可疑性原发房角关闭的晶状体悬韧带松弛度研究  

The relaxation of zonule in primary angle closure suspects

作　　者：郭竞敏 李木[1] 严晓琴[1] 张虹[1] 王军明[1] GUO Jing-Min;LI Mu;YAN Xiao-Qin;ZHANG Hong;WANG Jun-Ming(From the Department of Ophthalmology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,Hubei Province,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,湖北省武汉市430000

出　　处：《眼科新进展》2018年第5期461-463,467,共4页Recent Advances in Ophthalmology

摘　　要：目的比较可疑性原发房角关闭(primary angle closure suspect,PACS)患者与正常人各方位晶状体悬韧带松弛度差异,探究隐匿性晶状体偏位在青光眼发病中的作用。方法纳入PACS组患者19例(19眼)和与之年龄、性别、眼别匹配的正常对照组19名(19眼)。在标准暗室下采用Pentacam完成眼前节扫描,局部滴用复方托吡卡胺眼水一滴,30 min后再次采集Pentacam图像,自动获得散瞳前后4 mm范围8个方位(上方、颞上、颞侧、颞下、下方、鼻下、鼻侧、鼻上)周边前房深度(peripheral anterior chamber,peri-ACD)。以散瞳前后peri-ACD的差值(即△peri-ACD)反映悬韧带松弛度。以散瞳后8个方位peri-ACD差异明确是否存在晶状体偏位,并通过其极差值(即散瞳后8个方位peri-ACD中最大值减去最小值)反映晶状体偏位程度。结果PACS组与正常对照组不同方位△peri-ACD组内比较差异均有统计学意义(P<0.001、P=0.043),组间比较PACS组颞下方(0.40±0.28)mm小于正常对照组(0.55±0.15)mm(P=0.041),其余方位差异均无统计学意义(均为P>0.05)。散瞳后PACS组和正常对照组8个方位peri-ACD组内比较差异均有统计学意义(P=0.001、0.009),8个方位组间比较差异均有统计学意义(均为P<0.01)。PACS组和正常对照组间极差值比较差异无统计学意义[(0.35±0.18)mm、(0.43±0.28)mm](P=0.362)。结论 PACS组与正常对照组均存在晶状体悬韧带松弛度分布不均,而PACS组颞下方悬韧带松弛可能更为显著。Objective To compare the difference of relaxation distribution of zonule in different orientations between primary angle closure suspects(PACS)and normal controls,and to explore the role of latent subluxated lens in the pathogenesis of glaucoma.Methods Together 19 eyes of 19 PACS(PACS group)and 19 eyes of 19 age-,gender-and eye-matched normal controls(control group)were enrolled in this study.Pentacam was performed under standardized dark conditions before and 30 min after instillation of compound tropicamide eye drop.Peripheral anterior chamber depth(peri-ACD)of 8 orientations(superior,temporal superior,temporal,temporal inferior,inferior,nasal inferior,nasal,nasal superior position)in the central 4 mm diameter was measured automatically in each eye.The differences of peri-ACD(△peri-ACD)before and after mydriasis were measured to reflex the relaxation of zonule.The difference of peri-ACD in 8 orientations after mydriasis could confirm the possibility of latent subluxated lens,and its range could verify the degree of lens deviation.Results Significant difference was observed in each groups in terms of△peri-ACD(P<0.001,0.043).The△peri-ACD of the temporal inferior position was(0.40±0.28)mm in PACS group,which was smaller than that in the control group[(0.55±0.15)mm](P=0.041),but no significant difference was observed between PACS patients and normal controls in other orientations(all P>0.05).And significant difference was detected between the 8 positions of peri-ACD after mydriasis in each groups(P=0.001,0.009),and these parameters between the two groups were also significantly different(all P<0.01).Moreover,there was no significant difference in the difference of between the minimum and maximum peri-ACD in the PACS group and the control group[(0.35±0.18)mm vs.(0.43±0.28)mm](P=0.362).Conclusion The uneven relaxation distribution of zonule may exist in both PACS patients and normal controls,and the relaxation of zonule may be significant in temporal inferior position in PACS patients.

关 键 词：可疑性原发房角关闭 悬韧带 松弛 

分 类 号：R775.2[医药卫生—眼科]