浅前房眼明暗环境中房角结构与暗室激发试验结果的相关性分析  

Correlations between chamber angle structures and dark room provocative test in shallow anterior chamber eyes

作　　者：宿心洁 张大卫[1] 李珊珊 戴惟葭[2,3] Su Xinjie;Zhang Dawei;Li Shanshan;Dai Weijia(Department of Ophthalmolog,Beijing Luhe Hospital,Capital Medical University,Beijing 101199,China;Department of Ophthalmolog,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Ophthalmolog,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]首都医科大学附属北京潞河医院眼科,北京101199 [2]首都医科大学宣武医院眼科,北京100053 [3]海南省人民医院眼科,海口570311

出　　处：《眼科》2024年第4期267-274,共8页Ophthalmology in China

摘　　要：目的分析浅前房人群在明暗环境中的超声生物显微镜(UBM)图像测量房角结构参数值与暗室激发试验(DRPT)结果之间的相关性。设计回顾性病例系列。研究对象2017年12月至2019年6月就诊于首都医科大学宣武医院的浅前房患者70例(70眼)。方法利用UBM在明暗环境中对患者进行8个方位的房角检查,测量UBM图像中的眼前节参数,并记录出现接触性房角关闭的方位数目(NPAC)。根据虹膜根部与小梁网之间的位置关系,将接触性房角关闭分为三种类型:L型、B型以及S型。随后,对所有研究对象进行暗室激发试验,记录试验前后的眼压,以眼压较基线升高≥8 mmHg为阳性标准。分析UBM眼前节数据与DRPT中眼压变化量之间的相关性,并比较DRPT阳性组与阴性组之间房角参数的差异。选取单眼阳性者的阳性眼及双眼结果一致者的右眼纳入统计学分析。主要指标眼压、接触性房角关闭的方位数目(NPAC)及L型、B型和S型三种类型接触性房角关闭的方位数目(NPAC-L、NPAC-B、NPAC-S)。结果在70例患者中,有26(37%)例至少1眼DRPT结果为阳性,DRPT中的眼压变化量与亮NPAC-S(r=0.260,P=0.030)、暗NPAC(r=0.249,P=0.038)、暗NPAC-B(r=0.306,P=0.010),及NPAC-B明暗变化量(r=0.309,P=0.009)呈正相关;与暗TIA(r=-0.241,P=0.044)呈负相关。DRPT阳性组与阴性组比较,仅NPAC-B明暗变化量存在差异(z=-2.64,P=0.008)。结论将接触性房角关闭分型有利于精确反映房角状态,明亮环境下的S型房角关闭数以及暗环境下的B型房角关闭数与DRPT中的眼压升高相关。Objective To investigate the relationship between anterior chamber angle structures assessed using ultrasound biomicroscopy(UBM)and the dark room provocative test(DRPT)in individuals with shallow anterior chambers.Design Retrospective case series.Participants A total of 70 consecutive shallow anterior chamber patients who visited the ophthalmology clinic at Xuanwu Hospital,Capital Medical University,between December 2017 and June 2019.Methods UBM imaging was performed under both well-lit and dark conditions.Anterior segment parameters were taken,including the number of positional angle closures(NPAC).Positional angle closure was categorized as L-type,B-type,or S-type based on the closure pattern.All participants underwent DRPT to assess intraocular pressure(IOP)changes,with a positive outcome defined as an IOP increase≥8 mmHg from baseline.Correlations between the IOP change in the DRPT and various parameters assessed through UBM images were analyzed.The difference in the anterior chamber angle structures between the positive and negative DRPT groups were compared.Based on the results of the DRPT,positive eyes of unilateral positive individuals were enrolled,and for the subjects with consistent DRPT results in bilateral eyes,the right eyes were chosen for data analysis.Main Outcome Measures IOP,the number of positional angle closures(NPAC),three subtypes of NPAC including NPAC-L,NPAC-B,NPAC-S.Results Out of the total of 70 subjects,26(37%)cases belonged to the positive group.Light-NPAC-S(r=0.260,P=0.030),dark-NPAC(r=0.249,P=0.038),dark-NPAC-B(r=0.306,P=0.010),and the change of NPAC-B(r=0.309,P=0.009)were found to be positively associated with IOP elevation during DRPT,while dark-TIA(r=-0.241,P=0.044)was found to exhibit a negative correlation.Only the change of NPAC-B(z=-2.64,P=0.008)was found to have a statistically significant difference between eyes with positive and negative outcomes.Conclusion Categorizing positional angle closure provides a more precise representation of angle conditions.S-type closure un

关 键 词：超声生物显微镜 原发性房角关闭 生物测量 眼前节 

分 类 号：R770.4[医药卫生—眼科]