青少年开角型青光眼118例临床分析  

Clinical analysis of 118 juvenile open-angle glaucoma cases

作　　者：史慧敏[1] 

机构地区：[1]华中科技大学同济医学院附属襄樊医院眼科,中国湖北省襄樊市441021

出　　处：《国际眼科杂志》2009年第1期146-148,共3页International Eye Science

摘　　要：目的：探讨青少年开角型青光眼的临床特点，并对其早期诊断、治疗、预后进行分析讨论。方法：抽取1997／2007年收治的青少年开角型青光眼118例（236眼），对典性别、年龄、屈光状态眼压、房角、眼底、视野、家族史等各有关参数及治疗情况等，进行回顾性统计分析。结果：男51例（43．2％）、女67例（56．8％），发病年龄10～20岁占本组病例的70．3％，并发近视眼者占77．1％（182／236），治疗前最高眼压10～21mmHg者80眼（33．9％），21～25mmHg者52眼（22．0％），26～30mmHg者64眼（27．1％），31～40mmHg者29眼（12．3％），〉40mmHg者11眼（4．7％）。C／D〈0．6者146眼（61．9％），C／D06～0．8者81眼（34．3％），C／D〉0．8者9眼（3．8％）。视网膜神经纤维层缺损阳性率为94．9％，视野缺损阳性率为65．2％。房角全部为开角未见特殊异常。有青光眼家庭史者13例（11．0％）。本组有28例（50眼）施行滤过性手术，其余均为药物保守治疗。治疗后眼压控制良好，但视力提高者仅57眼（24．2％）。结论：青少年开角型青光眼（juvenile open angle glaucoma，JOAG）的发病年龄越来越年轻化，近视眼是JOAG最主要危险因素之一，视网膜神经纤维层缺损是JOAG早期诊断的一个高敏感性和高特异性客观依据，JOAG应早期诊断、合理治疗、定期随访，其预后比较乐观。AIM： To evaluate the clinical appearances, early diagnosis, treatment and prognosis of juvenile openangle glaucoma （JOAG）. METHODS ： The clinical retrospective analysis compared gender, age, refraction, intraocular pressure（IOP）, angle of anterior, ocular fundus, visual field, family history and treatment was conducted on 118 cases （236 eyes） with JOAG from 1997 to 2007. RESULTS： In all cases, 51 cases （43.2%） were male and 67 cases （56.8%） were female. The age from 10 to 20 years old in this group were covered 70. 3%. Those associated with myopia were 77.1%. Before treatment, the highest lOP of 80 eyes （33.9%） were 10-21mmHg, 52 eyes （22.0%） were 21-25mmHg, 64 eyes （27.1%） were 26-30mmHg, 29 eyes （12.3%） were 31-40mmHg, and 11 eyes （4.7%） were higher than 40mmHg. The results of C/Din146 eyes （61.9%） were 〈0.6, 81 eyes （34.3%） were 0.6- 0.8, and 9 eyes （3.8%） were more than 0.8. The positive rate of RNFLD was 94.9%. The positive rate of vision field defect was 65.2%. The angle of anterior chamber was open. Thirteen cases （11. 0%） had the glaucoma family history. Twenty-eight cases （50 eyes） were treated with operation. The others were treated with remedy. After treatment, lOP were controlled well. However, visual acuity was improved in only 57 eyes （24.2%）. CONCLUSION： The onset age of JOAG becomes more and more younger. Myopia is one of the most dangerous factor for JOAG. RNFLD is a highest sensitivity and specific objective basis. With early diagnosis, reasonable treatment, and regular follow-up, the prognosis of JOAG will be better.

关 键 词：青少年开角型青光眼 近视 早期诊断 合理治疗 

分 类 号：R775[医药卫生—眼科]