急性闭角型青光眼30例虹膜血管造影的临床特征  

Clinical characteristics of iris fluorescein angiography in 30 patients with acute angle-closure glaucoma

作　　者：徐楠 彭程 祝文文[2] 孙艳[2] 范姗姗[2] 祝寿荣[2] XU Nan;PENG Cheng;ZHU Wenwen;SUN Yan;FAN Shanshan;ZHU Shourong(School of Clinical Medicine,Affiliated Hospital of Weifang Medical University,Weifang,Shandong 261000,China;Ophthalmology Department,Affiliated Hospital of Weifang Medical University,Weifang,Shandong 261000,China)

机构地区：[1]潍坊医学院附属医院临床医学院,山东潍坊261000 [2]潍坊医学院附属医院眼科,山东潍坊261000

出　　处：《安徽医药》2024年第10期2063-2068,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的应用荧光素钠虹膜血管造影术(IFA)观察急性闭角型青光眼(AACG)病人的血房水屏障功能,探讨其在急性闭角型青光眼诊疗中的临床应用价值。方法选取2021年12月至2023年3月潍坊医学院附属医院收治的急性闭角型青光眼病人急性发作眼共30例(30眼),对侧眼为临床前期组30例(30眼)。对照组为需行眼底血管造影术(FFA)排除单眼眼底疾病病人,选择FFA结果正常眼入组共30例(30眼)。对全部病人均行IFA检查,观察虹膜血管荧光素渗漏起始时间、荧光素渗漏起始范围、强荧光素渗漏时间及范围和前房内荧光素消退时间,评估病人血房水屏障受损情况。结果AACG发作期虹膜血管荧光素渗漏发生率为100%(30眼),AACG临床前期虹膜血管渗漏发生率为63.33%(19眼),对照组均未见荧光素渗漏;AACG发作期IFA:虹膜血管荧光素渗漏严重,有明显强荧光时期,最终整个前房呈高荧光状态;AACG临床前期组IFA:63.33%(19眼)病人发生虹膜血管渗漏,早期瞳孔缘虹膜血管呈点状或者片状荧光渗漏,随造影时间延长渗漏呈先增强后减弱趋势,荧光素扩散至前房后逐渐消退,11例病人虹膜血管无荧光素渗漏;AACG急性发作组强荧光素渗漏范围与眼压(r_(s)=0.45,P=0.013)、前房内荧光素消退时间(r_(s)=0.54,P=0.002)均存在显著正相关关系。结论IFA可直观评估AACG的血-房水屏障功能及受损程度。急性闭角型青光眼发作期血-房水屏障及房水循环受损严重,血-房水屏障受损程度与眼压有显著正相关关系。部分急性闭角型青光眼临床前期病人存在IFA图像异常,IFA为AACG临床前期及高危人群的筛查和预防提供了新思路。Objective To observe the blood-aqueous barrier function in patients with acute angle-closure glaucoma(AACG)using fluorescein sodium iris angiography and to explore its clinical value in the diagnosis and treatment of acute angle-closure glaucoma.Methods A total of 30 cases(30 eyes)of acute exacerbation eyes of acute angle-closure glaucoma patients admitted to the Affiliated Hospital of Weifang Medical College from December 2021 to March 2023 were selected,and the contralateral eyes were 30 cases(30 eyes)of the preclinical group.The control group consisted of patients who required fundus fluorescein angiography(FFA)to exclude monocular fundus disease.Thirty eyes with normal FFA results were selected for the group(30 eyes).All patients underwent iris fluorescein angiography(IFA)examination.The onset time and range of fluorescein leakage in iris vessels,as well as the duration and range of strong fluorescein leakage and the fluorescence disappearance time in the anterior chamber were observed to assess the damage to the bloodaqueous barrier.Results The incidence of fluorescein leakage in iris vessels during the acute attack phase of AACG was 100%(30 eyes),while the incidence was 63.33%(19 eyes)in the preclinical stage of AACG and no leakage was observed in the control group.IFA during AACG attack phase showed severe iris vessel fluorescein leakage,with a period of significant strong fluorescence,resulting in the entire anterior chamber appearing highly fluorescent.In the preclinical stage of AACG,63.33%(19 eyes)of patients had iris vessel leakage,with punctate or patchy fluorescence leakage at the edge of the pupil,which increased and then decreased over time,and the fluorescein gradually diffused into the anterior chamber and then gradually disappeared.In 11 patients,there was no fluorescein leakage in iris vessels.In the AACG acute attack group,there was a significant positive correlation between the range of strong fluorescein leakage and intraocular pressure(r_(s)=0.45,P=0.013),the fluorescence disappearance tim

关 键 词：青光眼 闭角型 虹膜荧光素血管造影 血房水屏障 虹膜 眼压 

分 类 号：R775.2[医药卫生—眼科]