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Scientific Reports May 2024To explore altered patterns of static and dynamic functional brain network connectivity (sFNC and dFNC) in Primary angle-closure glaucoma (PACG) patients. Clinically...
To explore altered patterns of static and dynamic functional brain network connectivity (sFNC and dFNC) in Primary angle-closure glaucoma (PACG) patients. Clinically confirmed 34 PACG patients and 33 age- and gender-matched healthy controls (HCs) underwent evaluation using T1 anatomical and functional MRI on a 3 T scanner. Independent component analysis, sliding window, and the K-means clustering method were employed to investigate the functional network connectivity (FNC) and temporal metrics based on eight resting-state networks. Differences in FNC and temporal metrics were identified and subsequently correlated with clinical variables. For sFNC, compared with HCs, PACG patients showed three decreased interactions, including SMN-AN, SMN-VN and VN-AN pairs. For dFNC, we derived four highly structured states of FC that occurred repeatedly between individual scans and subjects, and the results are highly congruent with sFNC. In addition, PACG patients had a decreased fraction of time in state 3 and negatively correlated with IOP (p < 0.05). PACG patients exhibit abnormalities in both sFNC and dFNC. The high degree of overlap between static and dynamic results suggests the stability of functional connectivity networks in PACG patients, which provide a new perspective to understand the neuropathological mechanisms of optic nerve damage in PACG patients.
Topics: Humans; Glaucoma, Angle-Closure; Female; Male; Middle Aged; Magnetic Resonance Imaging; Aged; Nerve Net; Case-Control Studies; Brain
PubMed: 38778225
DOI: 10.1038/s41598-024-62635-6 -
Glaucoma Characteristics and Influencing Factors during the COVID-19 Pandemic in the Huizhou Region.Journal of Ophthalmology 2023Glaucoma in individuals who tested positive for the coronavirus disease 2019 (COVID-19) during the pandemic outbreak has not been comprehensively studied. Therefore,...
OBJECTIVE
Glaucoma in individuals who tested positive for the coronavirus disease 2019 (COVID-19) during the pandemic outbreak has not been comprehensively studied. Therefore, this study aimed to analyze the characteristics and risk factors of glaucoma during the COVID-19 pandemic in Huizhou.
METHODS
Retrospective data from outpatients with glaucoma at the Huizhou Hospital Affiliated with Guangzhou Medical University and Longmen County People's Hospital were collected during two periods: the COVID-19 pandemic period (Phase A: December 1, 2022, to January 19, 2023) and the prevention and control period (Phase B: December 1, 2021, to January 19, 2022). The demographic characteristics of the outpatients during both phases were compared. The characteristics of glaucoma in patients with COVID-19 during Phase A were examined. Multivariate logistic regression analysis was used to identify factors influencing the development of acute angle-closure glaucoma (AACG) in Phase A patients.
RESULTS
The proportion of patients with glaucoma was significantly higher during Phase A than during Phase B at both hospitals. No statistically significant differences were observed between patients with glaucoma during Phases A and B for age, sex, and region. A high COVID-19-positive rate was associated with old age, females, AACG, newly diagnosed glaucoma, and binocular involvement during phase A. Females testing positive for COVID-19, glaucoma that started after testing positive for COVID-19, and a history of medication use were associated with a higher proportion of AACG in phase A. Multivariable logistic regression analysis identified testing positive for COVID-19 as an independent potential risk factor for developing AACG.
CONCLUSION
In summary, during the COVID-19 pandemic in Huizhou, patients with COVID-19 were primarily affected by AACG, especially females, older individuals, and those with binocular involvement. Testing positive for COVID-19 increases the risk of developing AACG.
PubMed: 37927894
DOI: 10.1155/2023/8889754 -
Translational Vision Science &... Sep 2023The purpose of this study was to investigate the classification of angle closure eyes based on hierarchical cluster analysis of ocular biometrics measured in the dark...
PURPOSE
The purpose of this study was to investigate the classification of angle closure eyes based on hierarchical cluster analysis of ocular biometrics measured in the dark and light using anterior segment optical coherence tomography (AS-OCT).
METHODS
Participants of the Chinese American Eye Study received complete eye examinations to identify primary angle closure suspects (PACS) and primary angle closure without/with glaucoma (PAC/G). AS-OCT was performed in the dark and light. Biometric parameters describing the angle, iris, lens, and anterior chamber were analyzed. Hierarchical clustering was performed using Ward's method. Post hoc logistic regression models were developed to identify biometric predictors of angle closure staging.
