RESUMEN
Ocular hypertension (OHT) refers to a condition in which the intraocular pressure increases without causing glaucomatous optic nerve changes or visual field damage. The incidence rate of OHT in people over 40 years old is as high as 4% to 10%. According to the OHT Treatment Study (OHTS), the incidence of primary open angle glaucoma (POAG) among OHT patients is increasing year by year, so it is necessary to conduct long-term follow-up. This article elaborates on five major risk factors for the progression of OHT to POAG: age, intraocular pressure, vertical cup-disc ratio, pattern standard deviation of visual field, and central corneal thickness. It also summarizes other potential risk factors, such as long-term fluctuations in intraocular pressure, asymmetry of intraocular pressure and visual field between the two eyes, structural phenotypes of the optic disk, and optic disk hemorrhage. Predicting the risk of OHT progression to POAG based on risk factors, patients with different risk levels require different timing for treatment initiation and follow-up intervals. Those with higher risks should start preventive treatment earlier and have shorter follow-up intervals. Both drug therapy and selective laser trabeculoplasty can serve as initial treatment options for OHT. Combining evidence-based medicine research and individualized evaluation of treatment can enhance the clinical diagnosis and treatment level of OHT.
Asunto(s)
Medicina Basada en la Evidencia , Glaucoma de Ángulo Abierto , Hipertensión Ocular , Humanos , Hipertensión Ocular/diagnóstico , Hipertensión Ocular/terapia , Factores de Riesgo , Glaucoma de Ángulo Abierto/diagnóstico , Glaucoma de Ángulo Abierto/terapia , Presión Intraocular , Progresión de la EnfermedadRESUMEN
Childhood glaucoma is a disease that seriously endangers children's visual health. It will accompany the patients throughout their lives and bring a heavy burden to families and society. Most childhood blindness caused by glaucoma is preventable or treatable. Relevant research has made progress in recent years. Based on the new consensus reached by the World Glaucoma Association and the latest medical evidence at home and abroad, this article summarizes the definition, classification, diagnosis, molecular genetics, pathogenesis and comprehensive treatments including drugs and surgery of childhood glaucoma, with a focus on the application of various surgical methods, so as to provide reference for clinical and scientific research and improve the clinical diagnosis and treatment of childhood glaucoma.
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Glaucoma , Humanos , Glaucoma/diagnóstico , Glaucoma/terapia , NiñoRESUMEN
A new research concept has emerged in recent years, called real world study (RWS), which mainly relies on registration study and data management, and aims to evaluate the real effects and risks of actual clinical practice or health examination. This article compares the differences between RWS and randomized controlled trials, and summarizes the current situation of registration study in the medical field of RWS domestic and abroad, especially the current progress in the ophthalmic field. It is expected more medical centers will be able to conduct follow-ups based on the case registration system and carry out multicenter, large-scale RWS in the future.
Asunto(s)
Oftalmología , Ensayos Clínicos Controlados Aleatorios como Asunto , HumanosRESUMEN
Pathological diagnosis of salivary gland tumors is one of the most challenging areas in all head and neck surgical pathology. The classification of salivary gland tumors was updated in the 5th edition of the World Health Organization Classification of Head and Neck Tumours, most of which were based on their molecular pathological characteristerics. This new classification features a description of several new entitiesamong benign and malignant neoplasms, salivary gland tumors with updated naming or diagnostic criteria, and lesions deleted from this section, etc.This present review focuses on the updates and changes in the new classification of salivary gland tumors, and provides some reference for head and neck surgeons and pathologists.
