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Glaucoma: HELP
Articles by Xing-Huai Sun
Based on 93 articles published since 2009
(Why 93 articles?)
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Between 2009 and 2019, X. H. Sun wrote the following 93 articles about Glaucoma.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial [Management of peri-operation in anti-glaucoma surgery]. 2013

Sun, Xing-huai. · ·Zhonghua Yan Ke Za Zhi · Pubmed #23714022.

ABSTRACT: Anti-glaucoma surgery is one of important methods for glaucoma therapy. It is easy to perform a glaucoma surgery. However, it is not easy to perform a successful one. The management of peri-operation will provide a path for success of glaucoma surgery. The management of peri-operation includes a well preparation of pre-operation and a following-up care of post-operation, which requires a systemic and topical evaluation of patients in pre-operation based on the mechanism of IOP elevation to determine indications, a suitable surgical design, preventive measure for complications during the operation, and a skillful surgical technique. Finally, Careful follow- up of post-operation will guarantee a successful anti-glaucoma surgery and achieve the expectation of both physicians and patients.

2 Review [The progress of studies on aqueous humor dynamics abnormality induced by trabecular meshwork and Schlemm canal endothelial cell senescence and its relation with glaucoma]. 2017

Song, M M / Lei, Y / Wu, J H / Sun, X H. ·Department of Ophthalmology, Eye and ENT hospital of Fudan University, Key Laboratory of Myopia, Ministry of Health, Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China. ·Zhonghua Yan Ke Za Zhi · Pubmed #29141392.

ABSTRACT: Glaucoma is the second leading cause of blindness in the world next to cataract. Aging is a strong risk factor leading to elevated intraocular pressure (IOP). IOP is associated with aqueous humor circulation. Trabecular meshwork cells and Schlemm canal endothelial cells, which form the conventional outflow pathway, play an important role in maintaining the IOP. Cell senescence induces abnormalities of the aqueous humor dynamics, leading to elevated IOP. Trabecular meshwork cells cause increased intrinsic stiffness, autophagy dysfunction, abnormal expression of microRNA and mitochondrial dysfunction with senescence. The senescence of Schlemm canal endothelial cells decreases cell permeability and mechanotransduction and disrupts the endothelial nitric oxide synthase signaling pathway. The changes will increase aqueous humor outflow resistance and elevate IOP. This review discusses how cell senescence induces aqueous humor dynamics abnormalities and the relation with glaucoma.

3 Review Lack of Association between Serum Vitamin B₆, Vitamin B 2017

Li, Shengjie / Li, Danhui / Shao, Mingxi / Cao, Wenjun / Sun, Xinghuai. ·Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. lishengjie6363020@163.com. · Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Medical School, Xi'an Jiaotong University, Xi'an 710061, China. danhuili1002@sina.com. · Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. smingxi@sohu.com. · Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. wgkjyk@aliyun.com. · Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. wgkjyk@aliyun.com. · Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. xhsun@shmu.edu.cn. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai 200031, China. xhsun@shmu.edu.cn. · Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai 200031, China. xhsun@shmu.edu.cn. · Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China. xhsun@shmu.edu.cn. ·Nutrients · Pubmed #28635642.

ABSTRACT: Although vitamins play a major role in health, and their deficiency may be linked to symptoms of optic-nerve dysfunction, the association between serum vitamin levels and glaucoma in humans remains controversial. In this study, articles in the PubMed, Web of Science, and EMBASE databases were searched up to 25March 2017. Nine studies on primary open-angle glaucoma (POAG), four studies on normal tension glaucoma (NTG), and six studies on exfoliative glaucoma (EXG) were retrieved. The combined results showed no differences in the levels of serum vitamin B₆ between POAG (

4 Review Primary angle closure glaucoma: What we know and what we don't know. 2017

Sun, Xinghuai / Dai, Yi / Chen, Yuhong / Yu, Dao-Yi / Cringle, Stephen J / Chen, Junyi / Kong, Xiangmei / Wang, Xiaolei / Jiang, Chunhui. ·Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, China; Key Laboratory of Myopia of State Health Ministry (Fudan University) and Key Laboratory of Visual Impairment and Restoration of Shanghai, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, China. Electronic address: xhsun@shmu.edu.cn. · Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, China; Key Laboratory of Myopia of State Health Ministry (Fudan University) and Key Laboratory of Visual Impairment and Restoration of Shanghai, China. · Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia; Lions Eye Institute, The University of Western Australia, Perth, Australia. ·Prog Retin Eye Res · Pubmed #28039061.

ABSTRACT: Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG. Recent Genome Wide Association Studies identified several new PACG loci and genes, which may shed light on the molecular mechanisms of PACG. The current classification systems of PACG remain controversial. Focusing the anterior chamber angle is a principal management strategy for PACG. Treatments to open the angle or halt the angle closure process such as laser peripheral iridotomy and/or iridoplasty, as well as cataract extraction, are proving their effectiveness. PACG may be preventable in the early stages if future research can identify which kind of angles and/or persons are more likely to benefit from prophylactic treatment. New treatment strategies like adjusting the psychological status and balancing the sympathetic-parasympathetic nerve activity, and innovative medicines are needed to improve the prognosis of PACG. In this review, we intend to describe current understanding and unknown aspects of PACG, and to share the clinical experience and viewpoints of the authors.

