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Biomedical subjects

Gus Gazzard

Publications and source records attributed to Gus Gazzard.

At least 19 recordsLinked to original sources
PubMed2006

Correlations in refractive errors between siblings in the Singapore Cohort Study of Risk factors for Myopia.

BACKGROUND: The prevalence of myopia in parts of South East Asia has risen dramatically over the past 1-2 generations, suggesting that environmental factors may be particularly important determinants of refractive development in these populations. AIM: To assess the contribution of familial factors (shared genes and/or shared family environment) to refractive error and ocular component dimensions of school-aged children in Singapore. METHODS: Data were available for 315 children who had one or more siblings also participating in the Singapore Cohort Study of the Risk factors for Myopia (SCORM). Refractive error and ocular biometric parameters were measured under cycloplegia at baseline when children were 7-9 years, and at yearly follow-up sessions for the next 3 years, using consistent clinical procedures. The time children spent performing a variety of nearwork-related tasks was obtained from questionnaires. Familial influences were assessed by calculating between-sibling correlations. RESULTS: After adjusting for age and sex, the between-sibling correlation in refractive error was 0.447 (95% CI 0.314 to 0.564), suggesting that familial factors account for 63-100% of the variation in the cohort. The between-sibling correlation for 1-year change in refractive error was similarly high, at 0.420 (95% CI 0.282 to 0.543). All ocular component dimensions were correlated significantly between siblings, especially for corneal curvature and vitreous chamber depth--the major structural determinants of refraction. The amount of time siblings spent engaged in nearwork tasks (reading, watching TV, playing video games, computing) and in outdoor activities was also highly correlated between siblings (p<0.001). CONCLUSION: Shared genes and/or shared environment are important factors in the refractive development of children in Singapore. Because the time spent in nearwork tasks is highly correlated between siblings, epidemiological studies will benefit from precise, quantitative measures of refractive error in parents and more distant relatives in order to begin to dissociate genetic and environmental sources of variation.

Biometry↗
PubMed2006

Effect of trabeculectomy on lens opacities in an East Asian population.

OBJECTIVE: To examine the progression of lens opacity in Asian people after trabeculectomy and determine associated risk factors. METHODS: This was an observational case series of 243 people aged 36 to 82 years. Trabeculectomy was performed on 1 eye of each subject. Lens opacity was measured yearly using the Lens Opacification Classification System III. The main outcome measure was worsening of lens opacity defined as an increase of 2 or more Lens Opacification Classification System III units in any of the 3 lens regions, nuclear, cortical, and posterior subcapsular. Risk of progression was evaluated using logistic regression models. RESULTS: Data for 177 people were analyzed. One hundred seventeen (66%) of 177 subjects showed progression in opacity in any lens region at 3 years. Seventy-seven (66%) of 117 of those who progressed did so during the first year. Of these, 63 (82%) of 77 had lens opacity in the posterior subcapsular region. Factors associated with progression of posterior-subcapsular lens opacity at 1 year were diabetes (odds ratio, 2.4; 95% confidence interval, 1.0-5.4), use of antiglaucoma medication, dosage of topical steroid postoperatively, and being operated on by a trainee surgeon (odds ratio, 2.3; 95% confidence interval, 1.0-5.2). CONCLUSIONS: Trabeculectomy is associated with progression of lens opacity predominantly in the posterior subcapsular region. Modification of risk factors such as postoperative steroid use may delay progression.

Adult↗
PubMed2006

Changes in the optic disc after acute primary angle closure.

