前节OCT观察明暗光线下眼前节静态参数及其动态变化的研究

发布时间：2018-02-08 22:47

本文关键词： 青光眼闭角型眼前节相干光断层扫描　出处：《眼科》2017年04期 　论文类型：期刊论文

【摘要】：目的评价原发性闭角型青光眼急性发作对侧眼、一般窄房角眼及正常眼在明、暗光线下眼前节静态参数及其动态变化的差异。设计比较性病例系列。研究对象2013年5月至2015年5月在北京大学深圳医院、浙江医院眼科就诊的患者168例,临床前期组36眼、窄房角组120眼及正常宽角144眼。方法应用前节AS-OCT在明、暗光线下对入选眼进行检测,比较眼前节静态参数及明暗环境中动态变化的差异。主要指标眼前节各参数,包括瞳孔直径(PD)、虹膜面积(IA)、房角开放距离(AOD)、房角开放度数(ACA)、小梁虹膜空间面积(TISA)、房角隐窝面积(ARA)等。结果眼前节静态参数临床前期组与窄房角组差异无统计学意义。眼前节参数动态变化测量结果显示,从明处至暗处,即瞳孔散大时,窄房角组与临床前期组瞳孔直径变化值ΔPD均较正常宽角组小(P=0.002,0.011)。临床前期组虹膜面积增大(+5.83%),而一般窄房角组虹膜面积则随瞳孔散大而减少(-3.50%),但不及正常宽角眼明显(-12.50%,P=0.004)。临床前期组与窄房角组相比,虹膜面积变化率(ΔIA%)及每毫米瞳孔散大时虹膜面积变化率(ΔIA%/ΔPD)差异具有统计学意义(P=0.036)。从明处至暗处,各组AOD、ACA、TISA、ARA均减小,但变化值无统计学差异。结论仅有眼前节静态解剖参数的高危因素不能够有效识别发生房角关闭的高危窄房角眼。临床前期组与窄房角组瞳孔大小变化时相应虹膜横截面积变化可作为识别发生急性房角关闭高危眼的参考指标。
[Abstract]:Objective to evaluate the acute onset of primary angle-closure glaucoma in contralateral eyes, narrow atrial angle eyes and normal eyes. The difference of static parameters and dynamic changes of anterior segment under dark light. A series of comparative cases was designed. The subjects of the study were 168 cases of ophthalmology in Shenzhen Hospital of Peking University from May 2013 to May 2015, 36 eyes in the pre-clinical group, and 36 eyes in the pre-clinical group. Methods the anterior segment AS-OCT was used to detect the anterior segment of the eyes in bright and dark light to compare the static parameters of anterior segment and the dynamic changes in the environment of light and dark, the main outcome measures were the parameters of anterior segment. The results showed that there was no significant difference in the static parameters of anterior segment between the early clinical group and the narrow angle group, including the pupil diameter PDD, the iris area IAD, the angle opening distance AODO, the angle opening degree of ACAA, the trabecular iris space area and the angle recess area of the anterior chamber. The measurement results of dynamic changes in the parameters of the anterior segment show that, From the light to the dark, when the pupils dilate, The change value of pupil diameter 螖 PD in narrow atrium angle group and preclinical group was smaller than that in normal wide angle group. The iris area in preclinical group increased (5.83%), while in narrow atrium angle group, the iris area decreased with the dilation of pupil, but it was lower than that in normal wide angle group (5.83%). Compared with the narrow-atrial angle group, the preclinical group, the preclinical group and the narrow atrial angle group, The rate of change of iris area (螖 IAA) and the rate of change of iris area (螖 IA / 螖 PD) at dilated pupil per millimeter (螖 IA / 螖 PD) were significantly different (P = 0.036). From the light to the dark, the AODACATSAA ARA decreased in each group. Conclusion the high risk factors with only the static anatomical parameters of anterior segment can not effectively identify the high risk narrow atrial angle eyes in which the angle of atrium is closed. The change of pupil size in the preclinical group and the narrow atrial angle group is corresponding to that in the pre-clinical group and the narrow atrium angle group. The change of cross-sectional area can be used as a reference index to identify the high-risk eyes with acute atrial angle closure.
【作者单位】：浙江医院眼科;北京大学深圳医院眼科;
【分类号】：R775.2

【相似文献】