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Pupil constriction can alter the accuracy of dark room provocative test

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Chinese Medical Journal 2009年第21期122卷 2620-2623页

作者： WANG Bing-song WANG Ning-li nathan congdon LEI Kun Baskaran Mani Tongren Eye Center Beijing Tongren Hospital Capital Medical University Beijing 100730 China Department of Ophthalmology Beijing Shijitan Hospital Beijing 100038 China Department of Ophthalmology and Visual Science Chinese University of Hong Kong Hong Kong China Singapore National Eye Center Singapore

Background Primary angle-closure glaucoma （PACG） is a major cause of visual morbidity in East Asia. Dark-room provocative test （DRPT） has been used to determine which narrow angles have the risk to develop angle closure. However, the accuracy of DRPT might be altered because that after emerging from the dark room, the configuration of the angle is affected by the light of the slit-lamp and the appositionally closed angle reopens. The aim of this study was to examine the pupillary diameter in different light conditions and use it as a parameter to assess the accuracy of dark-room provocative test. Methods Patients with suspected primary angle-closure glaucoma undergoing DRPT were recruited. The anterior chamber angle was examined by anterior segment optical coherence tomography under the following conditions：（1） in standard room illumination; （2） after short-term dark-adaptation and （3） after DRPT. Mean values of pupil size and numbers of appositionally closed angle under different conditions were compared. Results A total of 47 eyes of 47 patients were analyzed. The pupil size after DRPT was smaller than that after short-term dark-adaptation （P 〈0.001） and smaller than that in standard room illumination （P=0.026）. The numbers of appositionally closed angles after short-term dark-adaptation were significantly larger than those after DRPT （P 〈0.001）. There was no significant difference between the numbers of appositionally closed angles in standard room illumination and after DRPT （P=-0.157）. Conclusions Constriction of pupil size immediately after prolonged dark room provocative test may lead to change in the angle configuration, which may lead to false negative results. We suggest a modified protocol of recording intraocular pressure immediately after DRPT and performing gonioscopy following short-term dark adaptation to improve the accuracy of angle closure assessment.

关键词： angle closure glaucoma diagnostic test biometry

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基层医院白内障培训项目术后视力预后

中山大学学报（医学科学版） 2010年第6期31卷 744-747页

作者：黄文勇康丹黄国富陈倩韵 nathan congdon 何明光眼科学国家重点实验室//中山大学中山眼科中心预防眼科广东广州510060

【目的】了解基层医院眼科医生在接受中山眼科中心手把手培训期间所施行的白内障手术的患者术后视力以及影响视力的常见手术并发症。【方法】选取韶关市曲江区中医院和郁南县中医院两家县级医院作为目标医院,两名从无任何手术经验的术者... 详细信息

【目的】了解基层医院眼科医生在接受中山眼科中心手把手培训期间所施行的白内障手术的患者术后视力以及影响视力的常见手术并发症。【方法】选取韶关市曲江区中医院和郁南县中医院两家县级医院作为目标医院,两名从无任何手术经验的术者,在接受培训期间对患者施行了手法小切口白内障摘除联合人工晶状体植入手术。对所有手术后超过3个月的患者并进行眼部临床检查。【结果】在518名符合入选条件的白内障术后患者中,共342名患者(66.02%,共385例术眼)来诊。其中26眼因存在与手术无关的视神经视网膜病变或晚期青光眼改变而不加入进一步数据分析。342名患者平均年龄为73.2(S8.8)岁,女性占62.28%。单眼手术301(77.19%)人,双眼手术41(12.2%)人。术后非矫正视力(UCVA)范围为0.1≤UCVA<0.3和UCVA<0.1者分别占9.74%和9.0%。术后针孔视力(做为最佳矫正视力,BCVA)范围为0.1≤BCVA<0.3和BCVA<0.1者分别占3.15%和4.3%。影响术后UCVA的原因主要包括屈光不正(56.34%)、无人工晶状体眼(18.31%)、散光(9.86%)、后囊膜混浊(8.45%),黄斑水肿(5.63%)及角膜混浊(1.41%)。【结论】基层医院医生接受手把手培训期间所施行的白内障手术的治疗效果良好。屈光不正是术后视力不良的主要原因。术前重视眼底疾病的诊断以及人工晶状体度数的准确测定有助于提高白内障手术的治疗质量和效果。

关键词：培训白内障手术术后低视力原因

The Prevalence of Blindness, Visual Impairment and Cataract Surgery in Tuoketuo and Shangdu Counties, Inner Mongolia, China

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Open Journal of Ophthalmology 2015年第1期5卷 23-30页

作者： Baixiang Xiao Jinglin Yi Hans Limburg Guiseng Zhang Richard Le Mesurier Andreas Müller nathan congdon Beatrice Iezzi Affiliated Eye Hospital of Nanchang University Nanchang City China Zhongshan Ophthalmic Center Guangzhou City China London School of Hygiene & Tropical Medicine London United Kingdom Inner Mongolia Red Cross Chaoju Eye Hospital Hohhot China The Fred Hollows Foundation Sydney Australia World Health Organization Western Pacific Regional Office Manila Philippines