RESULTS
Analysis of 159 eyes with PACS (N = 120) or PAC/G (N = 39) produced 2 clusters in the dark and light. In both analyses, cluster 1 (N = 132 in the dark and N = 126 in the light) was characterized by smaller angle opening distance (AOD)750 and trabecular iris space area (TISA)750, greater iris curvature (IC), and greater lens vault (LV; P < 0.001) than cluster 2. The proportion of PAC/PACG to PACS eyes was significantly higher in cluster 1 than 2 in the light (36:90 and 3:30, respectively; P = 0.02), but not the dark (36:96 and 3:24, respectively; P = 0.08). On multivariable regression analyses, smaller TISA750 (odds ratio [OR] = 0.84 per 0.01 mm2) and AOD750 (OR = 0.93 per 0.01 mm) in the light and smaller TISA750 (OR = 0.86 per 0.01 mm2) in the dark conferred higher risk of PAC/G (P ≤ 0.02).
CONCLUSIONS
Unsupervised cluster analysis of ocular biometrics can classify angle closure eyes by severity. Static biometrics measured in the light and dark are both predictive of PAC/G.
TRANSLATIONAL RELEVANCE
Clustering of biometrics measured in the light could provide an alternative source of information to risk-stratify angle closure eyes for more severe disease.
Topics: Humans; Anterior Chamber; Glaucoma; Tomography, Optical Coherence; Biometry; Cluster Analysis
PubMed: 37672252
DOI: 10.1167/tvst.12.9.4 -
Journal of Clinical Medicine Oct 2023This study evaluated the agreement and reproducibility of ACA measurements obtained using the built-in software of the CASIA2 (Version 3G.1) and the measurements derived...
PURPOSE
This study evaluated the agreement and reproducibility of ACA measurements obtained using the built-in software of the CASIA2 (Version 3G.1) and the measurements derived from expert clinicians.
METHODS
Healthy volunteers underwent ophthalmological evaluation and AS-OCT examination. ACA measurements derived from automated and manual SS location were obtained using the CASIA2 automated software and clinician identification, respectively. The intraobserver, interobserver reproducibility, CASIA2-human grader reproducibility and CASIA2 repeatability were assessed using intraclass correlation coefficients (ICCs).
RESULTS
The study examined 58 eyes of 30 participants. The CASIA2 software showed excellent repeatability for all ACA parameters (ICC > 0.84). Intraobserver, interobserver, and CASIA2-human grader reproducibility were also excellent (ICC > 0.87). Interobserver agreement was high, except for nasal TISA500, differing between observers 1 and 2 ( < 0.05). The agreement between CASIA2 measurements and human graders was high, except for nasal TISA500, where observer 1 values were smaller ( < 0.05).
CONCLUSION
The CASIA2 built-in software reliably measures ACA parameters in healthy individuals, demonstrating high consistency. Although a small difference was observed in nasal TISA500 measurements, interobserver and CASIA2-human grader reproducibility remained excellent. Automated SS detection has the potential to facilitate evaluation and monitoring of primary angle closure disease.
PubMed: 37835024
DOI: 10.3390/jcm12196381 -
Frontiers in Public Health 2023The aim of this study is to demonstrate the relevance of primary acute angle closure (APAC) and COVID-19 infection, compare the demographic features and manifestations... (Observational Study)
Observational Study
INTRODUCTION
The aim of this study is to demonstrate the relevance of primary acute angle closure (APAC) and COVID-19 infection, compare the demographic features and manifestations between COVID-19 positive and negative patients with APAC, and infer the underlying mechanism.
METHODS
This study is based on all patients diagnosed with APAC at the glaucoma center of Eye, Ear, Nose and Throat Hospital of Fudan University (Fenyang road center) from 15th December 2022 to 11th January 2023. Totally 171 APAC cases were categorized into COVID-19 positive and negative group. Demographic features and final treatment level of the patients were compared between the two groups. Clinical manifestations, intraocular pressure, and anterior chamber configuration were also compared between the two groups.
RESULTS
In the COVID-19 positive group, the number of cases with APAC onset spiked in 22nd December 2022, which coincided with the spike of COVID-19 antigen positive people. Compared to the COVID-19 negative group, COVID-19 positive APAC patients were younger with a lower percentage of APAC history. Additionally, more eyes of COVID-19 positive APAC patients showed keratic precipitates. COVID-19 positive eyes had significantly larger anterior chamber depth with a more dilated pupil. Therefore, COVID-19 infection could probably act as a triggering factor of APAC.
