原发性闭角型青光眼急性发作眼前节形态学研究  

Morphology of ocular anterior segment at acute episode in primary angle closure glaucoma

作　　者：张海涛[1] 徐亮[2] 陈长喜[2] 徐英英[1] 马强[3] 

机构地区：[1]新乡医学院第一附属医院眼科,河南省卫辉市453100 [2]首都医科大学附属北京同仁医院北京市眼科研究所,北京市100005 [3]新乡医学院,河南省新乡市453003

出　　处：《眼科新进展》2010年第2期147-150,共4页Recent Advances in Ophthalmology

摘　　要：目的通过比较原发性闭角型青光眼急性发作眼与其对侧眼眼前节结构,探索发生房角关闭特征性眼前节结构指标参数,为原发性闭角型青光眼早期筛查和诊断提供依据。方法采用回顾性研究,连续选择青光眼门诊中具有原发性闭角型青光眼单眼急性发作病史且无青光眼视神经和视野改变患者41例,均接受包括视力、眼压、裂隙灯、视野、视盘立体照相等检查,眼前节结构采用裂隙灯式OCT测量,参数包括中央前房深度、房角度数、房角开放距离、虹膜根部弯曲角度、虹膜根部弯曲距离、房角关闭象限数。结果急性发作眼中央前房深度为(1.66±0.24)mm,与对侧眼(1.83±0.22)mm相比差异有统计学意义(均为P<0.005)。急性发作眼平均房角度数和房角开放距离为(4.49±5.25)°和(0.04±0.05)mm,与对侧眼(10.17±5.93)°和(0.09±0.06)mm相比差异有统计学意义(均为P<0.01)。急性发作眼平均虹膜根部弯曲角度为(164.60±6.27)°,与对侧眼(160.00±3.23)°相比差异有统计学意义(P<0.01)。急性发作眼平均虹膜根部弯曲距离(1.30±0.23)mm,与对侧眼(1.19±0.22)mm相比差异无统计学意义(P>0.05)。急性发作眼房角关闭象限数为2.90±1.20,与对侧眼1.50±1.10相比差异有统计学意义(P<0.01)。而房角关闭率,急性发作眼中各象限的差异无统计学意义(P>0.05),其对侧眼颞侧较其他象限小(均为P<0.01);急性发作眼与对侧眼相比,其颞侧、鼻侧及上方的房角关闭率大于对侧眼相应象限(均为P<0.05)。通过判别分析发现,房角关闭象限数是具有判别急性发作眼和对侧眼能力的参数(P=0.001)。结论原发性闭角型青光眼急性发作眼与其对侧眼具有不同的眼前节形态特征,提示在原发性房角关闭发展过程中最易发生房角关闭的部位是下方,之后依次是上方、鼻侧及颞侧,房角关闭象限数有助于从形态学方面分辨原发性闭角型青光眼早期房角改变。Objective To investigate biometric characteristics of ocular anterior segment with happening angle closure by comparing anterior segments of acute episode eyes and contralateral eyes in primary angle closure glaucoma（PACG） for providing references on early screening and diagnosis of PACG.Methods About 41 PACG patients with unilateral acute episode eyes but without glaucoma optic neuropathy or visual field change were continually selected from glaucoma clinics and retrospectively analyzed.Visual acuity,intraocular pressure,slit-lamp,visual field and optic disc photograph were measured.Structures of ocular anterior segment were observed by slit-lamp OCT.The indices included central anterior chamber depth,angle of anterior chamber degree,angle opening distance,iris root curvature,iris root curvature distance and quadrants of angle closure.Results The anterior chamber depths were （1.66±0.24）mm in acute episode eyes and （1.83±0.22）mm in contralateral eyes（P〈0.001）.The average angle of anterior chamber degrees and angle opening distances were （4.49±5.25）° and （0.04±0.05）mm in acute episode eyes,（10.17±5.93）° and （0.09±0.06）mm in contralateral eyes,there were significant differences（both P〈0.01）.The average iris root curvatures were （164.60±6.27）°in acute episode eyes and （160.00±3.23）° in contralateral eyes,there was significant difference（P〈0.01）.The average iris root curvature distances were （1.30±0.23）mm in acute episode eyes and （1.19±0.22）mm in contralateral eyes,no statistical difference was found（P〉0.05）.The quadrants of angle closure were 2.90±1.20 in acute episode eyes and 1.50±1.10 in contralateral eyes,there was significant difference（P〈0.01）.Angle closure proportion was not significantly different among quadrants in acute episode eyes,no statistical difference was found（P〉0.05）,which in temporal was significantly less than other quadrants in contralateral eyes（all P〈0.01）,and which of temporal,nasal and sup

关 键 词：原发性闭角型青光眼 急性发作 眼前节 房角关闭 

分 类 号：R777.2[医药卫生—眼科]