Asunto(s)
Neoplasias de Cabeza y Cuello , Neoplasias de las Glándulas Salivales , Humanos , Neoplasias de las Glándulas Salivales/clasificación , Neoplasias de las Glándulas Salivales/patología , Glándulas Salivales , Organización Mundial de la SaludRESUMEN
A 4-month-old boy was admitted to the hospital after his parents noticed fog in his right eye for 27 days. Physical examination revealed multiple light brown macules on the skin. The intraocular pressure (IOP) of the right eye was 34.4 mmHg (1 mmHg=0.133kPa) and the corneal was enlarged and edema while the aqueous humor was cloudy with blood in the right eye. Yellow peripheral anterior synechia was seen on the temporal and inferior iris. Ultrasound biomicroscopy (UBM) showed extensive adhesion closure of the anterior chamber angle and the local thicken iris with the nodule. No obvious abnormality was observed in the left eye. It was confirmed as juvenile xanthogranuloma by skin lesion biopsy. IOP was normal after systemic and local therapy with corticosteroids and local IOP lowering medication. Follow up 35 months, IOP is normal without medication.
Asunto(s)
Glaucoma de Ángulo Cerrado , Glaucoma , Xantogranuloma Juvenil , Niño , Glaucoma/complicaciones , Glaucoma de Ángulo Cerrado/diagnóstico , Humanos , Lactante , Presión Intraocular , Iris , Masculino , Tonometría Ocular , Xantogranuloma Juvenil/complicaciones , Xantogranuloma Juvenil/diagnósticoRESUMEN
Objective: To analyze the proportion and clinical characteristics of underdiagnosed zonulopathy in angle closure glaucoma (ACG) patients and to explore the related risk factors. Methods: Case-control study. Continuous cases of ACG patients who underwent phacoemulsification combined with intraocular lens implantation and goniosynechialysis surgery [ACG group, including acute angle closure glaucoma (AACG) and chronic angle closure glaucoma (CACG)] from November 1, 2020 to October 31, 2021 and age-related cataract patients who underwent phacoemulsification combined with intraocular lens implantation surgery in the same period (control group) were included. The diagnosis of zonulopathy was determined according to the intraoperative signs such as wrinkles of the anterior capsule during continuous circular capsulorhexis. The proportion of zonulopathy, preoperative diagnosis rate of zonulopathy, demographic characteristics, anterior chamber depth (ACD), axis length, difference of ACD in both eyes (ACD of the contralateral eye minus ACD of the operated eye) were compared between the two groups. The related risk factors were explored. The paired t-test (comparison between two groups of normally distributed data), non-parametric test (comparison between two groups of non-normally distributed data), Chi-square test (categorical variables), univariate and multivariate logistic regression analysis were used. Results: There were 104 ACG patients (104 eyes), including 63 AACG patients (63 eyes) and 41 CACG patients (41 eyes), and 117 controls (117 eyes). There was no significant difference in age (P=0.29) and gender (P=0.07) between the two groups. The ACG group had shallower anterior chamber (P<0.001), shorter axial length (P<0.001) and more ACD difference in both eyes (P<0.001). In the ACG group, the proportion of zonulopathy was 46.2% (48/104), which was significantly higher than that (6.0%, 7/117) in the control group (P<0.001). In the control group, only zonular laxity was found, while in the ACG group, besides the predominant zonular laxity (68.8%, 33/48), there was zonular dehiscence (31.3%, 15/48). The eyes with AACG (57.1%, 36/63) had a higher proportion of zonulopathy than those with CACG (29.3%, 12/41) (P=0.006). In the ACG group, only 14 cases (29.8%) were diagnosed preoperatively according to slit lamp examination and/or ultrasound biomicroscopy. The proportion of underdiagnosed zonulopathy was 70.8% in the ACG group (34/48). A smaller ACD was found to be related to the zonulopathy in the ACG group. All AACG cases with an ACD ≤2.0 mm and CACG cases with an ACD ≤1.9 mm had zonulopathy. Multivariate logistic regression showed that the ACD difference in both eyes (P=0.025) and the diagnosis of ACG (AACG vs. cataract, P<0.001; CACG vs. cataract, P=0.023) were independent risk factors associated with zonulopathy. Conclusions: The proportion of underdiagnosed zonulopathy among ACG patients is high. Better preoperative diagnostic methods for zonulopathy are needed. Zonulopathy is common in ACG patients, especially in AACG patients, suggesting that zonulopathy may be related to the pathogenesis of ACG. The shallower the ACD, the riskier the zonulopathy. ACD differences between two eyes and ACG types (including AACG and CACG) were related risk factors of zonulopathy.(This article was published ahead of print on the Online-First Publishing Platform for Excellent Scientific Researches of Chinese Medical Association Publishing House on March 11, 2022).