DISCUSSION
The onset of APAC might be accelerated by COVID-19 infection for patients with younger age and milder anatomical configuration. Additionally, COVID-19 related APAC cases might have a more abrupt and fierce onset. Ophthalmic emergent services should not be neglected during the epidemic period.
Topics: Humans; COVID-19; Eye; Epidemics; Hospitals; Retrospective Studies
PubMed: 37645709
DOI: 10.3389/fpubh.2023.1196202 -
International Journal of Ophthalmology 2023To describe the outcome of using low-dose laser cycloplasty (LCP) in chronic angle-closure glaucoma (CACG).
AIM
To describe the outcome of using low-dose laser cycloplasty (LCP) in chronic angle-closure glaucoma (CACG).
METHODS
A retrospective case series. Medical charts of CACG patients who underwent LCP in the Eye Hospital of Wenzhou Medical University were reviewed. The main outcomes included intraocular pressure (IOP), the number of glaucoma medication, anterior segment parameters and surgery-related complications.
RESULTS
A total of 7 eyes of 7 CACG patients (age 38.9±11.0y) underwent LCP with a mean follow-up of 27.1±13.7mo (range 16-48mo). Following LCP, mean IOP and glaucoma medications decreased from 26.1±6.1 mm Hg with 3.1±1.1 glaucoma medications pre-treatment to 14.9±3.1 mm Hg (=0.027) with 0.4±1.1 glaucoma medications (=0.001) at final follow-up. The anterior chamber depth (ACD), angle opening distance and trabecular-iris angle increased from 1.65±0.33 mm, 0.05 mm (range 0-0.30 mm) and 5.1° (range, 0-31.97°) at baseline to 1.98±0.43 mm (=0.073), 0.53 mm (range 0.42-0.91 mm, =0.015), 45.9° (range, 40.2°-59.4°, (=0.015) in the long-term follow-up, respectively. The deepening of ACD and reopening of anterior chamber angle (ACA) was observed in 6 eyes (85.7%).
CONCLUSION
LCP is a promising treatment option for patients with CACG reducing IOP and glaucoma medication without serious complications. In addition, LCP can bring a significant deepening in ACD and reopening of ACA.
PubMed: 38111928
DOI: 10.18240/ijo.2023.12.13 -
Cureus May 2024To evaluate the outcomes of combined canaloplasty and trabeculotomy with phacoemulsification for primary angle-closure glaucoma (PACG).
PURPOSE
To evaluate the outcomes of combined canaloplasty and trabeculotomy with phacoemulsification for primary angle-closure glaucoma (PACG).
METHODS
In this retrospective, consecutive, single-surgeon case series, we analyzed the pre- and postoperative measurements of PACG patients who had the procedure. Adverse events were recorded. The main outcomes were mean intraocular pressure (IOP) in each quartile of the follow-up year and the number of IOP-lowering medications the patients were on by the end of each quartile compared to their baseline values.
RESULTS
A total of 46 eyes from 39 PACG patients were included. The preoperative IOP and glaucoma medications taken were 19.33±6.03 mm Hg and 1.80±1.39, respectively (N=46). Postoperative IOP means (mm Hg) in the subsequent four quartiles were 14.00±3.33 (N=44), 13.44±2.83 (N=32), 14.38±2.39 (N=16), and 14.92±2.90 (N=13) (p<0.0001). The mean number of meds was 0.32±0.80, 0.22±0.42, 0.59±0.80, and 0.08±0.28 in each respective quartile (p<0.0001), while the median was 0 across all quartiles.
CONCLUSIONS
Combining the OMNI surgical system with phacoemulsification led to substantial reductions in mean IOP and the number of IOP-lowering medications when compared to baseline measurements.
PubMed: 38887363
DOI: 10.7759/cureus.60549 -
Heliyon May 2024To evaluate abnormalities in serum and aqueous humor uric acid (UA) levels in primary angle closure glaucoma (PACG).
PURPOSE
To evaluate abnormalities in serum and aqueous humor uric acid (UA) levels in primary angle closure glaucoma (PACG).
METHODS
Patients with PACG and age-similar and gender-similar controls (patients scheduled for cataract extraction) were enrolled prospectively. Serum UA levels were determined by enzymatic colorimetry; aqueous humor UA levels by Enzyme-Linked ImmunoSorbent Assay. A -test was used to compare UA levels between PACG patients and controls, with one-way ANOVA used to compare levels across PACG subgroups with differing disease severity. Comparisons between PACG patients and controls were adjusted for systemic and ocular confounding factors using binary logistic regression.