5 Review Actinobacillus actinomycetemcomitans Keratitis After Glaucoma Infiltration Surgery: A Clinical Report and Literature Review. 2016

Hong, Jiaxu / Xu, Jianjiang / Cao, Wenjun / Ji, Jian / Sun, Xinghuai. ·From the Department of Ophthalmology and Visual Science, Shanghai Medical College, Eye and E Ear, Nose and Throat Hospital, Fudan University, Shanghai (JH, JX, WC, JJ, XS) · School of Life Sciences, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen University, Fujian (JH) · Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA (JH) · Institutes of Brain Science, China State Key Laboratory of Medical Neurobiology (XS) · and National Health and Family Planning Commission, Key Laboratory of Myopia, Shanghai, China (XS). ·Medicine (Baltimore) · Pubmed #26817919.

ABSTRACT: Actinobacillus actinomycetemcomitans infection is a rare and easily misdiagnosed ocular disease. In this article, the authors report a chronic, purulent, and difficult-to-treat case of A actinomycetemcomitans keratitis following a glaucoma infiltration surgery.A 56-year-old man with a long-standing history of open-angle glaucoma in both eyes presented with a 12-week history of ocular pain, redness, and blurred vision in his right eye. He underwent a glaucoma infiltration surgery in his right eye 6 months ago. Three months postoperatively, he developed peripheral corneal stromal opacities associated with a white, thin, cystic bleb, and conjunctival injection. These opacities grew despite topical treatment with topical tobramycin, levofloxacin, natamycin, amikacin, and metronidazole eye drops.Multiple corneal scrapings revealed no organisms, and no organisms grew on aerobic, anaerobic, fungal, or mycobacterial cultures. The patient's right eye developed a severe purulent corneal ulcer with a dense hypopyon and required a corneal transplantation. Histopathologic analysis and 16S ribosomalribonucleic acid polymerase chain reaction sequencing revealed A actinomycetemcomitans as the causative organism. Postoperatively, treatment was initiated with topical levofloxacin and cyclosporine, as well as oral levofloxacin and cyclosporine. Graft and host corneal transparency were maintained at the checkup 1 month after surgery.Although it is a rare cause of corneal disease, A actinomycetemcomitans should be suspected in patients with keratitis refractory to topical antibiotic therapy. Delay in diagnosis and appropriate treatment can result in vision loss.

6 Review Fixed-combination treatments for intraocular hypertension in Chinese patients - focus on bimatoprost-timolol. 2015

Fang, Yuan / Ling, Zhihong / Sun, Xinghuai. ·Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. · Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China ; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, People's Republic of China ; Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, People's Republic of China ; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, People's Republic of China. ·Drug Des Devel Ther · Pubmed #25999695.

ABSTRACT: Glaucoma is a common eye disease that can lead to irreversible vision loss if left untreated. The early diagnosis and treatment of primary open-angle glaucoma is challenging, and visual impairment in Chinese glaucoma patients is a serious concern. Most of these patients need more than one topical antiglaucoma agent to control their intraocular pressures (IOPs). In the People's Republic of China, the daily cost of different glaucoma medication varies greatly, and the treatment habits differ throughout the country. Prostaglandin analogs (PGAs) are recommended as first-line monotherapy, because of their efficacy and low risk of systemic side effects. Fixed-combination drops, particularly PGA-based fixed combinations, have recently been developed and used in patients with progression or who have failed to achieve their target IOPs. Here, we reviewed the current literature on the use of bimatoprost-timolol fixed combination (BTFC) in the People's Republic of China. BTFC has achieved good efficacy and tolerability in Chinese clinical trials. In addition, BTFC is more cost effective compared with other fixed combinations available in the People's Republic of China. Fixed-combination drops may offer benefits, such as keeping the ocular surface healthy, convenience of administration, and improvement in long-term adherence and quality of life. Therefore, BTFC has great potential for the treatment of Chinese glaucoma patients. However, the long-term efficacy of BTFC, comparisons of BTFC with other fixed-combination drugs, and treatment adherence and persistence with treatment in Chinese patients are unknown and will require further study.

7 Review Progress in understanding the association between high myopia and primary open-angle glaucoma. 2014

Ma, Fei / Dai, Jinhui / Sun, Xinghuai. ·Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, Ministry of Health PR China, Shanghai, China. ·Clin Exp Ophthalmol · Pubmed #23845009.

ABSTRACT: Many clinical and fundamental studies have shown that high myopia (HM) and glaucoma are closely associated. In particular, the occurrence and progression of primary open-angle glaucoma interact with the progression of HM. Two hypotheses have been proposed to explain the association between the two disorders: the hypertension gene theory and the collagen-related gene theory. HM and primary open-angle glaucoma patients show similar collagen changes and hypersensitive responses to glucocorticoids. Consequently, these common features may hold key information regarding their underlying mechanisms. Advances in life sciences, such as molecular genetics, provide opportunities for clarifying their association at the molecular level. This article reviews available research on the association between these two disorders from the perspectives of epidemiology, clinical manifestation, diagnosis and pathogenic mechanisms.

8 Review [The application and research progress of functional magnetic resonance imaging in glaucoma]. 2013

Yang, Hong-fang / Liu, Ting-ting / Sun, Xing-huai. · ·Zhonghua Yan Ke Za Zhi · Pubmed #24555211.