Aim: A population-based survey was conducted in Tuoketuo and Shangdu Counties in Inner Mongolia Autonomous Region, China, in the Autumn of 2010, to assess the prevalence and causes of blindness and visual impairment of people aged 50 years and over. Methods: Random cluster sampling was used to select 82 clusters of 50 residents in the 2 counties. Each survey team included an ophthalmologist, a nurse and a coordinator, who went to door to door in each cluster to identify eligible people. A torch, direct ophthalmoscope and portable slit lamp were used for eye examination. Visual acuity (VA) was tested for each eye of every subject. Those with VA below 6/18 in either eye were examined and causes identified. Results: The survey identified a prevalence of blindness in people aged 50+ in Tuoketuo of 1.2% (95% Confidence Interval: 0.7% - 1.7%) and in Shangdu of 1.4% (95% CI: 1.0% - 1.9%). Cataract was identified as the leading cause of blindness (BL) and severe visual impairment (SVI), and uncorrected refractive errors were the major causes of moderate visual impairment (MVI) in both counties. Over two thirds of blindness, SVI and MVI were identified as avoidable. Conclusions: The prevalence of blindness in people aged 50+ in Tuoketuo and Shangdu was low compared to other studies conducted in China [1] [2]. The prevalence of blindness of people aged 50 years and over could be reduced by up to two thirds through better eye services in the two study areas.

关键词： RAAB Prevalence of Blindness Cataract Cataract Surgical Coverage Survey Inner Mongolia China

原发性闭角型青光眼流行病学和群体筛选中的几个问题

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国外医学（眼科学分册） 1993年第5期17卷 301-306页

作者： nathan congdon Fang Wang 丁传庆

白种人中,75%～95%的原发性青光眼是开角型(POAG)的,闭角型(PACG)只占很小比例,在亚洲人和爱斯基摩人中则恰好相反,PACG要占原发性青光眼的80%～90%。据报道,爱斯基摩人PACG的患病率达2%～8%,而白种人只有0.1%。似乎可以用群体性前房浅... 详细信息

白种人中,75%～95%的原发性青光眼是开角型(POAG)的,闭角型(PACG)只占很小比例,在亚洲人和爱斯基摩人中则恰好相反,PACG要占原发性青光眼的80%～90%。据报道,爱斯基摩人PACG的患病率达2%～8%,而白种人只有0.1%。似乎可以用群体性前房浅的趋势来解释PACG的高发病率。亚洲人PACG的患病率介于白种人和爱斯基摩人之间。现有的生物统计学资料并未明显显示亚洲人的前房浅。PACG可以在群体基础上通过各种技术评估中央或周边前房深度、测量眼压或视盘、视野检查等方法来进行筛选。人口统计学资料.病史和家族史在PACG大面积筛选中有重要作用。高危人群包括妇女、年龄超过50岁的人、PACG先证者的直系亲属和远视眼患者。

关键词：青光眼闭角型流行病学群体筛选

Malignant glaucoma treated by low-dose laser cycloplasty: a 1-year multicenter prospective noncomparative study

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International Journal of Ophthalmology(English edition) 2024年第7期17卷 1248-1254页

作者： Hai-Shuang Lin Xiao-Ping Xu Xuan-Li Zheng Ji-Bing Wang Su-Jie Fan Zuo-HongWu Su-Mian Cheng Li-Jun Zhao Qin-Hua Cai Shao-Dan Zhang Shan-Shan Liu Ai-Guo Lyu Ying Zhang Hong Chen Dan-Ni Jiang Wu-Liang Li nathan congdon Clement C Tham Ming-Guang He Yuan-Bo Liang the Malignant Glaucoma TreatmentTrial Study(MGTT)Group Wenzhou Medical University Wenzhou 325027Zhejiang ProvinceChina Ningbo Eye Hospital Ningbo 315100Zhejiang ProvinceChina Weifang Eye Hospital Weifang 261000Shandong ProvinceChina Handan Eye Hospital Handan 056000Hebei ProvinceChina Aier Eye Hospital(Wuhan) Wuhan 430061Hubei ProvinceChina Hebei Eye Hospital Xingtai 054001Hebei ProvinceChina The Third People’s Hospital of Dalian Dalian 116033Liaoning ProvinceChina First Affiliated Hospital of Suzhou University Suzhou 215031Jiangsu ProvinceChina National Clinical Research Center for Ocular Diseases Eye HospitalWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina Glaucoma Research Institute Wenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina Centre for Public Health Queen’s University BelfastBelfast BT71NNUK Orbis International New YorkUSA Department of Ophthalmology and Visual Sciences the Chinese University of Hong KongHong Kong SAR 999077China Centre for Eye Research Australia University of MelbourneRoyal Victorian Eye and Ear HospitalEast Melbourne 3000VICAustralia 不详

