超声生物显微镜对慢性低眼压诊断和治疗的动态监测  

Dynamic detection of diagnosis and treatment for chronic ocular hypotension by ultrasonic biomicroscopy

作　　者：杨建刚[1] 熊全臣[1] 王肖华[1] 权彦龙[1] 冯朝晖[1] 

机构地区：[1]西安交通大学医学院第二附属医院眼科,中国陕西省西安市710004

出　　处：《国际眼科杂志》2007年第6期1624-1628,共5页International Eye Science

摘　　要：目的：一组以UBM诊断为基础的慢性低眼压患者，经眼压、裂隙灯显微镜、眼底检查、UBM3～6mo的动态监测，了解低眼压的恢复情况，不同治疗方法的效果，说明UBM在低眼压诊断和治疗中的作用。方法：慢性低眼压45眼（眼压≤8mmHg），平均眼压为5．59（2～8）mmHg，病史超过1mo。所有患者均进行常规眼科检查，包括视力、裂隙灯、眼压检查、前房角镜、间接检眼镜、UBM检查，治疗分为药物组和手术组，于治疗后1wk；1，3和6mo进行随访检查。结果：经UBM检查有24眼（53％）为钝伤性低眼压，主要为睫状体脉络膜脱离；16眼（36％）为各种内眼手术后所致的低眼压；1例（0．04％）患者为风湿性心脏病继发双眼葡萄膜炎。基线眼压与治疗后随访眼压比较，均存在显著性差异（P〈0．01）。末次眼压和基线眼压之间无相关性，而和病史及发病年龄均呈强的负相关性。42眼（93％）UBM检查有形态学结构改变，睫状体异常占87％。药物组和手术组的基线眼压分别为5．91和4．95mmHg，存在显著性差异（P〈0．05），药物组病史明显长于手术组，而手术组发病年龄明显低于药物组，随访的末次眼压分别为10．42和11．25mmHg，无显著性差异。结论：经治疗两组眼压均有显著提高，手术组的患者病情明显重于药物组，治疗前眼压低，发病年龄小，但治疗后眼压效果相似。UBM无论在低眼压的诊断，还是治疗后监测中均有非常重要的作用。AIM： To investigate the recovery of patients with chronic ocular hypotension whose diagnosis was based on ultrasonic biomicroscopy （UBM） and the effects of different treatments, and to illustrate the role of UBM in the diagnosis and treatment of ocular hypotension, according to dynamic monitoring of intraocular pressure （IOP）, slit-lamp microscopy, fudus examination and UBM. METHODS： A total of 45 eyes with chronic ocular hypotension was included in the study. Their mean IOP was 5.59mmHg （ranged from 2 to 8mmHg）, and case history was more than 1 month. All patients were carried out routine clinical examinations, including visual acuity, slit-lamp, IOP, gonioscope, indirect ophthalmoscope and UBM. Patients were divided into medication group and surgery group, and were followed up at 1 week, 1,3,6 months after treatment.RESULTS： Twenty-four eyes （53%） were diagnosed as blunt traumatic ocular hypotension by UBM, mainly ciliochoroidal detachment. Ocular hypotension of 16 eyes （36%） were caused by different intraocular surgeries. One patfent （4%） developed bilateral uveitfs secondary to rheumatic heart disease, IOP at different time points in the follow-up was significantly different from baseline IOP （P〈0.01）. Final IOP did not correlate with baseline IOP, while it presented significantly negative correlation with history and onset age. Forty-two eyes （93%） had morphological changes through UBM, abnormality of ciliary body taking up 87%. Baseline IOP of medication and surgery group were 5. 91mmHg and 4. 95mmHg respectively, and there existed a significant difference （P〈 0.05）. Medicationg group apparently had a longer history than surgery group, whereas onset age of surgery group was obviouly lower than that of medication group. The final IOP in the follow-up was 10. 42mmHg and 11.25mmHg respectively in medication group and surgery group, and there was no significant difference. CONCLUSION： IOP of both groups were elevated evidently. The conditions of patients in surg

关 键 词：低眼压 超声生物显微镜 睫状体脉络膜脱离 

分 类 号：R775[医药卫生—眼科]