Graves病与开角型青光眼的相关性分析  

Open-angle glaucoma associated with graves disease

作　　者：俞振飞[1] 方春庭[1] 

机构地区：[1]温州医学院附属第一医院眼科,325000

出　　处：《临床眼科杂志》2007年第2期114-116,共3页Journal of Clinical Ophthalmology

摘　　要：目的评价Graves病中开角型青光眼及高眼压的患病情况。方法对80例Graves病患者,进行全面的眼部检查,包括压平眼压、眼球突出度、自动静态阈值视野计检查和眼眶CT检查。患者的年龄为40～66岁,平均为51岁;男29例,女51例。随访眼压两次以上均大于21mmHg(1mmHg=0.133kPa)者定为高眼压;当视野缺损与视盘盘缘切迹相对应而房角又开放者诊断为开角型青光眼。结果80例Graves病患者中,有5例(6.25%)显示典型的青光眼性视野缺损,诊断为开角型青光眼,其中3例(3/5)在随访期中经多次(2次以上)测量眼压均低于21mmHg,诊断为正常眼压性青光眼(3.75%)。80例中8例(10%)在随访期中经多次(2次以上)测量眼压均高于21mmHg,但无典型的青光眼性视野缺损诊断为高眼压症。结论在Graves病患者中,开角型青光眼、正常眼压性青光眼及高眼压症的患病率均高于一般群体中的患病率,应引起人们注意,密切随访观察,以便及早预防视神经损害。Objective To estimate the prevalence of open-angle glaucoma and ocular hypertension in Graves disease. Methods In the present stady , a complete ophthalmic examination including applanation tonometry, exophthalmonetry, automated static threshold perimetry and computed tomography of the orbit was performed in 80 patients with Graves disease （ age range 40 - 66 years;mean 51 years ;51 women,29 men ）. Ocular hypertension was defind as an intraocular pressure greater than 21mmHg（2.8 kPa） on at least two occasions during the period of follow-up. We diagnosed patients as having glaucoma, when visual field defects correspond to rim notching of the disk without the compressive optic neuropathy. Results Of the 80 patients ,5 （ 6.25% ） exhibited typical glaucomatous visual field defects in automatic static threshold perimetry in the absence of compressive optic neuropathy. The intraocular pressure in three of the 5 patients was consistently less than 21mmHg（2.8 kPa） during the follow-up period. Thus,these patients were diagnosed as having normal-tension glaucoma. Of the 80 patients, 80 （ 10% ） were diagnosed as having ocular hypertension. Conclusion The prevanlence of normal-tension glaucoma as well as open-angle glaucoma and ocular hypertension was significantly higher among patients with Graves disease than in the general population. It means that periodic visual field tests should be performed in patients with Graves disease to prevent severe visual field loss caused by glaucoma as well as compressive optic neuropathy .

关 键 词：GRAVES病 开角型青光眼 高眼压症 

分 类 号：R581.1[医药卫生—内分泌]