应用超声生物显微镜与房角镜检查眼前房角结果的比较  

Comparison of results of chamber angle examination by ultrasound biomicroscopy and gonioscopy

作　　者：王宁利[1,2] 叶天才[1,2] 赖铭莹 欧阳洁[1,2] 曾明兵[1,2] 杨成武 

机构地区：[1]中山医科大学中山眼科中心 [2]深圳市眼科医院

出　　处：《中华眼科杂志》1999年第3期174-178,I010,共6页Chinese Journal of Ophthalmology

摘　　要：目的比较应用超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｙ，ＵＢＭ）与房角镜检查眼前房角的结果，为房角镜检查提供新的技术和资料。方法采用双盲法分别对１０例（２０只眼）的眼前房角进行超声生物显微镜和裂隙灯显微镜房角镜检查，并将两种检查结果进行比较，采用等级相关法对获取的资料和结果进行统计学分析（取α＝０．０５）。结果两种检查法在宽房角状态下对房角的检查结果有较好的一致性，但在窄房角状态时观察结果一致性较差，房角镜观察到的房角较ＵＢＭ观察到的房角宽。在狭窄房角状态下，两种检查法在虹膜根部附着点的判别上一致性较差；在周边虹膜形态的评价上，有近１／４的患者出现观察结果不一致。结论（１）房角镜检查由于受照明光线及操作时机械干扰的影响，所观察到的房角状态比自然状态稍宽，特别是判别房角是否为功能关闭较为困难；（２）在窄房角状态下判别虹膜根部附着点时，由于受房角可见程度的影响，房角镜所判断的附着点具有推测性；（３）在判别周边虹膜形态时，由于受虹膜表面不规则形态的影响，用房角镜检查有时将出现判别误差。Objective To compare the consistency of the chamber angles examined by ultrasound biomicroscope (UBM) and gonioscope and provide gonioscopic examination with new methods and technology. Methods 10 patients (20 eyes) were selected for the research. The same eyes were examined by UBM and gonioscope in turns. The results from the two methods were compared and the data were analyzed with Spearman correlation test. Results The results of two methods of chamber angle examination were well consistent when the angle was wide, but the consistency was not good when it was narrow. The angle examined by a gonioscope was wider than that by UBM. When the iris root insertion was evaluated in a narrow angle, the consistency was also not good, and when the peripheral iris morphology was evaluated, there were almost inconsistent results in onefourth of the patients. Conclusions The results of chamber angle examined by a gonioscope show a little wider than its natural status. Especially, it is difficult to distinguish the functional closure from the adhesive closure. Under the influence of light, the determination of iris root insertion by a gonioscope has a sense of conjecture. When peripheral iris morphology is evaluated, the influence of irregular iris might result in a wrong conclusion. Therefore, the technique of gonioscopic examination should be improved.

关 键 词：前房角镜检查 超声生物显微镜 青光眼 

分 类 号：R775.04[医药卫生—眼科] R770.43[医药卫生—临床医学]