Asunto(s)
Catarata , Glaucoma de Ángulo Cerrado , Facoemulsificación , Humanos , Glaucoma de Ángulo Cerrado/diagnóstico , Estudios de Casos y Controles , Facoemulsificación/efectos adversos , Catarata/complicaciones , Ojo/patología , Enfermedad Aguda , Presión IntraocularRESUMEN
OBJECTIVE: Tongue cancer is a common malignant tumor in the oral and maxillofacial region, most of which is squamous cell carcinoma. Cisplatin (DDP) is one of the chemotherapy drugs for patients with tongue squamous cell carcinoma (TSCC). However, DDP resistance has become a major obstacle to its clinical application. Our study aimed to investigate the effects of long non-coding RNA (lncRNA) KCNQ1 overlapping transcript 1 (KCNQ1OT1) on DDP resistance of tongue cancer and the underlying mechanism. PATIENTS AND METHODS: The levels of KCNQ1OT1, miR-124-3p, and tripartite motif containing 14 (TRIM14) were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The maximum size of tumor (MTS) assay was used to detect the cell survival rates. Furthermore, the cell proliferation was detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. Transwell assay was performed to detect the cell migration and invasion. Western blot assay was used to detect the protein levels of Vimentin, N-cadherin, E-cadherin, and TRIM14. The functional targets of KCNQ1OT1 and miR-124-3p, miR-124-3p and TRIM14 were predicted by starBase 3.0 and TargetScan. The relationship between KCNQ1OT1 and miR-124-3p was confirmed by Dual-Luciferase reporter assay, RNA immunoprecipitation (RIP) and RNA pull-down. Further, the relationship between miR-124-3p and TRIM14 was verified by Dual-Luciferase reporter assay. Animal experiment revealed the effect of KCNQ1OT1 on DDP resistance of tongue cancer cells in vivo. RESULTS: KCNQ1OT1 was upregulated in DDP-resistant tongue cancer tissues and cells, and mainly expressed in cytoplasm. Functionally, the knockdown of KCNQ1OT1 inhibited the survival rate, proliferation, migration, invasion, and EMT of the DDP-resistant tongue cancer cells. Of note, miR-124-3p acted as a target of KCNQ1OT1 and KCNQ1OT1 could reduce the expression of miR-124-3p. Moreover, miR-124-3p targeted TRIM14 and the downregulation of TRIM14 reduced the DDP resistance of tongue cancer cells. Importantly, KCNQ1OT1 regulated the TRIM14 expression by targeting miR-124-3p. Furthermore, KCNQ1OT1 knockdown reduced the DDP-resistant tumor growth and weight through the miR-124-3p/TRIM14 axis in vivo. CONCLUSIONS: LncRNA KCNQ1OT1 promotes the DDP resistance of tongue cancer by sponging miR-124-3p to regulate TRIM14 expression.