ABSTRACT: Recent advances on functional magnetic resonance technology have greatly broadened its application in many disciplines including ophthalmic research area. Functional magnetic resonance imaging(fMRI), which combines the anatomical and functional features of the neural system, is a non-invasive,objective and orienting method. Among so many sub-methods, blood oxygenation level dependent MRI reflects the neural activities of visual cortex; diffusion tensor imaging traces nerve fibers; gadolinium enhanced MRI could access blood-ocular barrier function; manganese enhanced MRI reveals axoplasmic transport and retinotopic projection to sub-cortical nucleus; blood volume MRI could evaluate lamina-specific hemodynamics of ocular wall; while magnetic resonance spectroscopy investigates the molecular metabolism in nerve system. Glaucoma may damage the whole visual pathway, and fMRI would helps us estimate the in vivo fiber integrity and visual functional status quo in glaucoma patients. Here we first review the basic principles of several fMRI techniques and then discuss the applications in research related to glaucoma.

9 Review [Glial cell and glaucomatous optic neuropathy]. 2012

Ling, Zhi-hong / Sun, Xing-huai. ·Department of Ophthalmology and Visual Science, Shanghai Medical College, Eye & ENT Hospital, Fudan University, Shanghai 200031, China. ·Zhonghua Yan Ke Za Zhi · Pubmed #22490920.

ABSTRACT: Glaucomatous optic neuropathy is a chronic disease accompanied by visual field loss, cupping of optic nerve head, and apoptosis of retinal ganglion cells (RGCs). The mechanism of glaucomatous optic neuropathy is unknown but glial cells play an important role in glaucomatous optic nerve damage and the repair process. We review the role of glial cells in the remodeling of optic nerve head, apoptosis of RGCs and immune reactions in glaucoma.

10 Review The effect of caffeine on intraocular pressure: a systematic review and meta-analysis. 2011

Li, Mao / Wang, Min / Guo, Wenyi / Wang, Jiajian / Sun, Xinghuai. ·Department of Ophthalmology and Vision Science, Eye and Ear Nose Throat Hospital, Shanghai Medical School, Fudan University, No.83, Fenyang Road, Shanghai, 200032, People's Republic of China. ·Graefes Arch Clin Exp Ophthalmol · Pubmed #20706731.

ABSTRACT: BACKGROUND: Caffeine is widely consumed, and its effect on intraocular pressure (IOP) has been reported in conflicting data. The aim of this meta-analysis was to quantitatively summarize the effect of caffeine on IOP in normal individuals and in patients with glaucoma or ocular hypertension (OHT). METHODS: A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify pertinent randomized controlled trials (RCTs) from the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and EMBASE. A systematic review and meta-analysis was performed. IOP at 0.5 hour (h), 1 h and 1.5 h after caffeine ingestion was the main outcome measurement. RESULTS: Six RCTs (two parallel-designed and four crossover-designed) evaluating 144 participants fulfilled inclusion criteria. The risk of bias for these studies was uncertain. Among the participants, 103 were normal individuals and 41 were patients with glaucoma or OHT. In normal individuals, the IOPs measured at 0.5 h, 1 h and 1.5 h post-intervention were not affected by ingestion of caffeine. The weighted mean difference (WMD) with 95% confidence intervals (95%CI) for each measurement point were -0.740 (-2.454, 0.974), 0.522 (-0.568, 1.613) and 0.580 (-1.524, 2.684). However, in patients with glaucoma or OHT, IOP increased at each measurement point, with the WMD and 95%CI being 0.347 (0.078, 0.616), 2.395 (1.741,3.049) and 1.998 (1.522,2.474) respectively. No publication bias was detected by either Begg's or Egger's test. CONCLUSION: Available evidences showed that caffeine had different effects on IOP in different groups of individuals. For normal individuals, IOP was not changed by ingestion of caffeine, while for patients with glaucoma or OHT, IOP increased significantly. More high-quality RCTs are warranted to confirm this. The mechanisms underlying this phenomenon and the clinical significance are to be explored.

11 Review [Primary glaucoma and psychological characteristics]. 2010

Wen, Wen / Sun, Xing-huai. ·Eye & ENT Hospital, Fudan University, Shanghai, China. ·Zhonghua Yan Ke Za Zhi · Pubmed #21055203.

ABSTRACT: Glaucoma is a most common irreversible blinding disease, which is also considered a typical psychosomatic disease. With the promotion of physical, mental and social medical care model, more and more attention has been paid to psychological changes in patients with glaucoma. The mental disturbance in patients with glaucoma is found to be different from ordinary persons in clinic using psychological assessment tools. The mood changes seen in these patients are closely related to the incidence of glaucoma, medication, surgery and quality of life. This review summarizes the research on the relationship between primary glaucoma and its psychological characteristics. A comprehensive and systematic understanding of the roles of the psychological characteristics in the occurrence and development of glaucoma will provide significant guidance in establishing a rational and standard treatment of psychological intervention.

12 Review The critical role of the conjunctiva in glaucoma filtration surgery. 2009

Yu, Dao-Yi / Morgan, William H / Sun, Xinghuai / Su, Er-Ning / Cringle, Stephen J / Yu, Paula K / House, Philip / Guo, Wenyi / Yu, Xiaobo. ·Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia. dyyu@cyllene.uwa.edu.au ·Prog Retin Eye Res · Pubmed #19573620.

