CAJ | 학술논문

目的比较降眼压前后原发性慢性闭角型青光眼(PACG)与原发性开角型青光眼(POAG)的视盘结构改变,了解两者间筛板顺应性是否存在差异.设计前瞻性对比研究.研究对象PACG 36例49眼和POAG 35例49眼.方法眼压降低前全部患者进行海德堡视网膜断层扫描(HRT-Ⅱ)及Humphrey静态视野检查.根据病情选择手术、激光或药物治疗,使眼压降至正常范嗣.眼压降低后1个月重复HRT检查和视野检查.比较POAG和PACG眼压降低前后HRT视盘参数的变化,采用多元线性逐步回归法校正治疗前眼压、眼压降低幅度、年龄、杯盘比等因素影响.主要指标眼压降低前后HRT视杯面积、盘沿面积、视杯容积、平均视杯深度的差值.结果 PACG及POAG组的视杯面积、视杯容积、平均视杯深度等指标在眼压降低后均明显降低(P<0.05),盘沿面积在眼压降低后均明显增加(P<0.05).视杯面积、盘沿面积、视杯容积、平均视杯深度在眼压降低前后的差值两组间无显著性差异(P>0.05).眼压降低前后这4个参数的差值与眼压降低幅度及杯盘比有关(P<0.05);与年龄及治疗前眼压无关(P>0.05).结论眼压降低后青光眼视盘形态结构有一定回复;但在PACG和POAG间,视盘形态结构回复的程度无明显差异,PACG和POAG的筛板顺应性可能无差异.
목적 비교강안압전후원발성만성폐각형청광안(PACG)여원발성개각형청광안(POAG)적시반결구개변,료해량자간사판순응성시부존재차이.설계전첨성대비연구.연구대상PACG 36례49안화POAG 35례49안.방법 안압강저전전부환자진행해덕보시망막단층소묘(HRT-Ⅱ)급Humphrey정태시야검사.근거병정선택수술、격광혹약물치료,사안압강지정상범사.안압강저후1개월중복HRT검사화시야검사.비교POAG화PACG안압강저전후HRT시반삼수적변화,채용다원선성축보회귀법교정치료전안압、안압강저폭도、년령、배반비등인소영향.주요지표안압강저전후HRT시배면적、반연면적、시배용적、평균시배심도적차치.결과 PACG급POAG조적시배면적、시배용적、평균시배심도등지표재안압강저후균명현강저(P<0.05),반연면적재안압강저후균명현증가(P<0.05).시배면적、반연면적、시배용적、평균시배심도재안압강저전후적차치량조간무현저성차이(P>0.05).안압강저전후저4개삼수적차치여안압강저폭도급배반비유관(P<0.05);여년령급치료전안압무관(P>0.05).결론 안압강저후청광안시반형태결구유일정회복;단재PACG화POAG간,시반형태결구회복적정도무명현차이,PACG화POAG적사판순응성가능무차이.
Objective To compare the changes in optic disc parameters after intraocular pressure (lOP) reduction between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG) eyes, and to determine if there is a difference of lamina eribrosa compliance between POAG and PACG. Design Prospective comparative study. Participants 36 PACG (49 eyes) and 35 POAG (49 eyes). Methods Patients underwent Heidelberg Retina Tomography (HRT Ⅱ) and Humphrey visual field test before IOP reduction. HRT and Humphrey visual field test were repeated one month after the IOP was reduced by laser, anti-glaucomatous medications or surgery treatment. Factors that affected the change in IOP were assessed including age, pretreatment IOP, IOP reduction, initial cup: disc ratio and diagnosis (POAG/PACG). Main outcome measures Changes of HRT parameters including cup area, mean cup depth, cup volume, and rim area after IOP reduction. Results The cup area, mean cup depth and cup volume decreased, and rim area in-creased significantly when the IOP was reduced (P<0.05), but there were no significant differences in the changes between PACG and POAG patients (P>0.05). Changes of these four HRT parameters were related to the amount of IOP reduction and the baseline ratio of cup to disc(P>0.05), but not related to age and pre-treatment IOP (P<0.05). Conclusions The cup became smaller and the rim area in-creased after IOP lowering with treatment in both POAG and PACG, and the magnitude of the change was similar in both groups. The lamina cribrosa compliance may not be different between POAG and PACG. (Ophthalmol CHN, 2009, 18: 264-269)