Two-Year Clinical Results After Selective Laser Trabeculoplasty for Normal Tension Glaucoma

Open Access JournalThis article aims to investigate the clinical results at 2 years after selective laser trabeculoplasty (SLT) for normal tension glaucoma (NTG). This prospective cohort study recruited NTG patients taking antiglaucoma medication. Subjects were excluded if they had previous glaucoma surgery/laser or corneal pathologies. All subjects underwent a 1-month washout. A single session of SLT was performed to 360° of the trabecular meshwork. Medication was resumed at 1 month to achieve a targeted 30% intraocular pressure (IOP) reduction from the post-washout/pre-SLT IOP. IOP was measured every 3 months and medication use was recorded at 3, 6, 12, and 24 months. Subjects with a secondary SLT or cataract extraction were excluded from IOP and medication analyses. At 24 months, 34 of the initial 45 right eyes were eligible for analyses. There were significant IOP reductions at all time intervals (except at 1 week) following SLT when compared to the prestudy (without medication) or pre-SLT (post-washout) IOP (P 20% from pre-SLT, without medication) was achieved in 11.1% (5/45). Reductions in IOP and medication use were evident at 2 years following SLT for the treatment of NTG whereas 11% remained medication free. Trial Registrations: The Clinical Trials Register of the University of Hong Kong HKCTR1847. The European Clinical Trials Database 2014-003305-15 (August 11, 2014).published_or_final_versio

The Association Between Clinical Parameters And Glaucoma-specific Quality Of Life In Chinese Primary Open-angle Glaucoma Patients

Objective: To investigate the association between clinical measurements and glaucoma-specific quality of life in Chinese glaucoma patients. Design: Cross-sectional study. Setting: An academic hospital in Hong Kong. Patients: A Chinese translation of the Glaucoma Quality of Life–15 questionnaire was completed by 51 consecutive patients with bilateral primary open-angle glaucoma. The binocular means of several clinical measurements were correlated with Glaucoma Quality of Life–15 findings using Pearson’s correlation coefficient and linear regression. The measurements were the visual field index and pattern standard deviation from the Humphrey Field Analyzer, Snellen best-corrected visual acuity, presenting intra-ocular pressure, current intra-ocular pressure, average retinal nerve fibre layer thickness via optical coherence tomography, and the number of topical anti-glaucoma medications being used. Results: In these patients, there was a significant correlation and linear relationship between a poorer Glaucoma Quality of Life–15 score and a lower visual field index (r=0.3, r2=0.1, P=0.01) and visual acuity (r=0.3, r2=0.1, P=0.03). A thinner retinal nerve fibre layer also correlated with a poorer Glaucoma Quality of Life–15 score, but did not attain statistical significance (r=0.3, P=0.07). There were no statistically significant correlations for the other clinical parameters with the Glaucoma Quality of Life–15 scores (all P values being >0.7). The three most problematic activities affecting quality of life were “adjusting to bright lights”, “going from a light to a dark room or vice versa”, and “seeing at night”. Conclusion: For Chinese primary open-angle glaucoma patients, binocular visual field index and visual acuity correlated linearly with glaucoma- specific quality of life, and activities involving dark adaptation were the most problematic.published_or_final_versio

A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results

BACKGROUND: The objective of this study was to investigate the effects of adjuvant selective laser trabeculoplasty (SLT) versus medication alone on intraocular pressure (IOP) control, medication use, and quality of life in patients with primary open-angle glaucoma. METHODS: This prospective, randomized control study recruited 41 consecutive primary open-angle glaucoma subjects with medically-controlled IOP /=0.4) or between the two treatment groups (P>/=0.2). CONCLUSION: A single session of adjuvant SLT provided further reductions in IOP and medication without substantial changes in quality of life or medication tolerability at 6 months.published_or_final_versio

Implementing Effective Group Work for Mathematical Achievement in Primary School Classrooms in Hong Kong

