapore hospital and 2788 population-based controls. METHODS Subjects underwent clinical examination and completed a questionnaire with details on family history of glaucoma, comorbidities, smoking and alcohol consumption. Glaucoma cases were subclassified as normal or high-tension glaucoma according to their untreated intraocular pressures. MAIN OUTCOME MEASURES The association of various health and lifestyle factors, with normal-tension and high-tension glaucoma was evaluated. RESULTS Using multiple logistic regression, primary open-angle glaucoma was associated with older age (odds ratio 1.12 per year older; 95% confidence interval 1.10-1.15; P < 0.001), family history of glaucoma (odds ratio 7.86; 95% confidence interval 4.48-13.79; P < 0.001), higher intraocular pressure (odds ratio 1.75 per 1 mmHg; 95% confidence interval 1.64-1.87; P < 0.001) and thinner central corneal thickness (odds ratio 1.01; 95% confidence interval 1.01-1.02; P < 0.001). Myopes were more likely to have primary open-angle glaucoma (P < 0.001). A current smoking habit was protective against normal-tension glaucoma (odds ratio 0.30; 95% confidence interval 0.10-0.92; P = 0.035). CONCLUSIONS AND RELEVANCE Older age, family history of glaucoma, higher intraocular pressure, thinner central corneal thickness and myopia were significantly associated with primary open-angle glaucoma amongst Chinese Singaporeans.
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Affiliation(s)
- Nathalie Chiam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Mani Baskaran
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Eye-ACP, Duke-NUS Medical School, Singapore
| | - Zheng Li
- Genome Institute of Singapore, Singapore
| | - Shamira Perera
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - David Goh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Rahat Husain
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Chiea Chuen Khor
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Department of Ophthalmology, National University Health System and National University of Singapore, Singapore.,Eye-ACP, Duke-NUS Medical School, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Department of Ophthalmology, National University Health System and National University of Singapore, Singapore.,Eye-ACP, Duke-NUS Medical School, Singapore
| | - Eranga N Vithana
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Department of Ophthalmology, National University Health System and National University of Singapore, Singapore.,Eye-ACP, Duke-NUS Medical School, Singapore
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Soleimanizad R, Nowroozzadeh MH, Ziaei H, Pakravan M, Yaseri M, Katibeh M. The Association of Central Corneal Thickness with Ocular and General Parameters in a Community Setting: The Yazd Eye Study. J Ophthalmic Vis Res 2017; 12:141-150. [PMID: 28540004 PMCID: PMC5423366 DOI: 10.4103/jovr.jovr_111_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess central corneal thickness (CCT) and its associations in an adult Iranian population. METHODS This was a population-based cross-sectional study of adults aged 40-80 years. Eyes with corneal disorders, previous ocular surgery, or trauma were excluded. All subjects underwent complete ophthalmic examination, general health assessment, laboratory tests, and a detailed interview. CCT was measured with an ultrasonic pachymeter. Intraocular pressure (IOP) was measured with Goldmann applanation tonometry. Except for the report on interocular differences in CCT, only one eye of each subject was used for the rest of statistical analyses. RESULTS The mean age (±SD) of the 1203 participants, who had CCT measurements and met inclusion criteria, was 51.8 ± 8.5 years. The mean CCT was 544 ± 35, 564 ± 28, and 544 ± 36 μm in the eyes of the normal, ocular hypertension, and glaucoma groups, respectively (P = 0.025). In participants without glaucoma, the mean interocular difference in CCT was 9 ± 12 μm. CCT was not significantly associated with age, sex, or some select systemic factors (body mass index, diabetes, hypertension, and renal failure). While controlling for age and sex, CCT was greater in individuals with higher IOPs (P < 0.001), larger vertical or horizontal cup-to-disc ratios (P = 0.044, and P = 0.025, respectively), and hyperopia (P = 0.009). CONCLUSION In this adult Iranian population, CCT was significantly associated with IOP, cup-to-disc ratio, and the refractive status of eye. CCT outside the normal range of 475-613 μm or with interocular asymmetry greater than 33 μm (6%) should prompt evaluation for potential ocular disorders.
