Serum complement component 3, complement component 4 and complement component 1q levels predict progressive visual field loss in older women with primary angle closure glaucoma

AimTo evaluate the association between serum levels of complement component (C) 3, C4 and C1q and visual field (VF) loss in patients with primary angle closure glaucoma (PACG).MethodsIn this prospective cohort study, a total of 308 patients with PACG were included. The patients were followed up every 6 months (at least 2 years), with clinical examination and VF testing. Based on their sex and age, the subjects were stratified into male and female subgroups, and by age at <60 and ≥60 years per subgroup.ResultsOne hundred twenty-three (39.94%) patients showed glaucoma VF progression. The serum levels of C3, C4 and C1q were significantly lower (p<0.05) in the progression group compared with the non-progression group in the ≥60 years female subgroup. In female patients with age ≥60 years, (1) lower levels of baseline C3 (HR=0.98, p<0.001), C4 (HR=0.96, p=0.01) and C1q levels (HR=0.99, p=0.003) were associated with a greater risk of VF progression; (2) patients with lower C3 levels had significantly (p<0.05) higher rates of VF loss progression, similar to those with lower C4 and lower C1q levels; and (3) the generalised additive model revealed a negative correlation between baseline C3 (p<0.001), C4 (p<0.001) and C1q (p<0.001) levels with the risk of VF progression. No statistical significance was observed in the male (<60 and ≥60 years) and female (<60 years) subgroups.ConclusionDecreased C3, C4 and C1q levels at baseline were significantly associated with a greater risk of VF loss progression only in older women with PACG.

Brain Functional Network Analysis of Patients with Primary Angle-Closure Glaucoma

Objectives. Recent resting-state functional magnetic resonance imaging (fMRI) studies have focused on glaucoma-related neuronal degeneration in structural and spontaneous functional brain activity. However, there are limited studies regarding the differences in the topological organization of the functional brain network in patients with glaucoma. In this study, we aimed to assess both potential alterations and the network efficiency in the functional brain networks of patients with primary angle-closure glaucoma (PACG). Methods. We applied resting-state fMRI data to construct the functional connectivity network of 33 patients with PACG ( 54.21 ± 7.21 years ) and 33 gender- and age-matched healthy controls ( 52.42 ± 7.80 years ). The differences in the global and regional topological brain network properties between the two groups were assessed using graph theoretical analysis. Partial correlations between the altered regional values and clinical parameters were computed for patients with PACG. Results. No significant differences in global topological measures were identified between the two groups. However, significant regional alterations were identified in the patients with PACG, including differences within visual and nonvisual (somatomotor and cognition-emotion) regions. The normalized clustering coefficient and normalized local efficiency of the right superior parietal gyrus were significantly correlated with the retinal fiber layer thickness (RNFLT) and the vertical cup to disk ratio (V C/D). In addition, the normalized node betweenness of the left middle frontal gyrus (orbital portion) was significantly correlated with the V C/D in the patients with PACG. Conclusions. Our results suggest that regional inefficiency with decrease and compensatory increase in local functional properties of visual and nonvisual nodes preserved the brain network of the PACG at the global level.

Effect of Intraocular Lens Biomaterials on the Treatment of Primary Angle Closure Glaucoma

To explore the effect of phacoemulsification along with intraocular lens (IOL) implantation on the treatment of primary angle closure glaucoma (PACG), a total of 50 patients (54 eyes) with PCG who had undergone surgery were selected as the research objects, in which, there were 16 eyes with the acute PACG in pre-clinical stage, 20 eyes with acute PACG during acute attack, and 18 eyes with chronic PACG, and all patients received phacoemulsification along with IOL implantation therapy. The patient’s best corrected visual acuity, anterior chamber (AC), anterior depth, intraocular pressure (IOP), visual field, and fundus conditions were measured during the operation, after the operation, and during the follow-up period. The postoperative visual acuity of the patients with three types of PACG was greatly corrected, in which 30 eyes had corrected visual acuity above 0.5, and there were statistically significant differences (SSDs) (P < 0.05); angle closure of 54 eyes had different degrees of improvement, the opening degree of the acute angle closure is better than that of the chronic angle closure, and there were SSDs (P < 0.05); each of 54 eyes showed different degrees of deepening in the central AC, and there were SSDs (P < 0.05); postoperative IOP decreased greatly in all 54 eyes, and there were SSDs (P < 0.05). In conclusion, the IOL implantation based on phacoemulsification can effectively treat the PACG, at the same time reduce IOP, promote angle opening, enhance vision field of the patients, and ultimately achieve the purpose of improving surgical success.