PURPOSE: To evaluate the changes in optic disc morphology in the first 4 months after an episode of acute primary angle closure (APAC) using stereoscopic optic disc photography and computer-assisted planimetry. DESIGN: Prospective observational case series. PARTICIPANTS: Forty-seven Asian subjects with unilateral APAC who were successfully treated with laser peripheral iridotomy (LPI). MAIN OUTCOME MEASURES: Cup-to-disc ratio (CDR) and optic cup and neuroretinal rim areas. METHODS: Stereoscopic optic disc photographs were taken 2 and 16 weeks after LPI, and the images were analyzed by computer-assisted planimetry. The overall, quadrantic, and 30 degrees sector areas of the optic disc, CDR, and neuroretinal rim area were analyzed by 2 independent masked graders, and the mean of the readings was used to calculate changes in optic disc parameters. RESULTS: The majority of the subjects were female (66%) and Chinese (90%), and the mean age was 67.6+/-11.2 years (range, 40-94). In APAC eyes from week 2 to week 16, the mean CDR increased from 0.56+/-0.05 to 0.59+/-0.03 (P<0.001), and the mean neuroretinal rim area decreased from 1.74+/-0.31 mm2 to 1.59+/-0.27 mm2 (P<0.001). Quadrantic and sector analysis showed preferential loss of neuroretinal rim area at the superotemporal and inferotemporal areas. There was no significant change in optic disc parameters in the fellow eyes over the study period. CONCLUSIONS: This study demonstrated changes in optic disc morphology from week 2 to week 16 after an episode of APAC. The pattern of optic nerve damage demonstrated in our study was comparable with that seen in primary open-angle glaucoma and experimental glaucoma models.

Acute Disease↗
PubMed2006

Long-term outcomes in fellow eyes after acute primary angle closure in the contralateral eye.

PURPOSE: To determine the long-term outcome of the contralateral eye in Asian persons with a unilateral attack of acute primary angle closure (APAC). DESIGN: Cross-sectional observational case series. PARTICIPANTS: Seventy-nine individuals who were examined from 4 to 10 years after a unilateral episode of APAC at 2 Singapore hospitals. METHODS: All subjects underwent a complete eye examination. The optic discs were graded clinically and photographically for the presence of glaucomatous optic neuropathy, and automated visual field tests were assessed for damage. All visual fields and optic nerve photographs (when available) underwent a second evaluation by a masked glaucoma specialist, who assessed whether the changes were compatible with glaucoma. MAIN OUTCOME MEASURES: Glaucomatous optic neuropathy, intraocular pressure (IOP), and visual impairment (defined as best-corrected visual acuity of worse than 6/12). RESULTS: Ninety of 138 eligible patients (65.2%) with APAC were examined, 79 with unilateral attacks. Subjects were predominantly Chinese (n = 68; 86%). There were 54 females (68%), and mean age was 68.5+/-8.9 years (standard deviation) at the time of APAC, with a mean duration of 6.3+/-1.5 years from the time of the APAC episode to the study examination. The contralateral eyes of 7 patients (8.9%) had definite or probable glaucoma, 2 of whom were felt to have glaucoma in that eye at the time of the attack. Three eyes had markedly cupped optic discs (cup-to-disc ratio > or = 0.9). Thirteen eyes (16.9%) had best-corrected vision worse than 6/12, due to cataract in almost half the cases. Only 1 eye had vision < 6/60, the cause of which was corneal decompensation. One other patient had only a central island remaining with vision of 6/12. Mean IOP of the study participants was 15.7+/-4.7 mmHg, with 6 subjects (7.6%) having undergone trabeculectomy. CONCLUSIONS: Definite or probable glaucoma was present at the time of diagnosis in 2 (2.5%) fellow eyes and developed in an additional 5 (6.5%) with a mean follow-up of 6 years. More than 80% of this cohort retained good vision in the contralateral eye, in contrast to the eye that underwent APAC. Unoperated cataract accounted for most of the visual impairment in this group.

Acute Disease↗
PubMed2006

Lens opacity, thickness, and position in subjects with acute primary angle closure.

PURPOSE: To compare lens thickness (LT), lens position (LP), relative lens position (RLP), and degree and type of lens opacity between affected and fellow eyes of subjects with acute primary angle closure (APAC) to identify any differences in lens characteristics that may be contributory to the acute episode. In addition, axial length (AL) and anterior chamber depth (ACD) measurements were evaluated. METHODS: Seventy-three study subjects with unilateral APAC were treated with sequential laser iridotomy (LI) in both eyes. Two weeks after LI, ACD, LT, and AL measurements were made in both eyes using ultrasound pachymetry. LP was defined as ACD+1/2LT and RLP as LP/AL. The Lens Opacity Classification III (LOCS III) System was used for grading lens opacity. RESULTS: The subjects were 90% Chinese and 63% female. Mean age was 61.0+/-10.9 years. Significant differences between the affected and fellow eyes were found in the ACD (2.11+/-0.35 vs 2.18+/-0.23; P=0.02) and LP (4.61+/-0.47 vs 4.75+/-0.29; P=0.02). Cortical opacity was greater in fellow eyes (0.32+/-0.72 vs 0.53+/-0.95; P=0.02). There was no difference in LT, RLP, or degree of lens opacity in the nuclear and posterior subcapsular regions. CONCLUSIONS: Compared with fellow eyes, APAC-affected eyes have shallower ACD, more anterior LP, and less cortical opacity. These differences may be contributory to APAC.

