急性闭角型青光眼临床前期房角的3D-OCT研究  

Study on chamber angle in acute primary angle-closure glaucoma at preclinical phase by three dimensional optical coherence tomography

作　　者：彭红娟[1] 赵桂玲[1] 黎思毅[2] 李瑞庄[1] 郑彪[1] 袁雪晖[1] 

机构地区：[1]广东医学院附属医院眼科,广东省湛江市524001 [2]广东医学院附属医院血管甲状腺乳腺外科,广东省湛江市524001

出　　处：《眼科新进展》2015年第7期656-659,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨急性闭角型青光眼的危险因素及筛查手段,为防治其导致的不可逆盲提供新思路。方法选取2013年3月至2014年10月于我院确诊的急性闭角型青光眼患者临床前期眼24例24眼为研究对象(即临床前期组),另外取我院就诊无前房浅、房角窄、无葡萄膜炎的43例43眼为对照组,应用光学相干断层扫描仪Topcon 3D 1000 OCT扫描房角,观察两组房角图像特征,并以Schwalbe线(SL线)为解剖标志线的房角开放距离(angle opening distance,SL-AOD)及小梁虹膜间面积(trabecular-iris space area,SL-TISA)定量评估两组房角的宽窄。结果 3D-OCT能清晰显示小梁网的形态为三角形中等强反射区及SL线,在3D-OCT能清晰显示SL线者占94%。临床前期组周边虹膜明显膨隆,小梁网与周边虹膜的间隙明显变窄,对照组周边虹膜轻度膨隆或者平坦,小梁网与周边虹膜的间隙宽。临床前期组的SL-AOD及SL-TISA分别为(0.117±0.047)mm、(0.055±0.023)mm2,均明显小于对照组的(0.371±0.096)mm、(0.121±0.030)mm2,差异均有统计学意义(均为P<0.05)。结论 3D-OCT能清晰扫描到急性闭角型青光眼临床前期房角的改变并定量分析,可能成为筛查急性闭角型青光眼危险因素的实用、可靠的新手段。Objective To evaluate the risks and screening methods for the acute primary angle-closure glaucoma（ PACG）,and provide the new ideal for preventing the blindness caused by the glaucoma. Methods A total of 23 patients（ 23 eyes） with diagnosis of acute PACG at preclinical phase in our hospital from March 2013 to October 2014 were chosen as PACG group,and43 healthy subjects（ 43 eyes） in control group. The anterior chamber angle were examined using three dimensional optical coherence tomography（ 3D-OCT）. The image feature of anterior chamber angle was observed,and the quantitative parameters of chamber angle by Schwalbe line-angle opening distance（ SL-AOD） and Schwalbe line trabeculareiris space area（ SL-TISA） in two groups were analyzed. Results The trabecular meshwork was clearly visible as triangulate and middle reflex zone,SL could be identified in 94%. In the PACG group,the periphery iris was obviously bulged,the interspace between trabecular meshwork and periphery iris was obviously narrowed. SL-AOD was（ 0. 117 ± 0. 047） mm and SL-TISA was（ 0. 055 ± 0. 023） mm2 in PACG group,were significantly smaller than those of control group,in which SL-AOD was（ 0. 371 ± 0.096） mm and SL-TISA was（ 0. 121 ± 0. 030） mm2（ all P〈0. 05）. Conclusion The image feature and quantitative evaluation of anterior chamber angle in PACG at preclinical phase can be clearly detected by 3D-OCT,3D-OCT may be a useful method to screen risks for PACG and has a potential for tracking the progression for PACG.

关 键 词：急性闭角型青光眼 急性闭角型青光眼临床前期 光学相干断层扫描 房角 Schwalbe线 

分 类 号：R775.2[医药卫生—眼科]