AIM:To report a one-year clinical outcomes of low-dose laser cycloplasty(LCP)among malignant glaucoma ***:In this prospective,multicenter,noncomparative clinical study,participants with malignant glaucoma were recruited and underwent LCP at eight ophthalmic centers in *** were followed up at 1wk,1,3,6,and *** pressure(IOP),number of glaucoma medications,anterior chamber depth(ACD),and complications were *** success was defined as the reformation of the anterior chamber based on slit-lamp *** was defined by the presence of a shallow orﬂat anterior chamber after initial recovery from ***:A total of 34 eyes received *** IOP and medications decreased from 36.1±11.5 mm Hg with 3.3±1.5 glaucoma medications pre-treatment to 20.9±9.8 mm Hg(P<0.001)with 2.9±1.6 medications(P=0.046)at 1d,and 17.4±6.7 mm Hg(P<0.001)with 1.3±1.7 medications(P<0.001)at *** ACD increased from 1.1±0.8 mm at baseline to 1.7±1.0 mm and to 2.0±0.5 mm at 1d and 12mo,respectively.A total of 32(94.1%)eyes achieved initial anatomical *** follow-up,2(5.9%)eyes failed and 8(23.5%)eyes relapsed,yielding a 12-month anatomical success rate of 64.3%.Complications including anterior synechia(8.82%),choroidal/ciliary detachment(5.88%)and hypopyon(2.94%)were observed within ***:LCP is simple,safe,and effective in reforming the anterior chamber in malignant glaucoma.

关键词： anterior chamber reformation intraocular pressure low-dose laser cycloplasty malignant glaucoma anatomical success

提供免费眼镜对中国学龄儿童学习成绩的影响：整群随机对照试验

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英国医学杂志中文版 2014年第6期17卷 360-368页

作者：马晓晨周钟强易红梅庞晓鹏史耀疆陈倩韵 Mirjam E. Meltzer Saskia le Cessie 何明光 Scott Rozelle 刘奕志 nathan congdon 美国加利福尼亚大学戴维斯分校农业及资源经济系中国中山大学中山眼科中心预防眼科眼科学国家重点实验室中国科学院地理科学与资源研究所农业政策研究中心中国人民大学农业与农村发展学院中国西北大学经济管理学院荷兰莱顿大学医学中心临床流行病学系荷兰莱顿大学医学中心医学统计和生物信息学系美国斯坦福大学国际问题研究所美国国际奥比斯21208 美国斯坦福大学国际发展中心

目的探讨免费眼镜对中国农村近视儿童学习成绩的影响。设计仅对研究者进行设盲的整群随机对照研究。地点2012-2013年，中国西部的两个市的252所学校。研究对象在19934名小学四、五年级儿童中的、任一眼裸眼视力〈6／12且戴镜视力可提高... 详细信息

目的探讨免费眼镜对中国农村近视儿童学习成绩的影响。设计仅对研究者进行设盲的整群随机对照研究。地点2012-2013年，中国西部的两个市的252所学校。研究对象在19934名小学四、五年级儿童中的、任一眼裸眼视力〈6／12且戴镜视力可提高至〉6／12的3177名（平均龄10．5岁）儿童，其中的3052名（96．0％）儿童完成了整个研究。干预措施纳入研究的儿童在学年开始时，以学校为单位（平均每组84所学校）随机分为3组，分别接受以下干预：仅获得配镜处方（此组为本研究的对照组），获得项目指定眼镜店换取眼镜的凭证，或现场获取免费眼镜。主要结果指标末次检查（研究结束）时的戴镜率和研究结束时用专门设计的数学测试考核的成绩（用研究开始的成绩进行调整，以标准差的改变来度量）。结果3177名纳入的儿童被随机分配到对照组（1036名，占32．6％）、凭证组（988名，占31．1％）和免费眼镜组（1153名，占36．3％）。虽然所有儿童戴镜后视力均有提高，但在研究开始时，仅15％的儿童配戴了眼镜。研究结束时免费眼镜组观察到的戴镜率为41％，儿童自诉的戴镜率为68％；对照组观察到的戴镜率为26％，儿童自诉的戴镜率为37％。相对于对照组，免费眼镜组对学习成绩影响为0．11标准差（SD）[95％可信区间（CI）0．01—0．21，P=0．03]。调整后的免费眼镜的效应（0．10SD，95％CI0．002～0．19；P=0．04）也远远大于父母的受教育程度（0．03，95％CI-0．04～0．09）及家庭的富裕程度（0．01，95％CI-0．06～0．08）。虽然组间有统计学差异，但差异的幅度还是比用于样本量计算的幅度，即0．20SD小。结论尽管儿童的依从性并不是非常好，向儿童提供免费眼镜对于提高儿童的数学成绩有统计学意义，但各组间差异小于预期。本研究中，儿童的近视患病率较高但戴镜率却很低。

关键词：随机对照试验集群育成中国孩子眼镜免费