Sousa David C, Ferreira Nuno P, Marques-Neves Carlos, Somers Alix, Vandewalle Evelien, Stalmans Ingeborg, Pinto Luís Abegão
Department of Ophthalmology, Hospital de Santa Maria, Lisboa, PT, Portugal.
Vision Sciences Study Center, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
J Curr Glaucoma Pract. 2018 Sep-Dec;12(3):102-106. doi: 10.5005/jp-journals-10028-1253.
High-intensity focused ultrasound cystoplasty (UCP) aims to noninvasively and selectively target the ciliary body, thus lowering intraocular pressure (IOP). To be used on a large scale, the safety of the UCP procedure should be studied. Therefore, its effect on pupil behavior is important to better inform patients and to help physicians predict possible treatment side effects. This study aimed to evaluate to what extent UCP procedure (EyeOP-1®) affects pupil dynamics.
Consecutive glaucoma patients with uncontrolled IOP despite optimal medication scheduled for UCP treatment were recruited and followed for 6 months. Pupillometry (PlusoptiX S0) was performed at baseline, and 1, 3 and 6 months after UCP procedure at scotopic and mesopic conditions. The difference between pupil diameter (PD) in both lighting conditions was calculated at the three follow-up visits. Demographic, clinical characteristics and specific ocular parameters (anterior chamber depth and volume, white-to-white measurement, axial length, phakic status) were registered. Statistical analysis was performed using STATA 14.1.
Sixteen eyes of 16 patients with a mean age of 69 ± 11 years were included. Mean preoperative IOP and number of medications were 23.6 ± 3.0 mm Hg and 2.4 ± 1.3, respectively. Mean baseline scotopic and mesopic PD were 4.8 ± 0.8 mm and 4.4 ± 0.9 mm, respectively (difference = 0.38 ± 0.30 mm; range 0.1 to 1.2 mm). At month-1, the pupil diameter (PD) change between scotopic (4.6 ± 0.7 mm) and mesopic (4.5 ± 0.8 mm) conditions decreased to 0.03 ± 0.34 mm, = 0.01. On the longer follow-up periods, however, the amplitude difference in PD compared to baseline was no longer significant (month-3: 0.28 ± 0.49 mm; month 6: 0.23 ± 0.41 mm; >0.05). At the end of follow-up, mean scotopic and mesopic PD were 4.7 ± 1.0 mm and 4.4 ± 0.9 mm, respectively.
In the early postoperative period after UCP treatment, most patients present with a less light-reactive pupil, which seems to normalize with time.
Sousa DC, Ferreira NP, Marques-Neves C, Somers A, Vandewalle E, Stalmans I, Pinto LA. High-intensity Focused Ultrasound Cycloplasty: Analysis of Pupil Dynamics. J Curr Glaucoma Pract 2018;12(3):102-106.
高强度聚焦超声睫状体成形术（UCP）旨在非侵入性且选择性地靶向睫状体，从而降低眼压（IOP）。为了大规模应用，应研究UCP手术的安全性。因此，其对瞳孔行为的影响对于更好地告知患者以及帮助医生预测可能的治疗副作用很重要。本研究旨在评估UCP手术（EyeOP-1®）对瞳孔动态的影响程度。
招募连续的青光眼患者，尽管使用了最佳药物治疗，但眼压仍未得到控制，计划进行UCP治疗，并随访6个月。在基线时以及UCP手术后1、3和6个月，在暗视和中视条件下进行瞳孔测量（PlusoptiX S0）。在三次随访时计算两种光照条件下瞳孔直径（PD）的差异。记录人口统计学、临床特征和特定眼部参数（前房深度和容积、白对白测量、眼轴长度、晶状体状态）。使用STATA 14.1进行统计分析。
纳入16例患者的16只眼，平均年龄为69±11岁。术前平均眼压和药物数量分别为23.6±3.0 mmHg和2.4±1.3。平均基线暗视和中视PD分别为4.8±0.8 mm和4.4±0.9 mm（差异=0.38±0.30 mm；范围0.1至1.2 mm）。在第1个月时，暗视（4.6±0.7 mm）和中视（4.5±0.8 mm）条件下的瞳孔直径（PD）变化降至0.03±0.34 mm，P=0.01。然而，在更长的随访期内，与基线相比PD的幅度差异不再显著（第3个月：0.28±0.49 mm；第6个月：0.23±0.41 mm；P>0.05）。随访结束时，平均暗视和中视PD分别为4.7±1.0 mm和4.4±0.9 mm。
在UCP治疗后的术后早期，大多数患者出现瞳孔对光反应减弱，这似乎会随时间恢复正常。
Sousa DC, Ferreira NP, Marques-Neves C, Somers A, Vandewalle E, Stalmans I, Pinto LA.高强度聚焦超声睫状体成形术：瞳孔动态分析。J Curr Glaucoma Pract 2018;12(3):102-106。
