Clinical Analysis Of Glaucomatous Optic Nerve Damage In Patients With Glaucomatocyclitic Crisis

Chapter 1 Analysis of the characteristics and related factors of visual field damage in patients with Glaucomatocyclitic Crisis syndromePurpose:Explore the characteristics of visual field damage and analyze its related factors in patients with Glaucomatocyclitic Crisis.Patients and Methods:A retrospective analysis was performed on 68 patients(78eyes)with Glaucomatocyclitic Crisis treated in our hospital from February 2013 to December 2018.Patients were divided into 2 groups according to whether glaucomatous optic nerve damage occurred.Group A(with glaucomatous optic nerve damage)18 cases and 22 eyes,Group B(without glaucomatous optic nerve damage)50 cases and 56 eyes,then the monocular patients in group A are recorded as group a,and the monocular patients in group B are recorded as group b.Record age,single/double eyes,course of disease,and IOP in the onset,visual field.The characteristics of visual field damage in group A were analyzed,and the related factors in groups A and B and the intraocular pressure characteristics in groups a and b were analyzed statistically.Results:There were 18 cases(22 eyes)of glaucomatous optic nerve damage(group A),accounting for 28.21%in group A,and 6 eyes of optic nerve damage in early stage,accounting for 27.27;7 eyes in middle stage,accounting for 31.82%;9 eyes in late stage,accounting for 40.91%.Correlation analysis of disease duration and visual field damage MD values showed that there was a significant positive correlation between the two(P<0.001);Comparison of gender,age,single/double eyes,disease duration,and IOP in onset between groups A and B.The results showed that the disease duration in group A was significantly longer than that in group B,which was statistically significant(P<0.001),while other indicators were not statistically different between the two groups(P=0.827,0.141,0.437,0.939).The non-parametric statistical rank sum test was conducted to determine whether the two groups a and b had intraocular pressure crossover.U=-4.432,p<0.001,the difference between the two groups was statistically significant.The intraocular pressure crossing phenomenon in the group b was significantly more than that in the group a.Conclusions:Glaucoma optic nerve injury occurs in Glaucomatocyclitic Crisis,and it is more likely in patients with long-term duration.The optic nerve injury is due to the cumulative effect of repeated onset of high intraocular pressure and secondary trabecular meshwork injury,so the disease should be diagnosed early and standardized treatment.Chapter 2 The Characteristics of Intraocular Pressure Dynamic Change in Patients with Glaucomatocyclitic CrisissyndromePurpose:To investigate the dynamic changes of intraocular pressure in the typical glaucomatous ciliary inflammatory syndrome from the onset to the intermittent phase,and provide a clinical basis for the diagnosis,differential diagnosis and treatment of the disease.Patients and Methods:Seventeen patients with typical glaucomatous ciliary inflammatory syndrome were included in the study.Randomized intraocular pressure(IOP)was recorded for each patient during the episode,and 24-hour intraocular pressure monitoring was performed with a customary postural method when it was determined that the patients was in an intermittent phase.The intraocular pressure curve and the line graph were drawn according to the measured values,and Mean value of mean intraocular pressure,peak intraocular pressure and valley intraocular pressure were calculated for 17 patients.The above data were statistically analyzed.Results:The IOP in affected eye in episodes is higher than that of the contralateral eye statistically(p<0.001);while in intermittent period the Mean value of mean IOP(P=0.001),the peak(P=0.002)and the valley(P=0.046)value of 24-hour IOP in affected eye are statistical different with that of the contralateral eye.All of these parameters of the affected eye in intermittent period are lower than that of the contralateral eye obviously.Conclusion:The dynamic change of intraocular pressure in the typical ciliary syndrome from the onset to the intermittent phase is consistent with the phenomenon of intraocular pressure crossover.This feature has important significance for the diagnosis and differential diagnosis of the disease,and can also guide the treatment of the disease.Chapter 3 A meta analysis of incidence of visual field damage and related factors in patients with Glaucomatocyclitic CrisisPurpose:Systematically analyze the ratio of visual field damage and related factors of Glaucomatocyclitic Crisis in domestic and foreign literatures.Patients and Methods:The computer retrieved Pubmed database,Wanfang data-base,China National Knowledge Infrastructure(CNKI)and combined with literature retrospective methods,collected domestic and foreign research literatures on the incidence and related factors of glaucomatous optic nerve injury of Glaucomatocyclitic Crisis.Using Stata 15.1 software,select the indicators:incidence,gender,age,single/double eyes,duration of disease,and intraocular pressure(IOP)at onset for meta-analysis.OR(odds risk)was used as the effect variable for the binary variables,and mean difference(MD)was used as the effect variable for the continuous variables.The results are expressed by each effect amount and its 95%Confidence interval(CI).If there is heterogeneity among the original studies,a random effects model is used;otherwise,a fixed effects model is used.Results:Meta analysis included a total of 13 literatures.The incidence of glaucomatous optic nerve damage in Glaucomatocyclitic Crisis syndrome was 0.251(95%CI:0.175-0.327).Three of them met the relevant factor analysis,and the results showed:There was a statistically significant difference in age,and duration of disease in PSS patients with/without glaucomatous optic nerve damage(p=0.000,p=0.000),there was no statistical difference between the two groups in gender,single/double eyes and IOP in onset(p=0.468,0.053,0.062).Conclusions:Glaucomatocyclitic Crisis syndrome can cause glaucomatous optic nerve damage.Glaucomatous optic nerve damage is more likely to occur in older and long-term PSS patients.For patients with old age and long course of disease,special attention should be paid to the detailed examination of visual function and follow-up consultation.