Acute Disease↗
PubMed2006

An evidence-based analysis of surgical interventions for uncomplicated rhegmatogenous retinal detachment.

PURPOSE: To evaluate the various surgical interventions available for uncomplicated rhegmatogenous retinal detachment. METHODS: Reports of controlled clinical trials of surgical interventions (pneumatic retinopexy, scleral buckling and vitrectomy) for uncomplicated rhegmatogenous retinal detachment indexed in MEDLINE from 1968 to January 2006 were included. The primary outcomes evaluated included single-operation reattachment rates, multiple reoperation reattachment rates and improvements in visual acuity (VA). RESULTS: We found five controlled trials (two randomized) comparing the efficacy of pneumatic retinopexy versus scleral buckling. The single-operation reattachment rates were higher for scleral buckling, but the final reattachment rates were similar. We found nine controlled trials (four randomized) evaluating vitrectomy. There were no statistically significant differences between retinal reattachment rates or final visual acuities, except in one randomized and one non-randomized controlled trial in which the VAs were significantly better in the vitrectomy than the scleral buckling group. CONCLUSIONS: Pneumatic retinopexy is a possible alternative to scleral buckling in the treatment of uncomplicated rhegmatogenous retinal detachment. The rates of missed or new retinal breaks after pneumatic retinopexy, however, are higher than following scleral buckling. The clinical outcomes of vitrectomy for rhegmatogenous retinal detachment compare favourably.

Cryotherapy↗
PubMed2006

Longitudinal study of anisometropia in Singaporean school children.

PURPOSE: The purpose of this study was to document the incidence rates of anisometropia, year-by-year prevalences, changes in the intereye difference in spherical equivalent (SE), and its association with myopia progression and axial length changes in a cohort of Singaporean school children. METHODS: This is a prospective cohort study of Singaporean school children (n = 1979) aged 7 to 9 years who were examined annually with cycloplegic refraction and ultrasonography over a 3-year period. RESULTS: In the 1908 children without anisometropia at commencement, the 3-year cumulative incidence rate of anisometropia (difference in SE at least 1.0 D) was 144 (7.55%; 95% CI: 6.42-8.85). The mean intereye difference in SE in all children at baseline was 0.29 +/- 0.46 D (SD: 0.46) and increased to 0.44 D (0.59) on the last examination. On the initial examination, 3.6% (95% CI: 2.8-4.4) or 71 children had anisometropia. Of the 59 of 71 children who completed all examinations, only 3 (5.1%) had an increase in the intereye difference in SE by at least 0.5 D, whereas 2 (3.4%) had a decrease of at least 0.5D. The mean intereye difference in SE was stable between visits. The change in intereye difference in SE correlated with the change in intereye axial length (r = 0.43). Compared with the isometropic children, each eye of the anisometropic children had a higher rate of progression of myopia. CONCLUSIONS: The 3-year incidence of anisometropia was 7.55% in these young Singaporean children. Although the frequency of anisometropia increased with time, the difference in SE between eyes tended to remain stable.

Anisometropia↗
PubMed2006

Myopia, axial length, and OCT characteristics of the macula in Singaporean children.

PURPOSE: The purpose of this study was to evaluate the associations between macular volume and thickness, as assessed by optic coherence tomography (OCT), with refraction and axial length (AL) in children. METHODS: A total of 104 Chinese school children (51 girls and 53 boys) 11 to 12 years of age were randomly selected from one school during the 2005 examination in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Cycloplegic autorefraction was performed to obtain refraction (defined as spherical equivalent [SE]) and ultrasound biometry performed to obtain the AL. Macular volume and thickness were then measured (StratusOCT3; Carl Zeiss Meditec, Dublin, CA). RESULTS: Children with moderate myopia (SE at least -3.0 D) tended to have smaller total macular volume and thinner quadrant-specific macular thickness (except in the inferior and superior inner quadrants), followed by children with low myopia (-0.5 -0.5 D). Total macular volume was positively associated with SE (beta=1.58, 95% CI, 0.84 to 2.32, standardized beta=0.14, P<0.001) and negatively associated with AL (beta=-1.20, 95% CI, -1.62 to -0.79, standardized beta=0.45, P<0.001) in multiple linear regression models controlling for age and gender. CONCLUSIONS: In children, increasing axial myopia was associated with reduced macular volume and thickness. These findings suggest that early anatomic changes may be present in the retinas of children with axial myopia.

