Objective To measure optic disc parameters in Mongolian and Han healthy subjects with or without family history of glaucoma, to explore the causes of the differences and their significance in the diagnosis of early glaucoma. Methods Fifteen healthy Mongolian individuals (30 eyes), 30 healthy Han individuals (60 eyes) with a family history of open-angle (30 eyes) or angle-closure (30 eyes) glaucoma, and 45 healthy Han individuals (90 eyes) without a family history of glaucoma were enrolled in this study. The 45 healthy Han individuals without a family history of glaucoma included three age-groups: 20 to 29 years old group, 30 to 39 years old group and 40 to 49 years old group, each group have 15 subjects (30 eyes). Thirteen parameters were measured by Heidelberg retina tomography (HRT) for all subjects, including disc area, cup area, rim area, cup volume, rim volume, cup/disc area ratio, linear cup/disc ratio, mean cup depth, maximum cup depth, cup shape, disc height variation contour, mean retinal nerve fiber layer (RNFL) thickness and optic nerve fiber layer crosssectional area. The results were analyzed and compared between the above groups. Results There was no statistically significant (t=0.791,P=0.132) of the height variation contour between Mongolian and Han without a family history of glaucoma (20 to 29 years old) group. The other parameters of Mongolian were smaller than Han without a family history of glaucoma (20 to 29 years old) group, but the difference was not statistically significant (t=-1.039, -0.799, -0.840,-1.108, -0.956, -0.695, -0.931, -1.099, -1.074, -0.580, -0.204, -1.425; P＞0.05). The parameters in Han with a family history of open-angle glaucoma group were bigger than Han without a family history of glaucoma (30 to 39 years old) group. The differences were statistically significant for disc area, cup area, rim area, cup volume, rim volume, cup area ratio, linear cup/disc ratio, mean cup depth, cup shape measure, nerve fiber layer cross-sectional area (t=4.758, 3.187, 2.544, 2.674, 1.798, 3.676, 2.721, 2.715, 2.510, 2.373; P＜0.05), but were not statistically significant for maximum cup depth, disc height variation contour and mean RNFL thickness (t=1.649, 1.565, 0.767; P＞0.05). Most parameters in Han with a family history of angle-closure glaucoma group were the same as that in Han without a family history of glaucoma (40 to 49 years old) group, including cup area, rim area, cup volume, rim volume, cup/disc area ratio, linear cup/disc ratio, mean optic cup depth, maximum cup depth, cup shape, disc height variation contour, mean RNFL thickness, optic nerve fiber layer cross-section (t=1.201, 1.697, 1.000, 0.516, 0.740, -0.172, -0.070, -0.972, 1.530, -0.390, -0.091, 0.659; P＞0.05); but the difference of disc area between these 2 groups was statistically significant (t=2.224,P＜0.05). Conclusions The family history of glaucoma can change the optic disc parameters of healthy individuals, especially those with a family history of open-angle glaucoma. There is no difference of optic disc parameters between healthy Mongolian and Han subjects.
Objective To observe the changes of visual pathway of central nervous system in patients with glaucoma.Methods Thirty-five subjects were enrolled in this prospective study. There were seven patients of chronic primary angle closure glaucoma with bilateral visual field defects, 12 patients of primary open angle glaucoma with bilateral visual field defects, and 16 normal subjects. GE Signa HD 1.5 T magnetic resonance scanners and head eight phased array were used. The mean fractional anisotropy (FA) and the mean average diffusion coefficient (DCavg) of white matter tracts in visual pathway of bilateral optic nerve, optic chiasma, bilateral optic tract，bilateral optic radiation were measured by diffusion tensor imaging, meanwhile the white matter tracts were reconstructed by fiber tracking system. The volumes of lateral geniculate body were measured by coronal proton density weighted magnetic resonance imaging.Results The differences of FA among bilateral optic nerve, optic chiasma, bilateral optic tract，bilateral optic radiation were statistically significant (F=25.985，20.626，12.262，22.399，21.708，24.994，22.774；P＜0.05). There was no difference of DCavg among bilateral optic nerve, optic chiasma, bilateral optic tract，bilateral optic radiation（F=2.097，2.178，0.530，0.983，0.608, 0.866, 1.504；P＞0.05）. The differences of volume of lateral geniculate body among three groups were statistically significant （F=18.631，17.274；P＜0.05）. Conclusion There is degeneration in visual pathway of central nervous system in patients with glaucoma.