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Affiliation(s)
- Reza Soleimanizad
- Department of Ophthalmology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Mohammad Hosein Nowroozzadeh
- Poostchi Ophthalmology Research Center and Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Ziaei
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Pakravan
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Katibeh
- Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Center for Global Health, Department of Public Health, Aarhus University, Denmark
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15
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Swierkowska J, Gajecka M. Genetic factors influencing the reduction of central corneal thickness in disorders affecting the eye. Ophthalmic Genet 2017; 38:501-510. [DOI: 10.1080/13816810.2017.1313993] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Marzena Gajecka
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
- Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, Poznan, Poland
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the role of central corneal thickness (CCT) in the clinical management of a glaucoma patient. RECENT FINDINGS The prognostic value of CCT is well recognized in patients with ocular hypertension. However, its predictive value in other glaucoma suspects and patients with established glaucoma is less certain. Tonometry artefacts can result from variations in CCT. However, an adequately validated correction algorithm for Goldmann applanation tonometry measurements does not exist. Newer methods of tonometry are potentially less influenced by CCT but are limited in their clinical use. There may also be biological and genetic associations between corneal thickness and glaucoma. Demographics, environmental factors, glaucoma treatment and the measurement device used have a significant influence on CCT, and should be considered when interpreting the effect of cornea thickness in patients with glaucoma. New measurements of the biomechanical properties of the cornea are likely to be better approximations of the globe biomechanics than CCT, but these require further evaluation. SUMMARY The clinical significance of CCT is well recognized in the context of glaucoma diagnosis and management, though the extent of its importance remains debatable. Corneal biomechanical properties may be more significantly associated with glaucoma than CCT.
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Sarfraz MH, Mehboob MA, Haq RIU. Correlation between central corneal thickness and visual field defects, cup to disc ratio and retinal nerve fiber layer thickness in primary open angle glaucoma patients. Pak J Med Sci 2017; 33:132-136. [PMID: 28367186 PMCID: PMC5368294 DOI: 10.12669/pjms.331.11623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To evaluate the correlation between Central Corneal Thickness (CCT) and Visual Field (VF) defect parameters like Mean Deviation (MD) and Pattern Standard Deviation (PSD), Cup-to-Disc Ratio (CDR) and Retinal Nerve Fibre Layer Thickness (RNFL-T) in Primary Open-Angle Glaucoma (POAG) patients. Methods: This cross sectional study was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from September 2015 to September 2016. Sixty eyes of 30 patients with diagnosed POAG were analysed. Correlation of CCT with other variables was studied. Results: Mean age of study population was 43.13±7.54 years. Out of 30 patients, 19 (63.33%) were males and 11 (36.67%) were females. Mean CCT, MD, PSD, CDR and RNFL-T of study population was 528.57±25.47µm, -9.11±3.07, 6.93±2.73, 0.63±0.13 and 77.79±10.44µm respectively. There was significant correlation of CCT with MD, PSD and CDR (r=-0.52, p<0.001; r=-0.59, p<0.001;r=-0.41, p=0.001 respectively). The correlation of CCT with RNFL-T was not statistically significant (r=-0.14, p=0.284). Conclusion: Central corneal thickness had significant correlation with visual field parameters like mean deviation and pattern standard deviation, as well as with cup-to-disc ratio. However, central corneal thickness had no significant relationship with retinal nerve fibre layer thickness.