The Hong Kong Education Bureau recommends that primary school pupils’ mathematical achievement be enhanced via collaborative discussions engendered by group work. This pedagogic change may be hindered by Confucian heritage classroom practices and Western-dominated group work approaches that predominate in Hong Kong. To overcome these obstacles, we introduced a relational approach to group work in a quasi-experimental study. Our sample included 20 teachers randomly allocated to experimental (12) and control (8) conditions and their 504 mathematics pupils (aged 9–10). The relational approach focused on the development of peer relationships in a culturally appropriate manner and was implemented over 7 months. Pupils were pre-/post-tested for mathematical achievement and systematically observed, and the teachers were assessed for subject knowledge and pre-/post-tested for pedagogic efficacy. Analysis of covariance (ANCOVA) and hierarchical linear modeling (HLM) results show enhanced mathematical achievement, supported by improved peer-based communication skills and time-on-task for the experimental pupils. Experimental teachers raised their pedagogic efficacy. Results indicate the potential of the relational approach for boosting academic achievement via enhanced child-peer-teacher interaction and the need to reassess the role of peer-based latent collectivist learning in Confucian heritage classrooms.postprin

The Correlation of Retinal Nerve Fiber Layer Thickness With Blood Pressure in a Chinese Hypertensive Population

To investigate the association between retinal nerve fiber layer (RNFL) thickness and blood pressure (BP) in subjects with systemic hypertension. Subjects with systemic hypertension on anti-hypertensive medications were screened by fundus photography and referred for glaucoma work-up if there was enlarged vertical cup-to-disc (VCDR) ratio ≥0.6, VCDR asymmetry ≥0.2, or optic disc hemorrhage. Workup included a complete ophthalmological examination, Humphrey visual field test, and RNFL thickness measurement by optical coherence tomography. The intraocular pressure (IOP) and RNFL thicknesses (global and quadrant) were averaged from both eyes and the means were correlated with: the systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) using Pearson correlation. Among 4000 screened hypertensive subjects, 133 were referred for glaucoma workup and 110 completed the workup. Of the 4000 screened subjects, 1.3% had glaucoma (0.9% had normal tension glaucoma [NTG], 0.2% had primary open angle glaucoma, and 0.2% had primary angle closure glaucoma), whereas 0.3% were NTG suspects. The SBP was negatively correlated with the mean superior RNFL thickness (P=0.01). The DBP was negatively correlated with the mean global (P=0.03), superior (P=0.02), and nasal (P=0.003) RNFL thickness. The MAP was negatively correlated with the mean global (P=0.01), superior (P=0.002), and nasal (P=0.004) RNFL thickness while positively correlated with the mean IOP (P=0.02). In medically treated hypertensive subjects, glaucoma was present in 1.3%, with NTG being most prevalent. MAP control may help with IOP lowering and RNFL preservation, although future prospective studies will be needed. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.published_or_final_versio

Predictors of success in selective laser trabeculoplasty for primary open angle glaucoma in Chinese

2014-2015 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Prevalence of occult hepatitis B infection in a highly endemic area for chronic hepatitis B: A study of a large blood donor population

Background and aims: The aim of the present study was to determine the population prevalence of occult hepatitis B (OHB) infection and its clinical profile in a highly endemic area of chronic hepatitis B virus disease. Methods: OHB was first identified by individual sample testing for hepatitis B surface antigen (HBsAg) followed by nucleic acid testing (NAT) and vice versa for 3044 (cohort 1, stored sera from donation within 1 year) and 9990 (cohort 2, prospective study) blood donors, respectively. OHB was confirmed meticulously by ≥2 out of 3 tests with detectable hepatitis B virus (HBV) DNA using a sensitive standardised assay. Detailed serology and viral load in the serum and liver were studied. Results: The prevalence of OHB was 0.13% (4/3044) and 0.11% (11/9967) for cohort 1 and 2, respectively. In cohort 2, 10 out of 11 OHB samples were positive for anti-HBc (hepatitis B core antigen) antibody (all were immunoglobulin G). Seven had detectable anti-HBs. The serum HBV DNA levels were extremely low (highest 14.1 IU/ml). Of the six donors who underwent liver biopsies, all had normal liver biochemistry, extremely low liver HBV DNA (highest 6.21 copies/cell) and nearly normal liver histology. For those with viral sequence generation, none had the common HBsAg mutant G145R. Conclusions: The prevalence of OHB in a highly endemic area of chronic HBV was very low, thus implying a low impact on transfusion services. To implement universal screening, the high cost of NAT should be taken into account. OHB blood donors had very low HBV replication, and normal liver biochemistry and histology, conferring a favourable prognosis.published_or_final_versio