Asunto(s)
Antineoplásicos/farmacología , Carcinoma de Células Escamosas/tratamiento farmacológico , Cisplatino/farmacología , ARN Largo no Codificante/metabolismo , Neoplasias de la Lengua/tratamiento farmacológico , Animales , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Resistencia a Antineoplásicos/efectos de los fármacos , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Péptidos y Proteínas de Señalización Intracelular/genética , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , MicroARNs/genética , MicroARNs/metabolismo , Neoplasias Experimentales/tratamiento farmacológico , Neoplasias Experimentales/genética , Neoplasias Experimentales/metabolismo , Canales de Potasio con Entrada de Voltaje/genética , Canales de Potasio con Entrada de Voltaje/metabolismo , ARN Largo no Codificante/genética , Neoplasias de la Lengua/genética , Neoplasias de la Lengua/metabolismo , Proteínas de Motivos Tripartitos/genética , Proteínas de Motivos Tripartitos/metabolismo , Células Tumorales CultivadasRESUMEN
Glaucoma is the leading cause of irreversible blindness throughout the world. Primary angle closure glaucoma (PACG) is one of the common types of this disease. Research indicates that its prevalence is always associated with many factors, including ocular anatomical characteristics and the genetic susceptibility. According to many studies, phenotypes related to PACG, such as anterior chamber depth, relative lens position and thickness, chamber angle state, and axial length, are heritable. Heritability is an important indicator to quantify this genetic tendency. Therefore, the study of heritability plays an important role in explaining the genetic susceptibility and understanding the mechanism of these diseases. This article reviews the heritability of the phenotypes that relate to PACG. (Chin J Ophthalmol, 2018, 54:864-867).
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Glaucoma de Ángulo Cerrado , Patrón de Herencia , Fenotipo , Cámara Anterior , Glaucoma de Ángulo Cerrado/genética , Humanos , CristalinoRESUMEN
The standardization of clinical diagnosis and treatment of glaucoma is crucial to ensuring the quality of medical treatment and yielding high quality results in clinical research. Based on the results of a questionnaire survey, this paper analyzes the reasons for the gap between the current situations of glaucoma diagnosis and treatment in China and the international and domestic guidelines and consensus, emphasizes the importance of standardization in clinical diagnosis and treatment, and discusses the feasible strategies for improving the standardization of diagnosis and treatment.The goal is to improve glaucoma diagnosis and treatment service capability, bridge the gap between reality and domestic and international guidelines and consensus, and further standardize the management of glaucoma as a chronic disease, through efforts in strengthening training and promoting standardization. (Chin J Ophthalmol, 2018, 54: 161-163).
Asunto(s)
Glaucoma , China , Enfermedad Crónica , Glaucoma/diagnóstico , Glaucoma/terapia , Humanos , Encuestas y CuestionariosRESUMEN
Objective: To analysis of the change of the constitution of the admitted patients with glaucoma in Capital Medical University affiliated Beijing Tongren Hospital between 2003-2005(group 2003) and 2013-2015(group 2013). Methods: The medical charts information of inpatient with glaucoma were collected by ICD-10 of the disease diagnosis. Statistical analysis was conducted for the change of the proportion of types, gender and age. The age difference between two groups was analyzed by rank sum test and the difference of different types of glaucoma was analyzed by chi square test. Results: Totally, 8 160 inpatients cases were included. There were 2 878 cases in the group of 2003 and 5 282 cases in the group of 2013. Between two groups, there was no statistical difference in age. The ratio of male patients decreased from 55.8% (1 607/2 878) to 51.7%(2 732/5 282) (χ(2)=23.73, P<0.05).Primary angle-closure glaucoma(PACG) was the main type (2 987/8 160, 36.6%) followed by secondary glaucoma (SG, 2 172/8 160, 26.6%). PACG reduced from 40.0% (1 151/2 878) to 34.8%(1 836/5 282) (χ(2)=21.99, P<0.01). Congenital glaucoma(CG) increased from 4.6%(132/2 878) to 8.3%(437/5 282)(χ(2)=39.04, P<0.01). Glaucoma related with trauma reduced from 27.2%(208/764) to 18.2%(256/1 408)(χ(2)=24.11, P<0.01). Glaucoma with syndrome increased from 3.8%(29/764) to 7.2%(102/1 408)(χ(2)=10.39, P<0.01). Conclusions: The constitution of the admitted patients with glaucoma in our hospital changed during the ten years. PACG was still the major type of inpatient glaucoma.(Chin J Ophthalmol, 2017, 53: 610-615).