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Affiliation(s)
- Muhammad Haroon Sarfraz
- Dr. Muhammad Haroon Sarfraz, MBBS. Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan
| | | | - Rana Intisar Ul Haq
- Dr. Rana Intisar ul Haq, MCPS(Ophth), FCPS(Ophth). Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan
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Tolesa K, Gessesse GW. Central corneal thickness in newly diagnosed glaucoma patients in South West Ethiopia: a cross-sectional study. BMC Ophthalmol 2016; 16:152. [PMID: 27580950 PMCID: PMC5007694 DOI: 10.1186/s12886-016-0334-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/23/2016] [Indexed: 11/29/2022] Open
Abstract
Background Reports of central corneal thickness (CCT) among glaucoma patients, particularly for pseudoexfoliative glaucoma (PXG) and Primary Angle Closure Glaucoma (PACG) are scarce in the Sub-Saharan African (SSA) population. The aim of this study is to evaluate CCT in black patients with newly diagnosed glaucoma and ocular hypertension (OHT) in South West Ethiopia. Methods This was a prospective study undertaken with an ultrasonic pachymeter from June 2014 to February 2015 in Jimma University Specialized Hospital. Patients aged 18 years and older newly diagnosed with glaucoma or OHT were included. Results A total of 162 eyes of 162 subjects were included. Hundred and fifty five subjects were glaucomatous: (67 PXG, 42 Primary Open Angle Glaucoma (POAG), 28 PACG, 14 Normal Tension Glaucoma (NTG), 5 Juvenile Open Angle Glaucoma (JOAG) and 6 (OHT). The mean age was 59.3 ± 12.8 years. For the whole sample, CCT was 518.67 (±39.97) μm. OHT group had significantly greater CCT (576.33 ± 49.32 μm) than the glaucomatous groups (p = 0.004). POAG (506.69 ± 35.08 μm) and NTG (510.79 ± 44.37 μm) groups had thinner CCT than PXG (520.48 ± 38.95 μm), PACG (524.00 ± 37.16 μm), and JOAG (518.00 ± 30.82 μm) groups, but this was not statistically significant (p = 0. 296). There was a statistically significant decline of CCT with advanced age (P = 0.02). There wasn’t significant difference of average CCT between the ethnic groups (P = 0.3) and gender (P = 0.064). Conclusion The mean CCT of Ethiopian glaucoma patients is thinner than Caucasians and similar to those reported from previous studies in Sub Saharan Africa. OHT patients had thicker CCT; there was no statistically significant difference observed in average CCT amongst glaucoma subtypes.
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Affiliation(s)
- Kumale Tolesa
- Jimma University, Ethiopia, P.O. Box: 378, Jimma, Ethiopia
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Pan CW, Li J, Zhong H, Shen W, Niu Z, Yuan Y, Chen Q. Ethnic Variations in Central Corneal Thickness in a Rural Population in China: The Yunnan Minority Eye Studies. PLoS One 2015; 10:e0135913. [PMID: 26274328 PMCID: PMC4537213 DOI: 10.1371/journal.pone.0135913] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 07/28/2015] [Indexed: 12/03/2022] Open
Abstract
Purpose To describe the ethnic differences in central corneal thickness (CCT) in population-based samples of ethnic Bai, Yi and Han people living in rural China. Methods 6504 adults (2119 ethnic Bai, 2202 ethnic Yi and 2183 ethnic Han) aged 50 years or older participated in the study. Each subject underwent standardized ocular examinations and interviewer-administered questionnaires for risk factor assessment. CCT was measured for both eyes using an ultrasound pachymeter. Regression and principal component analysis were performed to examine the relationship of ethnicity and other factors with CCT. Results The mean CCT readings were 536.4 ± 34.2 μm in ethnic Bai, 532.1 ± 32.1 μm in ethnic Yi and 529.6 ± 32.7 μm in ethnic Han adults (P<0.001), respectively. There was a decreasing trend of mean CCT with increasing age across all ethnic groups. In multivariate linear regression models, increasing CCT was associated with younger age (P<0.001), male gender (P<0.001), Bai (P<0.001) or Yi (P<0.001) ethnicity, greater body mass index (P<0.001), higher systolic blood pressure (P<0.001), greater corneal curvature (P<0.001), deeper anterior chamber (P < 0.001), and thicker lens (P<0.001). Ethnicity contributed significantly to presence of thin cornea (60%; P< 0.001) compared with other factors. CCT had similar impact on intraocular pressure readings across all ethnic groups. Conclusions This study of more than 6500 multiethnic participants demonstrates significant ethnic variations in CCT, with Han ethnicity having the thinnest cornea compared with ethnic minorities. These data are essential to guide future multiethnic clinical trials on CCT-related ocular conditions such as glaucoma.