ABSTRACT: This review considers the critical role of the conjunctiva in determining the success or failure of glaucoma filtration surgery. Glaucoma filtration surgery can be defined as an attempt to lower intraocular pressure (IOP) by the surgical formation of an artificial drainage pathway from the anterior chamber to the subconjunctival space. Many types of glaucoma filtration surgery have been developed since the first attempts almost 180 years ago. The wide range of new techniques and devices currently under investigation is testament to the limitations of current techniques and the need for improved therapeutic outcomes. Whilst great attention has been paid to surgical techniques and devices to create the drainage pathway, relatively little attention has been given to address the question of why drainage from such artificial pathways is often problematic. This is in contrast to normal drainage pathways which last a lifetime. Furthermore, the consequences of potential changes in aqueous humour properties induced by glaucoma filtration surgery have not been sufficiently addressed. The mechanisms by which aqueous fluid is drained from the subconjunctival space after filtration surgery have also received relatively little attention. We propose that factors such as the degree of tissue damage during surgery, the surrounding tissue reaction to any surgical implant, and the degree of disruption of normal aqueous properties, are all factors which influence the successful formation of long term drainage channels from the conjunctiva, and that these channels are the key to successful filtration surgery. In recent years it has been suggested that the rate of fluid drainage from the subconjunctival space is actually the determining factor in the resultant IOP reduction. Improved knowledge of aqueous humour induced changes in such drainage pathways has the potential to significantly improve the surgical management of glaucoma. We describe for the first time a novel type of drainage surgery which attempts to minimise surgical trauma to the overlying conjunctiva. The rationale is that a healthy conjunctiva allows drainage channels to form and less opportunity for inflammation and scar tissue formation which are a frequent cause of failure in glaucoma filtration surgery. Successful drainage over extended periods of time has been demonstrated in monkey and rabbit eyes. Long lasting drainage pathways were clearly associated with the presence of lymphatic drainage pathways. A new philosophy in glaucoma drainage surgery is proposed in which minimisation of surgical trauma to the conjunctiva and the encouragement of the development of conjunctival drainage pathways, particularly lymphatic pathways, are central pillars to a successful outcome in glaucoma filtration surgery.

13 Review [Glaucoma surgery in China: problems and solutions]. 2009

Sun, Xing-Huai. ·Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China. xhsun@shmu.edu.cn ·Zhonghua Yan Ke Za Zhi · Pubmed #19484923.

ABSTRACT: This article reviews the progress of glaucoma surgery in the world combined with author's experiences in clinical practice and analyses the present condition and problems of glaucoma surgery in China. The issues are addressed and discussed in this paper also including current focus on the prevention of postoperative shallow anterior chamber by nonpenetrating trabecular surgery in primary open angle glaucoma and phacoemulsification in primary angle closure glaucoma, and the fibro-scarring of filtering bleb by anti-metabolism medicines and filling materials under scleral flap.

14 Clinical Trial Intraocular pressure lowering efficacy and safety of travoprost 0.004% as a replacement therapy in patients with open angle glaucoma or ocular hypertension. 2010

Ge, Jian / Sun, Xing-huai / Wang, Ning-li / Zhao, Jia-liang / Wu, Ling-ling / Chen, Xiao-ming / Wang, Zhi-xin / Li, Benny. ·Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, Guangdong 510060, China. gejian@mail.sysu.edu.cn ·Chin Med J (Engl) · Pubmed #20819599.

ABSTRACT: BACKGROUND: Travoprost has been widely used for the treatment of patients with open-angle glaucoma (OAG) or ocular hypertension (OH). The aim of this study was to evaluate the intraocular pressure (IOP) lowering efficacy of travoprost 0.004% monotherapy in patients previously treated with other topical hypotensive medications, and in previously untreated patients. METHODS: This open-label, 12-week study in 1651 adult patients with ocular hypertension or open-angle glaucoma who were untreated or required a change in therapy (due to either inadequate efficacy or safety issues) as judged by the investigator was conducted at 6 sites in China. Previously treated patients were instructed to discontinue their prior medications at the first visit. All the patients were dosed with travoprost 0.004% once-daily at 8 p.m. in both eyes for 12 weeks. Efficacy and safety evaluations were conducted at week 4 and 12. IOP measurements were performed at the same time of day at the follow-up visits. RESULTS: For patients transitioned to travoprost, mean IOP reductions from baseline in untreated and treated patients with different prior medications at week 12 were: latanoprost, (4.3 +/- 4.6) mmHg; beta-blocker, (6.3 +/- 4.0) mmHg; alpha-agonist, (7.5 +/- 4.3) mmHg; topical carbonic anhydrase inhibitors, (8.0 +/- 4.9) mmHg. All mean IOP changes from baseline were statistically significant (P < 0.001). No treatment-related serious adverse events were reported in this study. CONCLUSIONS: In patients treated with other hypotensive medications or untreated, the IOP reduction with travoprost was significant. The results of this study demonstrated the potential benefit of using travoprost as a replacement therapy in order to ensure adequate IOP control. Travoprost administered once daily was safe and well tolerated in patients with glaucoma or ocular hypertension.

15 Article Comparison of spectral domain and swept source optical coherence tomography for angle assessment of Chinese elderly subjects. 2019

Qiao, Yunsheng / Tan, Chen / Zhang, Min / Sun, Xinghuai / Chen, Junyi. ·Department of Ophthalmology & Visual Science, Eye and ENT Hospital of Fudan University, 83 Fenyang Rd, Shanghai, 200031, China. · NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, 200031, China. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China. · Department of Ophthalmology & Visual Science, Eye and ENT Hospital of Fudan University, 83 Fenyang Rd, Shanghai, 200031, China. chenjy@fudan.edu.cn. ·BMC Ophthalmol · Pubmed #31286869.