Objective To evaluate the diagnosis of blue-on-yellow perimetry and macular threshold perimetry in early primary glaucoma. Methods Humphrey II 750 automatic perimetry was used to test 60 eyes of 60 cases in normal control group and 63 eyes of 63 cases in early primary glaucoma group with white-on-white perimetry (W/W), blue-on-yellow perimetry (B/Y)，and macular threshold perimetry (M TP). The results of the visual field defects detected by the three perimetries were compared and analyzed.Results The differences of mean sensibility of W/W, B/Y and MTP between the two groups had statistical significance［t=-3 .01, P=0.0054 (W/W); t=-2.95, P=0.006 3 (B/Y); t=-2.59,P=0. 0150 (MTP)］. In the diagnosis of early primary glaucoma, the sensitivity of MTP was the highest (83%), B/Y was the second (65%), and W/W was the lowest (48%). When B/Y and MTP were combined, the sensitivity was improved to 94% using parallel testing, and the specificity was improved to 87% using serial testing.Conclusions B/Y and MTP are valuable in diagnosis of early primary glaucoma, and the sensitivity and specificity of the diagnosis can be improved when B/Y and MTP are combined. (Chin J Ocul Fundus Dis，2003，19：102-105)
Objective To determine the difference of global indices of retinal thickness at posterior pole in primary and suspected glaucoma. Methods Forty-five global indices of analysis on retinal thickness at posterior pole in every case, including 12 cases of primary open-angle glaucoma and 11 cases of suspected glaucoma were obtained by advanced retinal thickness analyzer. Every index was also compared. Results There were significant differences between primary and suspected glaucoma in foveal shape deviation (FSD), foveal corrected thickness deviation (FCTD), foveal fixation corrected thickness deviation (FFD), foveola thickness deviation (VTD), corrected foveola thickness deviation (CVTD), peri-foveal abnormally thin area (PFATN), posterior-pole pattern deviation (PPPD), and posterior-pole abnormally thin area (PPATN). Conclusion There are significant difference of morphologic indices of retinal thickness at posterior pole between primary and suspected glaucoma. (Chin J Ocul Fundus Dis, 2002, 18: 113-115)
Objective To evaluate the applic ation of blue-on-yellow(B/Y) perimetry in detecting the early visual field loss of glaucoma． Methods The B/Y perimetry of the G2 strategy in the OCTOPUS 101 perimetry was used to examine the visual field of 16 normal persons (32 eyes), 25 cases (35 eyes) of primary open-angle glau coma (POAG) with abnormal white-on-white (W/W) visual fields, 15 cases (15 eye s) of early POAG with normal W/W visual field, and 11 cases (22 eyes) of suspect ed POAG． Results The mean sensitivity (MS) in the normal cases, suspected POAG, early POAG, middle POAG, and late POAG was ( 23．24plusmn;1．22) dB，(20．97plusmn;3．42) dB，(18．44plusmn;3．57) dB，(11．04plusmn;1．85) dB and (8．55plusmn;2．29) dB, respectively． It was demonstrated that B/Y perimetry was more sensitive than W/W perimetry in detecting the glaucomatous visual fi eld defects,and its sensitivity was 92% and specificity was 90．62%． The averag e number of defective points in central visual field with B/Y perimetry was more than that with W/W perimetry in early and middle POAG． Conclusion B/Y perimetry is a relatively sensitive method for detection of the early visual field loss in POAG． (Chin J Ocul Fundus Dis, 2001,17:125-127)
ObjectiveTo observe the ocular manifestations of presumed ocular tuberculosis in patients with pulmonary tuberculosis. MethodsOne hundred and fifty nine patients with pulmonary tuberculosis received examinations of visual acuity, slit lamp microscopy and indirect ophthalmoscopy. Those patients with retinochoroidal inflammatory lesions, retinal hemorrhages or detachments underwent fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) to determine whether the presumed ocular tuberculosis was involved. There were 9 patients (16 eyes, 5.67%) of presumed ocular tuberculosis, including 5 males and 4 females. The age was ranged from 19 to 64 years old, with an average of 35.12 years. Seven patients