RESULTS
In all, 131 PACG patients and 112 controls were included. The serum UA level was 266 ± 69 μmol/L in the PACG group and 269 ± 73 μmol/L in the control group (p = 0.71). The aqueous humor UA level was 35.4 ± 8.2 μmol/L in the PACG group and 53.9 ± 18.6 μmol/L in the control group (p < 0.001). This difference remained significant after adjusting for age, gender, systolic blood pressure, diastolic blood pressure, body mass index, axial length, central corneal thickness, anterior chamber depth, lens thickness, white-to-white distance, corneal endothelial cell density, and serum UA level (odds ratio: 0.88, 95 % confidence interval: 0.83-0.93, p < 0.001).
CONCLUSION
Aqueous humor UA levels differ between PACG patients and controls, but serum UA levels do not. This indicates that local UA plays a role in the pathogenesis of PACG, but systemic UA does not.
PubMed: 38742075
DOI: 10.1016/j.heliyon.2024.e30721 -
Cureus Oct 2023Today, branded medications and polytherapy are frequently prescribed for glaucoma, even without giving the patient the proper instructions. Hence, the safety,...
BACKGROUND AND OBJECTIVES
Today, branded medications and polytherapy are frequently prescribed for glaucoma, even without giving the patient the proper instructions. Hence, the safety, effectiveness, cost, and patient compliance of glaucoma medication must be weighed, and the anti-glaucoma medicine usage must be studied. Analysis of glaucoma patients' prescription usage was the objective of this study.
MATERIAL AND METHODS
Between January 2021 and February 2022, this prospective and observational study was carried out at Andhra Medical College in Vishakhapatnam. One hundred prescriptions of those with primary open-angle and angle closure glaucoma were assessed. Age and gender-based subgroup analyses were conducted. R software (version 4.2.1) (The R Foundation for Statistical Computing, Vienna, Austria) was leveraged for data analysis.
RESULTS
Out of 146 examined prescriptions, 100 (69%) were deemed suitable for analysis. Participants' mean age was 54.2 ± 10.8 years. Sixty-two were over 50 years old, and 36 were men. The mean intraocular pressure was 25.4 ± 1.7 mm of Hg. Per prescription, there were about 1.75 anti-glaucoma drugs. Fixed-dose combinations (FDC) were found in 43 prescriptions. Generic medications and patient instructions prevailed in most prescriptions (78%) and (84%). Timolol was used in each FDC with brimonidine, dorzolamide, or bimatoprost.
CONCLUSION
The most often prescribed anti-glaucoma drug, timolol, was also identified as an essential component of the FDC. Doctors must prescribe generic medications with detailed directions for the patients.
PubMed: 37954708
DOI: 10.7759/cureus.46765 -
Toxins Nov 2023Snakebite-related fatalities disproportionately affect populations in impoverished socio-economic regions, marked by limited access to adequate healthcare and... (Review)
Review
Snakebite-related fatalities disproportionately affect populations in impoverished socio-economic regions, marked by limited access to adequate healthcare and constrained antivenom availability. Early medical intervention is pivotal in mitigating mortality and morbidity associated with snakebite envenoming (SBE). While clinical assessment remains fundamental in treating SBE, this review aims to spotlight objective parameters that could also affect outcomes. Selected studies that identify factors associated with poor outcomes are predominantly region-specific, single-site, and observational, yet collectively reveal similar findings. They consistently report factors such as treatment delays, susceptibility in vulnerable groups such as children and pregnant women, as well as various biochemical and haematological abnormalities. Acute kidney injury (AKI), low platelets, leucocytosis, abnormal coagulation, and elevated creatine kinase (CK) all show an association with poor outcomes. Furthermore, recognising rare and unusual SBE presentations such as adrenal insufficiency, severe hypertension, intracranial haemorrhage, acute angle closure glaucoma, and bowel ischaemia also has a bearing on outcomes. Despite the integration of these parameters into clinical decision tools and guidelines, the validation of this evidence is limited. This review underscores the imperative for high-quality, multi-centre studies aligned with consensus-driven Core Outcome Sets (COS) and Patient-Reported Outcome Measures (PROMS) to validate and strengthen the current evidence.
Topics: Pregnancy; Child; Animals; Humans; Female; Snake Bites; Antivenins; Snake Venoms; Snakes; Risk Factors
PubMed: 38133179
DOI: 10.3390/toxins15120675