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Affiliation(s)
- Chen-Wei Pan
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jun Li
- The Second People’s Hospital of Yunnan Province, Kunming, China
| | - Hua Zhong
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei Shen
- The Second People’s Hospital of Yunnan Province, Kunming, China
| | - Zhiqiang Niu
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuansheng Yuan
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qin Chen
- First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- * E-mail:
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Liang H, Zuo HY, Chen JM, Cai J, Qin YZ, Huang YP, Chen YY, Tang DY, Tan SJ. Corneal endothelial cell density and morphology and central corneal thickness in Guangxi Maonan and Han adolescent students of China. Int J Ophthalmol 2015; 8:608-11. [PMID: 26086017 DOI: 10.3980/j.issn.2222-3959.2015.03.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 07/04/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the corneal endothelial cell density and morphology and central corneal thickness in the Guangxi Maonan and Han adolescent students of China. METHODS Noncontact specular microscope (Topcon SP3000P, Tokyo, Japan) was performed in 133 adolescent students of Maonan nationality (M:F 54:79) and 105 adolescent students of Han nationality (M:F 50:55), 5 to 20y of age, who were randomly selected from 3 schools in Huanjiang Maonan Autonomous County of Guangxi Zhuang Autonomous Region of China. Parameters studied included endothelial cell density, mean cell area, coefficient of variation in cell size, percentage hexagonality and central corneal thickness. RESULTS Endothelial cell density, mean cell area, coefficient of variation in cell size, percentage hexagonality and central corneal thickness in the study population were (2969.50±253.93) cells/mm(2), (339.23±29.44) µm(2), (29.96±4.07) %, (64.58±9.41) % and (523.71±32.82) µm in Maonan and (2998.26±262.65) cells/mm(2), (336.11±30.07) µm(2), (29.89±5.03) %, (64.91±11.64) % and (524.39±33.15) µm in Han, respectively. No significant differences were observed in endothelial cell density, mean cell area, coefficient of variation in cell size, percentage hexagonality and central corneal thickness between Maonan and Han (P=0.615, 0.659, 0.528, 0.551, 0.999). In Maonan and Han, we found age was negatively correlated with endothelial cell density and percentage hexagonality and positively correlated with mean cell area and coefficient of variation in cell size. Negative correlation was also found between central corneal thickness and age in Han, whereas no correlation was found in Maonan. CONCLUSION There were no differences between Maonan and Han in corneal endothelial cell density and morphology and central corneal thickness. In these two nationalities, there were statistically significant decrease in endothelial cell density and percentage hexagonality with increasing age and statistically significant increase in cell area and coefficient of variation in cell size with increasing age. Central corneal thinned with increasing age in Han, whereas difference did not attain statistical significance in Maonan.