were affected bilaterally and 2 patients affected unilaterally. There were 8 patients (15 eyes, 93.75%) with uveitis and 1 patient (1 eye, 6.25%) with central retinal vein occlusion (CRVO). The blood laboratory tests were negative in all cases. ResultsThe corrected vision was from light sensation to 0.15 in 6 uveitis eyes, 0.8 to 1.0 in 10 eyes. The anterior segment change was found in 10 eyes, which including granulomatous uveitis (8 eyes) and non-granulomatous uveitis (2 eyes). Granulomatous uveitis eyes had iris nodules, posterior synechia of the iris and mutton-fat keratic precipitates (KP). Non-granulomatous uveitis eyes had KP only. Choroidal tubercles were found in 7 eyes in which 3-7 off-white lesions of varying sizes were found with local retinal detachment. FFA revealed hypo-fluorescence with obscure boundary in arterial phase and arterial and venous phase, and hyper-fluorescence with obscure boundary in later phase. OCT showed retinal pigment epithelium uplift. There was 1 eye with CRVO, which had punctate, splinter and linear hemorrhage, white lesions in some hemorrhagic focus. ConclusionThe presumed ocular tuberculosis eyes showed mainly granulomatous inflammation and multiple choroid tubercles, and CRVO sometime.
ObjectiveTo observe the changes of glaucoma optic nerve head (ONH) parameters and macular ganglion cell complex (GCC) structure in preperimetric glaucoma (PPG) patients. Methods Eighteen PPG patients (18 eyes, PPG group), 22 primary open-angle glaucoma (POAG) patients (22 eyes, POAG group), and 20 patients (20 eyes) with physiologic large optic cup (physiological big optic cup group) were included in this study. Seventeen healthy volunteers (17 eyes) were the normal control. The optic nerve head and macular was scanned by fourier-domain optic coherence tomography (FD-OCT) for all subjects. The following 15 parameters, including nerve fiber layer thickness (RNFL), the optic disk rim volume (RV), optic nerve head volume (NHV), optic disc area (ODA), rim area (RA), cup volume (CV), cup/disc area ratio (CDAR), vertical cup/disc ratio (VCDR), horizontal cup/disc ratio (HCDR) and optic cup area (CA), macular GCC, superior GCC, inferior GCC thickness, focal loss of volume (FLV) and global loss of volume (GLV), were measured at 10 different quadrants. The relationship between macular GCC thickness or optic disc RNFL thickness and RA was analyzed by simple linear regression analysis. ResultsThe RNFL thickness of PPG patients was (99.29±19.93) μm (superior quadrant), (97.29±22.86) μm (inferior), (114.61±15.64) μm (superior temporal, ST), (119.22±26.19) μm (inferior temporal, IT), (116.11±39.32) μm (superior nasal, SN), (111.33±37.65) μm (inferior nasal, IN), (77.56±17.22) μm (temporal upper, TU), (76.78±10.34) μm (temporal lower, TL), (88.94± 42.54) μm (nasal upper, NU), and (82.33±43.83) μm (nasal lower, NL) respectively, which was thinner than normal control group and physiologic large cup group, but thicker than POAG patients. Compared to normal controls and physiologic large cup patients, PPG patients also had 4 parameters reduced (RV, NHV, ODA and RA), and 5 parameters increased (CV, CDAR, VCDR, HCDR and CA), the differences are statistically significant (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05). For macular GCC parameters, PPG patients also had 3 parameters reduced (average GCC, superior and inferior GCC thickness), and 2 parameters increased (GLV and FLV) compared to normal control group and physiologic large cup patients (P < 0.05). However, these parameters were similar to POAG patients (P > 0.05).Simple linear regression analysis showed that, with the GCC macular thinning, reducing the number of ganglion cells reduced, optic disc RNFL thickness became thinner (regression coefficient=1.25, P=0.00) and RV reduced (regression coefficient=0.037, P=0.00). ConclusionsPPG patients and normal control had a similar distribution of optic disc RNFL. Five parameters (RV, NHV, ODA, RA, macular GCC thickness) were less than normal control and physiological big optic cup group, but had no significant differences compared with POAG group.