Anthropometry↗
PubMed2005

Use of surodex in phacotrabeculectomy surgery.

PURPOSE: To evaluate the use of Surodex (Oculex Pharmaceuticals, Sunnyvale, California) a drug delivery system incorporating 60 micrograms of dexamethasone in a pellet, in phacotrabeculectomy surgery. DESIGN: Nonrandomized, prospective, interventional case series. METHODS: Phacotrabeculectomy was performed on 37 Asian subjects with primary open-angle glaucoma (POAG) using a standardized technique. All subjects received a Surodex pellet underneath the scleral flap. Results were compared with those of 31 POAG subjects who had undergone phacotrabeculectomy augmented with 50 mg/ml of intraoperative 5-fluorouracil (5-FU) during the same period. RESULTS: Mean follow-up in months was 19.7 +/- 7.9 and 22.1 +/- 6.2 for the Surodex and 5-FU groups, respectively (P = .29). There was a 20.1% decrease in intraocular pressure in the Surodex group compared with 28.5% decrease in the 5-FU group (P = .6). Postoperative complications occurred in three cases (8.1%) and six cases (19.3%), respectively (P = .04). CONCLUSIONS: Combined phacotrabeculectomy surgery augmented by intra-scleral placement of Surodex results in good control of IOP and a low incidence of complications.

Anterior Eye Segment↗
PubMed2005

Utility assessment among cataract surgery patients.

PURPOSE: To evaluate the utility values (time trade-off, standard gamble for death, standard gamble for blindness) of patients scheduled for cataract surgery. SETTING: Tertiary eye hospital in Singapore. METHODS: Questions on time trade-off, standard gamble for death, standard gamble for blindness utilities, and visual function from an adapted version of the VF-14 were asked in a clinic interview of 217 Chinese patients. RESULTS: The mean utility time trade-off of cataract surgery patients was 0.77 (95% confidence interval [CI] 0.76, 0.78), mean standard gamble for death was 0.77 (95% CI 0.77, 0.78), and mean standard gamble for blindness was 0.76 (95% CI 0.75, 0.77). Adults with lower VF-14 scores had lower utilities, although there was no relationship between visual acuity and utilities. Utilities were also lower in patients who reported difficulty seeing in bright light. CONCLUSIONS: The utilities of cataract patients scheduled for surgery were comparable to those in patients with other chronic ocular diseases. Cataract surgery patients with lower utilities tended to have worse visual function and greater difficulty seeing in bright light.

Adult↗
PubMed2005

Prevalence of cataract in rural Indonesia.

PURPOSE: To describe the prevalence of cataract in adults in rural Sumatra, Indonesia. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A random sample of all adults aged 21 years or older living in 3 rural villages in central Sumatra was assessed. Nine hundred nineteen of 1089 (84.4%) eligible adults participated. METHODS: A team of 7 ophthalmologists examined the anterior segment of both eyes using a portable slit lamp after pupil dilatation. Lens opacity was graded according to the Lens Opacities Classification System III (LOCS III). A structured questionnaire was used to collect data on education level and income. MAIN OUTCOME MEASURES: Cataract was defined as either a LOCS III nuclear region score of > or =4.0, cortical > or =4.0, or posterior subcapsular (PSC) cataract > or =2.0, in either eye. RESULTS: Two hundred one (21.9%) of 919 subjects were found to have cataract. The age-adjusted prevalence rate of cataract (including cataract surgery) was 23.0% (95% confidence interval, 20.8-25.2). The most common type of cataract for both genders (adjusted for age) was mixed (13%) followed by nuclear only (5.7%), and cortical only (4%). The prevalence rate of any cataract for adults aged 21 to 29 was 1.1%, increasing to 82.8% for those aged older than 60 years. Similar trends with age were noted for nuclear, cortical, and PSC cataract. Women had higher prevalence rates than men for all types of cataract except cortical. There was a trend of increasing prevalence of all types of cataract with decreasing education (P<0.001). CONCLUSIONS: Cataract prevalence in adults aged 21 years and older in rural Indonesia is among the highest reported in Southeast Asia. Despite this, there are inadequate resources available to manage this treatable disease. Allocation of resources to tackle the present burden of cataract would likely have large personal, social, and economic benefits.