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Affiliation(s)
- Hao Liang
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Hui-Yi Zuo
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jin-Mao Chen
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jie Cai
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yu-Zhua Qin
- People's Hospital of Huanjiang Maonan Autonomous County, Huanjiang 547100, Guangxi Zhuang Autonomous Region, China
| | - Yu-Ping Huang
- People's Hospital of Huanjiang Maonan Autonomous County, Huanjiang 547100, Guangxi Zhuang Autonomous Region, China
| | - Ying-Ying Chen
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Dong-Yong Tang
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Shao-Jian Tan
- Department of Ophthalmology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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Moghimi S, Torabi H, Hashemian H, Amini H, Lin S. Central corneal thickness in primary angle closure and open angle glaucoma. J Ophthalmic Vis Res 2015; 9:439-43. [PMID: 25709768 PMCID: PMC4329703 DOI: 10.4103/2008-322x.150812] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 05/05/2014] [Indexed: 11/17/2022] Open
Abstract
Purpose: To quantitatively analyze central corneal thickness (CCT) in patients with primary angle closure glaucoma (PACG) and primary open-angle glaucoma (POAG), and to evaluate its correlation with severity of glaucoma. Methods: In this retrospective study, records of patients with previously diagnosed POAG or PACG at a tertiary glaucoma service were reviewed. CCT was measured by ultrasound pachymetry. Mean deviation (MD) on visual field (VF) testing was recorded for glaucoma severity determination. CCT and age- and sex-adjusted CCT were compared among the study groups using Student's t-test and analysis of covariance (ANCOVA), respectively. Univariate and multivariate regression models were used for correlation of age, MD and CCT. Results: A total of 115 patients with PACG, 215 with POAG, and 100 normal controls were included with mean age of 64.1 ± 10.4, 59.9 ± 10.5, and 62.04 ± 10.80 years, respectively. CCT was thicker in PACG eyes (545.5 ± 46.1 μm) as compared to POAG eyes (531.7 ± 37.3 μm) and controls (531.0 ± 38.3 μm) even after age and gender adjustment (ANCOVA, P = 0.05). CCT was found to decrease with increasing age only in the POAG group (β = -0.57, P = 0.01). Disease severity (MD of VF) was significantly and inversely correlated with CCT in both POAG and PACG eyes (β = 1.89, P = 0.02; and β = 1.38, P = 0.04, respectively) after age and sex correction. Conclusion: PACG eyes had thicker CCT as compared to POAG and normal healthy eyes in Iranian subjects. Severity of the disease was inversely correlated with CCT in eyes with both POAG and PACG.
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Affiliation(s)
- Sasan Moghimi
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran ; Koret Vision Center, University of California, San Francisco Medical School, San Francisco, CA, USA
| | - Hamidreza Torabi
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Hesam Hashemian
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Heydar Amini
- Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Shan Lin
- Koret Vision Center, University of California, San Francisco Medical School, San Francisco, CA, USA
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Tu YS, Damji KF, Chen ZH, Arora S, Yin ZQ. Phenotypic features of Chinese family members with primary angle closure. Can J Ophthalmol 2013; 48:193-8. [PMID: 23769781 DOI: 10.1016/j.jcjo.2013.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 01/10/2013] [Accepted: 01/24/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe ocular phenotypic features in Chinese families with primary angle closure (PAC). DESIGN Prospective cohort study. PARTICIPANTS 428 individuals of 103 eligible families. METHODS Probands identified in clinic and their relatives were examined. Measurements included intraocular pressure, anterior chamber depth, lens thickness, axial length, and gonioscopic features related to the anterior chamber angle. Electroretinogram (ERG) testing for dark and light adaptation on both eyes of each individual examined was also obtained. RESULTS There were 144 PAC affected patients (33.7%), 60 suspects (14%), and 224 unaffected individuals (52.3%). There were more than 2 affected members in 51 families (49.5%). Compared with unaffected individuals, affected individuals were more likely to be female, have shallower peripheral and central anterior chamber depths, narrower angles, thicker lenses, and shorter axial lengths (p<0.001). Affected patients and suspects had similar axial lengths (p>0.05). Compared with unaffected individuals, affected and suspect individuals showed ERG adaptation abnormalities (p<0.05). Of 45 unaffected individuals with mean axial length ≤ 22.00 mm (10.51%), 20 individuals (4.67%) showed ERG adaptation abnormalities similar to affected patients and suspects (p> 0.05). CONCLUSIONS Patients with PAC were significantly more likely to be female, have shorter axial length, and have thicker lenses compared with unaffected individuals. PAC suspects showed similar axial lengths to affected individuals. ERG abnormalities mainly occurred in affected patients and suspects, but also occurred in unaffected individuals with short axial length.
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Affiliation(s)
- Yun Shu Tu
- Southwest Eye Hospital/Southwest Hospital, the Third Military Medical University, Chongqing, China
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