Improving population-level refractive error monitoring via mixture distributions

Introduction: Sampling and describing the distribution of refractive error in populations is critical to understanding eye care needs, refractive differences between groups and factors affecting refractive development. We investigated the ability of mixture models to describe refractive error distributions. Methods: We used key informants to identify raw refractive error datasets and a systematic search strategy to identify published binned datasets of community-representative refractive error. Mixture models combine various component distributions via weighting to describe an observed distribution. We modelled raw refractive error data with a single-Gaussian (normal) distribution, mixtures of two to six Gaussian distributions and an additive model of an exponential and Gaussian (ex-Gaussian) distribution. We tested the relative fitting accuracy of each method via Bayesian Information Criterion (BIC) and then compared the ability of selected models to predict the observed prevalence of refractive error across a range of cut-points for both the raw and binned refractive data. Results: We obtained large raw refractive error datasets from the United States and Korea. The ability of our models to fit the data improved significantly from a single-Gaussian to a two-Gaussian-component additive model and then remained stable with ≥3-Gaussian-component mixture models. Means and standard deviations for BIC relative to 1 for the single-Gaussian model, where lower is better, were 0.89 ± 0.05, 0.88 ± 0.06, 0.89 ± 0.06, 0.89 ± 0.06 and 0.90 ± 0.06 for two-, three-, four-, five- and six-Gaussian-component models, respectively, tested across US and Korean raw data grouped by age decade. Means and standard deviations for the difference between observed and model-based estimates of refractive error prevalence across a range of cut-points for the raw data were −3.0% ± 6.3, 0.5% ± 1.9, 0.6% ± 1.5 and −1.8% ± 4.0 for one-, two- and three-Gaussian-component and ex-Gaussian models, respectively. Conclusions: Mixture models appear able to describe the population distribution of refractive error accurately, offering significant advantages over commonly quoted simple summary statistics such as mean, standard deviation and prevalence

Reduction of covalently closed circular DNA with long-term nucleos(t)ide analogue treatment in chronic hepatitis B

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Assessing Transboundary-Local Aerosols Interaction Over Complex Terrain Using a Doppler LiDAR Network

This is the final version. Available from Wiley via the DOI in this recordData Availability Statement: Surface metrological data sets in Hong Kong are available at Hong Kong Observatory’s website: https://www.hko.gov.hk/en/cis/climat.htm. PM2.5 concentrations data sets can be obtained from Hong Kong Environmental Protection Department: https://www.aqhi.gov.hk/en.html. Processed 3DREAMS LiDAR data set and HKIA LiDAR data sets can be obtained in the repository: https://figshare.com/s/78e928f29c57ff86b5eeTransboundary-local aerosols interaction requires to be comprehensively understood in urban air quality research. A year-long intensive observation of the atmospheric boundary layer (ABL) at multiple sites in Hong Kong was conducted using a four-Doppler Light Detection and Ranging (LiDAR) network with different scanning modes. Results show that heterogeneity of the ABL in terms of mixing layer height and wind shear was induced by orographic topography. Interaction between local and advected aerosol layers during a transboundary air pollution (TAP) episode was identified by the network. During TAP episode, downward transport of transboundary aerosol relied on small scale eddies with weak wind speed in nighttime, while the transport of surface local aerosol to upper level was the dominated process in daytime, but the heterogeneity of the ABL affected by terrain determined the capacity of the mixing, eventually resulting in the opposite transport direction of aerosols in the transboundary-local aerosols interaction.Dr. Stanley Ho Medicine Development FoundationVice-Chancellor’s Discretionary Fund of The Chinese University of Hong Kon