Adult↗
PubMed2005

Cataract progression after prophylactic laser peripheral iridotomy: potential implications for the prevention of glaucoma blindness.

PURPOSE: To evaluate changes in lens opacity in the first year after prophylactic laser peripheral iridotomy (LPI) performed in fellow eyes of subjects with acute primary angle closure (APAC). DESIGN: Prospective observational case series. PARTICIPANTS: Sixty Asian subjects with unilateral APAC. METHODS: All fellow eyes underwent prophylactic LPI within the first week of presentation, followed by 1 week of topical steroids. The degree of lens opacity was graded at the slit-lamp examination using the Lens Opacity Classification System III (LOCS III) with standard color photographs as the reference for grading of lens opacity. This was performed 2 weeks, 4 months, and 12 months after LPI. Progression in lens opacity was defined as an increase in LOCS III grade by 2 or more units in any lens region. MAIN OUTCOME MEASURES: Lens Opacity Classification Sytem III grades in nuclear, cortical, and posterior subcapsular (PSC) regions. RESULTS: Most patients were Chinese (85%) and female (63.3%), with an average age of 61.5 +/- 10.6 years. The mean baseline LOCS grades in the nuclear, cortical, and PSC regions were 3.58 +/- 0.74, 0.57 +/- 1.08, and 0.23 +/- 0.72, respectively. With 12 months of follow-up, 14 of the 60 eyes (23.3%; 95% confidence interval, 16.9-29.7%) showed significant progression in any lens region. Progression in the nuclear, cortical, and PSC regions was documented in 5%, 6.7%, and 16.7% of cases, respectively. By use of logistic regression, the following factors were not found to be significant for cataract progression in any lens region: age, race, gender, history of hypertension or diabetes, presence of peripheral anterior synechiae or angle width at baseline, and total laser energy delivered. CONCLUSIONS: In fellow eyes of APAC, prophylactic LPI is complicated by significant cataract progression, mainly in the posterior subcapsular region. These findings may have implications for the role of prophylactic LPI in the prevention of angle-closure blindness.

Acute Disease↗
PubMed2005

Utility values in Singapore Chinese adults with primary open-angle and primary angle-closure glaucoma.

PURPOSE: To evaluate utility values in Chinese glaucoma patients. PATIENT AND METHODS: Singapore Chinese residents (n = 213) with primary open-angle glaucoma or primary angle-closure glaucoma were recruited from a single tertiary ophthalmic center. Standard face-to-face interviews were conducted to ask about utility values (time trade-off and standard gamble for both death and blindness). Ocular information, including current visual acuity, intraocular pressure, visual field defect, and cup-disc ratio were also obtained. RESULTS: The mean time trade-off utility value was 0.88 (95% confidence interval 0.85, 0.91), and standard gamble for death and blindness were 0.94 (95% confidence interval 0.93, 0.96) and 0.95 (95% confidence interval 0.93, 0.97), respectively. Only 35.7% of patients were willing to trade time, and 34.3% willing to risk blindness in return for perfect vision. Both primary angle-closure glaucoma and primary open-angle glaucoma patients had similar utility values. After adjusting for age, gender, language spoken, educational level, and diagnosis, patients with better eye visual field PSD > 10 were 2.52 times (95% confidence interval 1.13, 5.61) more willing to trade time. In a multivariate model, the odds ratio of willingness to risk blindness for a complete hypothetical glaucoma cure was 9.88 (95% confidence interval 1.65, 59.23) for patients who had only visited an ophthalmologist 15 years or more ago, and 0.53 (95% confidence interval 0.27, 1.02) for patients who had previous trabeculectomy. CONCLUSION: Most Chinese glaucoma patients in Singapore are not willing to trade time or risk blindness. Patients with worse visual fields in the better-seeing eye are more willing to trade time; whereas patients who have not seen an ophthalmologist for at least 15 years or who had no history of a previous trabeculectomy are more willing to risk blindness.