ABSTRACT: BACKGROUND: This comparative study aimed to demonstrate the differences between swept source OCT (SS-OCT) (1310 nm) and spectral domain OCT (SD-OCT) (840 nm) for the identification and measurement of anterior chamber angle (ACA) structures. METHODS: Sixty seven eyes from 67 healthy subjects underwent ACA imaging at the nasal and temporal sides using SS-OCT and SD-OCT with different wavelength (Tomey, 1310 nm and RTvue, 840 nm). Images were evaluated for the ability to distinguish angle structures including the Schwalbe's line (SL), the Schlemm's canal (SC) and the scleral spur (SS). The length of trabecular meshwork (LTM), the angle-opening distance (AOD500 and AOD750) and the length of Schlemm's canal (LSC) were also measured. RESULTS: The nasal identification rate for SL, SC and SS were 91.04%/89.55%, 50.75%/40.30% and 100.0%/74.63% (SS-OCT/SD-OCT), respectively. The temporal identification rate for SL, SC and SS were 86.57%/91.04%, 68.66%/70.15% and 100.0%/65.67% (SS-OCT/SD-OCT), respectively. Differences between SS-OCT and SD-OCT were found in terms of the visualization of the SS. With respect to the measurements of angle, the evaluation of LTM at the nasal side, LSC at the temporal side and AOD500/750 at both sides showed significant difference between the two devices. However, there existed good correlation between the AOD500/750 measured by SS-OCT and SD-OCT (Spearman's rank correlation coefficient > 0.8, p < 0.000). CONCLUSIONS: SS-OCT displayed a better performance in detecting deeper structures of the angle such as the SS. However, for discriminating structures lying in transparent or semi-transparent tissue such as the SL and the SC, the two devices showed good consistency. Although SS-OCT and SD-OCT demonstrated high correlation for angle measurement (AOD500/750), their agreement was poor.

16 Article Association between Pretreatment Serum Uric Acid Levels and Progression of Newly Diagnosed Primary Angle-Closure Glaucoma: A Prospective Cohort Study. 2019

Li, Shengjie / Shao, Mingxi / Cao, Wenjun / Sun, Xinghuai. ·Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. · Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China. · NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China. · Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai 200031, China. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai 200032, China. ·Oxid Med Cell Longev · Pubmed #30881597.

ABSTRACT: Purpose: Increased evidence reveals that uric acid (UA) may have an important neuroprotective effect through its antioxidant properties. The aim of the present study was to investigate the relationship between pretreatment serum UA levels and the progression of newly diagnosed primary angle-closure glaucoma (PACG). Methods: This prospective observational cohort study included 64 patients with newly diagnosed PACG who were followed up for a mean period of 12.77 months (range: 3-28 months). All subjects underwent a complete ophthalmological examination during the baseline and final follow-up visits, together with the acquisition of blood samples for UA measurements. During the follow-up period, the progression of PACG was defined as a clinical diagnosis of medically uncontrolled intraocular pressure and a loss of visual field with a mean deviation of >1 dB/year. Univariable and multivariable Cox regression models were used to investigate the association between baseline serum UA levels and the progression of PACG. The cumulative probability of progression of glaucoma was analyzed using the Kaplan-Meier method. Results: During follow-up, 32 subjects were defined as progressive PACG, among whom baseline UA values were significantly higher in nonprogressing subjects than in progressing subjects (0.314 ± 0.069 mmol/l versus [vs.] 0.258 ± 0.069 mmol/l, respectively; Conclusion: An association between high baseline serum UA levels and a decreased risk for progressing PACG was found. This primary finding suggests that high serum UA levels may have a protective role against PACG and could slow disease progression.

17 Article Association of serum uric acid levels with primary open-angle glaucoma: a 5-year case-control study. 2019

Li, Shengjie / Shao, Mingxi / Li, Danhui / Tang, Binghua / Cao, Wenjun / Sun, Xinghuai. ·Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China. · Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Medical School, Xi'an Jiaotong University, Xi'an, China. · Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China. · Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China. · Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China. ·Acta Ophthalmol · Pubmed #29673085.

ABSTRACT: PURPOSE: It has been hypothesised that uric acid (UA) has a protective effect against oxidative damage in the central nervous system. Therefore, we investigated serum UA concentrations in patients with primary open-angle glaucoma (POAG) and explored the relationship between serum UA concentration and glaucoma severity. METHODS: This prospective, cross-sectional, case-control study was conducted in 163 POAG patients and 103 normal controls. Clinical and demographic information was obtained from the medical data platform of the Eye & ENT Hospital of Fudan University, Shanghai, China. The POAG patients were categorised into mild [median deviation (MD) ≤ 6.00 dB], moderate (MD > 6 Db-≥12 dB) and severe (MD > 12 dB) subgroups, based on their visual field MD results. RESULTS: The level of serum UA in the POAG group (0.321 ± 0.084 mmol/l) was approximately 12.77% lower (p < 0.001) than that of the control group (0.362 ± 0.053 mmol/l). The UA/creatinine (Cr) ratio was approximately 14.99% lower (p < 0.001) in patients with POAG (4.47 ± 1.15), compared with the control group (5.14 ± 1.05). The mean level of UA was lowest in the severe POAG group, followed by the moderate POAG group, and the mild POAG group (p < 0.001). A similar trend was observed when UA levels were compared between the POAG and control groups in males. Multivariate regression analyses showed a significant negative correlation between UA and vertical cup-disc ratio (B = -0.320, p = 0.034), and UA and MD (B = -0.441, p = 0.031) in males. CONCLUSION: Primary open-angle glaucoma patients have lower UA levels; however, a negative association between UA levels and disease severity was evident in male patients.

