眼前节光学相干断层在青光眼术后滤过泡功能评估中的应用

发布时间：2018-06-02 11:48

  本文选题：眼前节光学相干断层扫描 + 滤过泡　； 参考：《山东大学》2010年硕士论文

【摘要】： 目的：探讨眼前节光学相干断层扫描仪(anterior segment optical coherence tomography, AS-OCT)在观察青光眼滤过手术后滤过泡的形态及其功能评价中的意义,并分析四种分型滤过泡术后平均眼压的差异。 方法：收集在我院门诊就诊的已行青光眼滤过手术1个月以上的患者79例(共103眼),术后随访时间为1～24个月,平均(9.45±10.83)个月。利用裂隙灯检查及AS-OCT检测法分别观察滤过泡形态,将其按照形态特点并参考术后眼压分型,即Ⅰ弥散型滤过泡、Ⅱ微囊型滤过泡、Ⅲ包裹型滤过泡及Ⅳ扁平型滤过泡,比较这两种检测方法的一致性,并比较使用AS-OCT检测分型下四种滤过泡术后眼压的差异。 结果：103眼术后随访的平均眼压为(17.86±6.21) mmHg。裂隙灯检查法示59眼为弥散型滤过泡(59／103,57.28%),22眼为微囊型滤过泡(22／103,21.36%),8眼为包裹型滤过泡(8／103,7.77%),14眼为扁平型滤过泡(14／103,13.59%)；AS-OCT检测示55眼为弥散型滤过泡(55／103,53.39%),平均眼压为(12.76+3.97)mmHg,27眼为微囊型滤过泡(27／103,26.22%),平均眼压为(15.07±3.43)mmHg,7眼为包裹型滤过泡(7／103,6.80%),平均眼压为(28.40±7.42) mmHg,14眼为扁平型滤过泡(14／103,13.59%),平均眼压为(23.64±6.43) mmHg。对于滤过泡分型的评价,AS-OCT检测法与裂隙灯检查法有较好的一致性(X2=271.58,P0.05, Pearson=0.8515)。本研究中,弥散型滤过泡与包裹型滤过泡间的眼压差异有统计学意义(t=3.205,P0.01)；弥散型滤过泡与扁平型滤过泡间的眼压差异有统计学意义(t=2.664,P0.01)；微囊型滤过泡与包裹型滤过泡间的眼压差异有统计学意义(t=2.789,P0.01)；微囊型滤过泡与扁平型滤过泡间的眼压差异不甚明显(t=2.102,0.05P0.01)；弥散型滤过泡与微囊型滤过泡间的眼压差异无统计学意义(t=0.876,P0.05)；包裹型滤过泡与扁平型滤过泡间的眼压差异无统计学意义(t=1.613,P0.05)。 结论：AS-OCT作为一种非接触检查,无需耦合剂及体位要求,可被广大患者所接受,它具有无创性、非接触性和高分辨率等优点,能够清晰显示滤过泡内部的形态,包括滤泡结构、巩膜瓣位置、内口开放情况和滤泡内囊状腔隙情况,在青光眼术后滤过泡功能评估中有重要的临床意义。
[Abstract]:Objective: to investigate the significance of anterior segment optical coherence tomography, AS-CT in evaluating the morphology and function of filtering bleb after glaucoma filtering operation, and to analyze the difference of mean intraocular pressure (IOP) after four types of filtering blebs. Methods: 79 patients (103 eyes) who had undergone glaucoma filtration surgery in our outpatient department were collected. The follow-up time was 1 ~ 24 months (mean 9.45 卤10.83 months). The morphology of filtering bleb was observed by slit lamp examination and AS-OCT detection. According to the morphological characteristics and according to the postoperative intraocular pressure classification, they were divided into three types, I. E. diffusion bleb, 鈪，

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