Adult↗
PubMed2005

Comparisons of the handheld autorefractor, table-mounted autorefractor, and subjective refraction in Singapore adults.

PURPOSE: The purpose of this article was to compare the Retinomax with the table-mounted autorefractor and subjective refraction in Singapore adults. METHODS: Adults (n = 100) attending a tertiary eye hospital clinic were examined by an optometrist. First, subjective refraction testing was performed using a trial lens set, followed by handheld autorefractor tests using the Nikon Retinomax and the table-mounted autorefractor (Topcon RM8000B). Spherical equivalent and vector components of astigmatism were analyzed: J0 (Cartesian astigmatism) and J45 (oblique astigmatism). RESULTS: The Retinomax autorefractor readings (mean = -4.69 D) were more minus compared with the table-mounted autorefractor (mean = -4.05 D) and subjective refraction (mean = -3.90 D). There were significant differences in J0 and J45 for comparisons between subjective refraction and Retinomax autorefraction, and table-mounted autorefraction and Retinomax autorefraction. CONCLUSION: The Retinomax autorefractor measures were more minus compared with the table-mounted autorefractor and subjective refraction. The Retinomax autorefractor is not recommended for research purposes, unless in remote inaccessible areas where a portable instrument is necessary and cycloplegia is not possible.

Adult↗
PubMed2005

Asymptomatic choroidal granulomas in common variable immunodeficiency.

Common variable immunodeficiency disease represents the most common cause of significant antibody deficiency in adults. It is a heterogeneous group of disorders that can be sporadic or familial with various modes of inheritance with defects in B-cell function, regulatory T-cells and macrophage function all being reported. Herein a case of asymptomatic bilateral choroidal granulomatous disease in a 27-year-old man with common variable immunodeficiency disease is described.

Adult↗
PubMed2005

Myopia and associated pathological complications.

Besides the direct economic and social burden of myopia, associated ocular complications may lead to substantial visual loss. In several population and clinic-based cohorts, case-control and cross-sectional studies, higher risks of posterior subcapsular cataract, cortical and nuclear cataract in myopic patients were reported. Patients with high myopia (spherical equivalent at least -6.0 D) are more susceptible to ocular abnormalities. The prevalent risks of glaucoma were higher in myopic adults, and risks of chorioretinal abnormalities such as retinal detachment, chorioretinal atrophy and lacquer cracks increased with severity of myopia and greater axial length. Myopic adults were more likely to have tilted, rotated, and larger discs as well as other optic disc abnormalities. Often, these studies support possible associations between myopia and specific ocular complications, but we cannot infer causality because of limitations in study methodology. The detection and treatment of possible pathological ocular complications is essential in the management of high myopia. The ocular risks associated with myopia should not be underestimated and there is a public health need to prevent the onset or progression of myopia.

Adolescent↗
PubMed2005

Molecular analysis of the myocilin gene in Chinese subjects with chronic primary-angle closure glaucoma.

PURPOSE: Mutations in the myocilin (MYOC) gene have been implicated in juvenile as well as late-onset primary open-angle glaucoma (POAG). Overall, MYOC mutations account for 3% to 5% of cases of POAG worldwide, making it the most significant gene identified so far in glaucoma. Although there are some similarities in the phenotype of POAG and in particular chronic primary angle-closure glaucoma (PACG), little is known about the role of MYOC in the causation of PACG. To address this, the MYOC gene was screened in a cohort of 106 patients with chronic PACG. METHODS: Genomic DNA was extracted from leukocytes of the peripheral blood and exons 1 to 3 of the MYOC gene were PCR amplified and subjected to bidirectional sequencing and analysis. RESULTS: One hundred six patients with chronic PACG of Chinese ethnicity were studied. Sequencing of the MYOC gene in these patients revealed eight sequence variants. Of these, one was a nonsense change, three were missense changes, two were synonymous codon changes, and two were changes in noncoding sequences. These included the Arg46Stop and Thr353Ile mutations, which have been reported in individuals with POAG. However, all the sequence alterations identified have been found in normal Chinese subjects. CONCLUSIONS: The results of this study do not support a role for MYOC mutations in the pathogenesis of chronic PACG in the Chinese.

Aged↗