18 Article [The function-structure impairment pattern of optic nerves in primary open-angle glaucoma and normal-tension glaucoma]. 2018

Wang, X M / Sun, X H / Dai, Y / Kong, X M / Chen, Y H. ·Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China. ·Zhonghua Yan Ke Za Zhi · Pubmed #30440151.

ABSTRACT:

19 Article [Rational application of optical coherence tomography in examining glaucomatous optic neuropathy]. 2018

Sun, X H / Dai, Y. ·Department of Ophthalmology & Visual Science, Shanghai Medical College of Fudan University, Department of Ophthalmology, Eye & ENT Hospital of Fudan University, NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai 200031, China. ·Zhonghua Yan Ke Za Zhi · Pubmed #30440149.

ABSTRACT: Glaucoma-related retinal imaging using frequency domain optical coherence tomography (OCT) has become an important but not the only basis for the diagnosis and follow-up of glaucoma. The circumpapillary retinal nerve fiber layer thickness and the macular ganglion cell thickness are two commonly used structural parameters in glaucoma. Their diagnostic efficacy is similar, but each has different influencing factors. Clinically, these two parameters should be analyzed together to improve the specificity and sensitivity for detecting glaucomatous optic nerve damage. Recently, there have been quite a few clinical studies on new OCT technologies and concepts related to glaucoma, but it is still necessary to further confirm the application value. Ophthalmologists should master the principle of glaucoma-related OCT retinal imaging, combining with other clinical evaluation methods, to improve early diagnosis and timely detection of glaucomatous progression.

20 Article EphrinB/EphB forward signaling in Müller cells causes apoptosis of retinal ganglion cells by increasing tumor necrosis factor alpha production in rat experimental glaucomatous model. 2018

Liu, Shu-Ting / Zhong, Shu-Min / Li, Xue-Yan / Gao, Feng / Li, Fang / Zhang, Meng-Lu / Zhu, Ke / Sun, Xing-Huai / Wang, Xin / Miao, Yanying / Yang, Xiong-Li / Wang, Zhongfeng. ·Department of Neurology, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, Zhongshan Hospital, Fudan University, 131 Dongan Road, Shanghai, 200032, China. · Department of Ophthalmology at Eye & ENT Hospital, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, 200031, China. · Department of Neurology, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, Zhongshan Hospital, Fudan University, 131 Dongan Road, Shanghai, 200032, China. yymiao@fudan.edu.cn. · Department of Neurology, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology, Zhongshan Hospital, Fudan University, 131 Dongan Road, Shanghai, 200032, China. zfwang@fudan.edu.cn. ·Acta Neuropathol Commun · Pubmed #30355282.

ABSTRACT: It was previously shown that EphB/ephrinB reverse signaling in retinal ganglion cells (RGCs) is activated and involved in RGC apoptosis in a rat chronic ocular hypertension (COH) model. In the present work, we first show that ephrinB/EphB forward signaling was activated in COH retinas, and RGC apoptosis in COH retinas was reduced by PP2, an inhibitor of ephrinB/EphB forward signaling. We further demonstrate that treatment of cultured Müller cells with ephrinB1-Fc, an EphB1 activator, or intravitreal injection of ephrinB1-Fc in normal rats induced an increase in phosphorylated EphB levels in these cells, indicating the activation of ephrinB/EphB forward signaling, similar to those in COH retinas. The ephrinB1-Fc treatment did not induce Müller cell gliosis, as evidenced by unchanged GFAP expression, but significantly up-regulated mRNA and protein levels of tumor necrosis factor-α (TNF-α) in Müller cells, thereby promoting RGC apoptosis. Production of TNF-α induced by the activation of ephrinB/EphB forward signaling was mediated by the NR2B subunit of NMDA receptors, which was followed by a distinct PI3K/Akt/NF-κB signaling pathway, as pharmacological interference of each step of this pathway caused a reduction of TNF-α production, thus attenuating RGC apoptosis. Functional analysis of forward and reverse signaling in such a unique system, in which ephrin and Eph exist respectively in a glial element and a neuronal element, is of theoretical importance. Moreover, our results also raise a possibility that suppression of ephrinB/EphB forward signaling may be a new strategy for ameliorating RGC apoptosis in glaucoma.

21 Article Mechanical Strain Induces Distinct Human Scleral Fibroblast Lineages: Differential Roles in Cell Proliferation, Apoptosis, Migration, and Differentiation. 2018

Qiu, Chen / Chen, Minjie / Yao, Jing / Sun, Xinghuai / Xu, Jianjiang / Zhang, Rong / Wang, Xin / Li, Gang / Qian, Shaohong. ·Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China. · Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China. · Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. ·Invest Ophthalmol Vis Sci · Pubmed #29847646.

