CAJ | 학술논문

目的探讨Sturge-Weber综合征并发青光眼的临床特点及手术治疗效果.方法回顾性系列病例研究.收集2003年1月至2007年12月住院治疗的16例(21只眼)Sturge-Weber综合征并发青光眼患者的临床资料,进行回顾性分析.应用Stata 7.0统计学软件对数据进行分析.对有随访资料的10例(11只眼)患者术前、后眼压比较采用配对t检验.结果患者年龄为1个月至31岁,中位数年龄为11岁.颜面部血管瘤位于双侧的有8例,其中2例伴有全身皮肤广泛血管瘤.16例患者中,并发单侧青光眼11例,其中3例伴有双侧颜面部血管瘤;并发双侧青光眼5例,均伴有双侧颜面部血管瘤.16例患者前房角镜检查均为宽角.21只患眼均行B超检查,其中8只眼(38.1%)的脉络膜探及弥漫性中高回声占位性病变.超声活体显微镜检查显示有虹膜后凹、睫状体内低回声区、睫状体浅脱离等.有18只眼进行了抗青光眼手术治疗,包括小梁切开术、小梁切除术、非穿透性深层巩膜切除术、Ahmed青光眼阀植入术、睫状体冷冻术,术后发现行小梁切除术的5只眼中,有4只眼出现脉络膜脱离.术后10例(11只术眼)患者平均随访22个月,随访时患者眼压均低于其术前眼压(均≤21 mm Hg,1 mm Hg=0.133 kPa),术前后眼压差异有统计学意义(t=5.3956,P<0.01).结论 Sturge-Weber综合征并发青光眼患者的临床特征为颜面部血管瘤、宽房角、脉络膜血管瘤.抗青光眼手术治疗能有效降低眼压.
목적 탐토Sturge-Weber종합정병발청광안적림상특점급수술치료효과.방법 회고성계렬병례연구.수집2003년1월지2007년12월주원치료적16례(21지안)Sturge-Weber종합정병발청광안환자적림상자료,진행회고성분석.응용Stata 7.0통계학연건대수거진행분석.대유수방자료적10례(11지안)환자술전、후안압비교채용배대t검험.결과 환자년령위1개월지31세,중위수년령위11세.안면부혈관류위우쌍측적유8례,기중2례반유전신피부엄범혈관류.16례환자중,병발단측청광안11례,기중3례반유쌍측안면부혈관류;병발쌍측청광안5례,균반유쌍측안면부혈관류.16례환자전방각경검사균위관각.21지환안균행B초검사,기중8지안(38.1%)적맥락막탐급미만성중고회성점위성병변.초성활체현미경검사현시유홍막후요、첩상체내저회성구、첩상체천탈리등.유18지안진행료항청광안수술치료,포괄소량절개술、소량절제술、비천투성심층공막절제술、Ahmed청광안벌식입술、첩상체냉동술,술후발현행소량절제술적5지안중,유4지안출현맥락막탈리.술후10례(11지술안)환자평균수방22개월,수방시환자안압균저우기술전안압(균≤21 mm Hg,1 mm Hg=0.133 kPa),술전후안압차이유통계학의의(t=5.3956,P<0.01).결론 Sturge-Weber종합정병발청광안환자적림상특정위안면부혈관류、관방각、맥락막혈관류.항청광안수술치료능유효강저안압.
Objective To investigate the clinical features of Sturge-Weber syndreme-associated glaucoma and its surgical treatment.Methods A retrospective case series study.The general clinical data and related ocular manifestations in 16 patients (21 eyes) with Sturge-Weber syndrome-associated glaucoma in our hospital from January 2003 to December 2007 were analyzed retrospectively.Results Age of the patients ranged between 1 month to 31 years old, and the median age was 11 years.Bilateral facial angiomas were present in 8 patients, and two of them had extensive hemangioma.Eleven cases had unilateral glaucoma and 3 of them had bilateral facial angiomas.Five patients had bilateral glaucoma and all of them had bilateral facial angiomas.Open anterior chamber angle was found in all affected eyes by goniescopy.B-scan ultrasonography was performed in 21 eyes and diffused occupying lesions in the choroid were found in 8 eyes (38.1%), Posterior bowing of the iris, low echo in ciliary body and shallow ciliary body detachment were found by ultrasound biomicroscopy.Anti-glaucoma surgeries including trabeculotomy, trabeculectomy, non-penetrating deep sclerectomy, valve implantation and cyclocryotherapy were performed in 18 eyes.Eighty percent of the eyes which underwent trabeculectomy developed choroidal detachment after operation.Ten patients (11 eyes) were followed-up for 22 months on average.Intraocular pressure was significantly lower than that before the operation (t=5.3956, P<0.01).Intraocular pressure in all followed-up eyes was controlled at ≤21 mm Hg(1 mm Hg=0.133 kPa).Conclusions The clinical features of Sturge-Weber syndrome-associated glaucoma include facial angiomas, open anterior chamber angle and choroidal hemangioma.Anti-glaucoma surgery can reduce the intraocular pressure effectively.