ABSTRACT: Purpose: The purpose of this study was to explore the effect of mechanical strain on human scleral fibroblasts (HSFs) and compare cell behaviors of HSFs from distinct regions. Methods: Primary HSFs were cultivated using a digestive protocol. Cells were seeded on collagen I-coated Bioflex plates, and a FX-5000 tension system was used to perform biaxial mechanical strain in vitro. We applied 10%, 0.5-Hz mechanical strain. Cell behaviors of peripapillary and periphery HSFs were compared after the strain. Edu imaging, Cell Counting Kit-8 assay, and cell cycle flow cytometry were conducted to analyze cell proliferation ability. For cell apoptosis, flow cytometry of Annexin V/propidium iodide, caspase 3 activity, and Western blot were performed. Immunofluorescence, real-time PCR, and Western blot were used to investigate cell differentiation. A migration assay was also performed. Results: Under the mechanical strain of 10%, 0.5 Hz for 24 hours, the proliferation ability and cell apoptosis of peripapillary HSFs did not have a significant change. The expression of alpha-smooth muscle actin (α-SMA) slightly decreased. However, increased cell proliferation, attenuated cell apoptosis and more expression of α-SMA were shown in the periphery HSFs under the same condition. The migration rate was also increased for periphery HSFs, whereas it kept almost the same for peripapillary HSFs under 10%, 0.5-Hz strain for 8 hours. Conclusions: Mechanical strain affected the cell behaviors of HSFs. The different performance of cells from distinct regions may suggest familial linages of HSFs, probably induced by mechanical strain.

22 Article What Are the Characteristics of Primary Angle Closure With Longer Axial Length? 2018

Li, Mengwei / Chen, Yuhong / Jiang, Zhenying / Chen, Xiaoxiao / Chen, Junyi / Sun, Xinghuai. ·Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China. · Key Laboratory of Myopia, Ministry of Health (Fudan University) and Key Laboratory of Visual Impairment and Restoration of Shanghai, China. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China. ·Invest Ophthalmol Vis Sci · Pubmed #29625458.

ABSTRACT: Purpose: To compare biometric parameters between primary angle closure with longer axial length (AL) and those with medium or shorter AL. Methods: We prospectively recruited 138 primary angle-closure patients. Low-coherence interferometry and ultrasound biomicroscopy examinations were performed before laser peripheral iridotomy and pilocarpine treatment. AL was categorized as shorter (<22.5 mm), medium (≥22.5 to <23.5 mm), or longer (≥23.5 mm). Anterior chamber depth and width (ACD and ACW), lens vault (LV), anterior vault (AV), relative AV (AV/AL), relative lens position (RLP, [ACD + 1/2 lens thickness]/AL), trabecular-ciliary angle (TCA), keratometry, and other biometric parameters were compared among different AL groups. Results: Among 138 angle-closure patients, 15 (10.9%) patients had longer ALs, of which 11 (73.3%) were male. These angle-closure eyes with longer AL had flatter cornea (P = 0.006 and 0.022 for flat and steep keratometry) and larger ACW (P = 0.006), but smaller RLP (P = 0.019) than those with medium AL; similarly, they had flatter cornea (P < 0.001 for both flat and steep keratometry), and larger ACW (P < 0.001), AV (P = 0.004), and TCA (P = 0.024), but smaller relative AV (P = 0.040) and RLP (P = 0.005) than those with shorter AL. No significant differences were found in the other parameters. Conclusions: Primary angle closure with longer AL was uncommon. Causes of angle closure in these atypical patients were manifold. These patients were predominantly male; they had smaller relative dimension of the anterior segment, flatter cornea, and more anterior RLP and less anteriorly rotated ciliary body compared with those angle-closure patients with relatively shorter AL.

23 Article White Matter Abnormalities and Correlation With Severity in Normal Tension Glaucoma: A Whole Brain Atlas-Based Diffusion Tensor Study. 2018

Wang, Rong / Tang, Zuohua / Sun, Xinghuai / Wu, Lingjie / Wang, Jie / Zhong, Yufeng / Xiao, Zebin. ·Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China. · Department of Ophthalmology & Visual Science, Eye & ENT Hospital of Shanghai Medical School, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Key Laboratory of Myopia, NHFPC (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China. · Department of Otolaryngology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China. · Department of Radiology, Jinshan Hospital of Shanghai Medical School, Fudan University, Shanghai, China. ·Invest Ophthalmol Vis Sci · Pubmed #29625454.

ABSTRACT: Purpose: To detect injury of whole brain white matter (WM) in normal tension glaucoma (NTG) patients by using diffusion tensor imaging (DTI) and to analyze the correlations between DTI parameters and glaucoma indices. Methods: Twenty mild, 17 moderate, and 18 severe NTG patients as well as 25 normal subjects were enrolled in this study. Atlas-based diffusion tensor analysis was performed to measure the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). One-way analyses of variance were used for comparisons of DTI parameters between NTG subgroups and normal control (NC) group. The relationships between DTI parameters and glaucoma indices were also assessed by Pearson's correlation and "broken-stick" analyses. Results: As compared with NC subjects, significantly decreased FA and AD and increased MD and RD were observed in the bilateral posterior thalamic radiation, bilateral sagittal stratum, bilateral cingulum-hippocampus, and bilateral fornix/stria terminalis in NTG patients. The DTI parameters of these WM regions correlated with the mean deviation of visual field (MDVF) and retinal nerve fiber layer (RNFL) thickness. Additionally, there was a tipping point between MDVF and DTI parameters as well as between MDVF and RNFL thickness. Conclusions: Atlas-based DTI analysis was capable of indicating WM damage in the four regions associated with visual and visual-related functions in NTG patients, and it could also be used for investigating disease progression and pathologic changes. In addition, WM impairment and RNFL thinning occurred before patients showed detectable visual field loss.

24 Article Comparative analysis of retinal ganglion cell damage in three glaucomatous rat models. 2018

Huang, Wanjing / Hu, Fangyuan / Wang, Min / Gao, Fengjuan / Xu, Ping / Xing, Chao / Sun, Xinghuai / Zhang, Shenghai / Wu, Jihong. ·From the Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan University, Shanghai, China. · From the Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China; Key Laboratory of Myopia, Ministry of Health, Shanghai, China. · From the Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China; Key Laboratory of Myopia, Ministry of Health, Shanghai, China. Electronic address: zsheent_fdu@163.com. · From the Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality, Shanghai, China; Key Laboratory of Myopia, Ministry of Health, Shanghai, China. Electronic address: jihongwu@fudan.edu.cn. ·Exp Eye Res · Pubmed #29605491.

ABSTRACT: Progressive retinal ganglion cell (RGC) death is the major cause of retinal nerve fiber layer thinning and visual field defects in glaucoma. The purpose of this study was to compare RGC damage in three commonly used glaucomatous rat models. These models were generated by (i) injection of paramagnetic microbeads into the anterior chamber; (ii) cauterization of three episcleral veins of the eye (EVC); and (iii) intravitreal injection of N-Methyl-D-Aspartate (NMDA). Intraocular pressure (IOP) was measured with a rebound tonometer at 6, 12, and 18 h; 1, 3, and 5 days; and 1, 2, 3, 4, 6, and 8 weeks. We measured the RGC density of the three glaucomatous models in the flat-mounted retina by immunofluorescence. Subsequently, the thicknesses of both retinal ganglion cell layer (GCL) and inner retinal layer (IRL) were analyzed by hematoxylin and eosin staining of retinal sections. The visual functional deterioration was evaluated by measurement of the photopic negative response (PhNR) of different models. The IOP averages during three weeks were 22.35 ± 1.23 mmHg (mean ± SD), 20.91 ± 1.97 mmHg, and 9.67 ± 0.42 mmHg, with 50.2%, 44.00% and 66.76% RGC loss by 8 weeks, respectively, in the microbead group, EVC group and NMDA group. Decreased thickness in the GCL was observed in all three groups, while the thickness of IRL and ONL was decreased in the EVC and NMDA groups. Significant positive correlation of RGC loss rate with ΔIOP integral were demonstrated in both microbead and EVC models. Moreover, we found that the PhNR amplitudes declined early by the first day in the NMDA group, 5 days later in the EVC group and by 7 days in the microbead group. Each glaucomatous rat model has its strength and weakness. Our study provides detailed data for choosing suitable animal models to advance glaucoma research.

25 Article Comparison of retinal microvascular changes in eyes with high-tension glaucoma or normal-tension glaucoma: a quantitative optic coherence tomography angiographic study. 2018

Xu, Huan / Zhai, Ruyi / Zong, Yuan / Kong, Xiangmei / Jiang, Chunhui / Sun, Xinghuai / He, Yi / Li, Xiqi. ·Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Rd., Shanghai, 200031, People's Republic of China. · Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China. · Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China. · Department of Ophthalmology and Visual Science, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Rd., Shanghai, 200031, People's Republic of China. kongxm95@163.com. · Key Laboratory of Myopia, Ministry of Health (Fudan University), Shanghai, China. kongxm95@163.com. · Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China. kongxm95@163.com. · State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China. · The Key Laboratory on Adaptive Optics, Chinese Academy of Sciences, Chengdu, 610209, China. · The Laboratory on Adaptive Optics, Institute of Optics and Electronics, Chinese Academy of Sciences, Chengdu, 610209, China. ·Graefes Arch Clin Exp Ophthalmol · Pubmed #29450622.

ABSTRACT: PURPOSE: The aim of this study is to determine and compare the changes in the retinal vasculature in eyes with high-tension glaucoma (HTG) or normal-tension glaucoma (NTG). METHODS: The right eyes of 43 HTG subjects, 33 NTG subjects, and 51 age- and sex-matched normal subjects were included in this cross-sectional study. Signals were projected from the internal limiting membrane to retinal pigment epithelium. The retinal perfused vessel densities in the peripapillary and parafoveal regions were measured automatically with optic coherence tomography angiography and the split-spectrum amplitude-decorrelation angiography algorithm. RESULTS: Compared with normal eyes, glaucomatous eyes had a smaller retinal nerve fibre layer (RNFL) thickness, smaller full parafoveal retinal thickness, and lower retinal perfused vessel density (PVD) in the peripapillary and parafoveal regions (all P < 0.01). The visual field, RNFL and retinal thicknesses, and PVD in the parafoveal region in the HTG eyes were similar to those in the NTG eyes. However, the NTG eyes had a significantly lower mean PVD than the HTG eyes in the peripapillary region. When the different sectors of the peripapillary region were studied, the difference was still significant in most sectors (all P < 0.05), except the inferotemporal sector (P = 0.676). CONCLUSIONS: The retinal perfused vessel density is significantly reduced in HTG and NTG eyes, and more prominently in the peripapillary region in NTG eyes.

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