中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2013年
3期
249-253
,共5页
李梅%乔荣华%潘英姿%才瑜%方圆%王捷
李梅%喬榮華%潘英姿%纔瑜%方圓%王捷
리매%교영화%반영자%재유%방원%왕첩
巩膜厚度%中央角膜厚度%眼轴长度%超声生物显微镜%青光眼
鞏膜厚度%中央角膜厚度%眼軸長度%超聲生物顯微鏡%青光眼
공막후도%중앙각막후도%안축장도%초성생물현미경%청광안
Scleral thickness%Central corneal thickness%Axial length%Ultrasound biomicroscopy%Glaucoma
背景 巩膜厚度与青光眼关系密切,不同类型青光眼的临床特点不同,其巩膜厚度可能存在一定差异,但目前的相关研究结果有一定争议. 目的 研究各种类型的青光眼患者前部巩膜厚度(AST)、中央角膜厚度(CCT)和眼轴长度间的关系.方法 采用回顾性描述性研究设计.纳入2009年3月至2010年11月就诊于北京大学第一医院眼科门诊的连续患者160例,其中原发性开角型青光眼(POAG) 34例34眼、正常眼压性青光眼(NTG) 37例37眼、原发性闭角型青光眼(PACG) 35例35眼及高眼压症(OHT) 17例17眼,对照组为早期白内障患者37例37眼.分别采用超声角膜测厚仪、眼部A型超声测量仪测量各组患者的CCT、AST及眼轴长度,采用超声生物显微镜(UBM)测量系统测量颞侧巩膜突后2 mm处的巩膜厚度.采用协方差分析法和SNK-q检验对各组的测量参数进行比较,用Pearson积矩相关分析和线性回归法对上述各组患者AST、CCT及眼轴长度间的关系进行分析. 结果 PACG组、POAG组、NTG组及OHT组的CCT值分别为(535.54±5.20)、(550.47±5.28)、(521.61±5.07)和(575.75±7.76) μm,对照组为(535.06±5.06) μm,5个组间的总体差异有统计学意义(F=9.560,P=0.000),其中OHT组的CCT值较其他各组均增加,差异均有统计学意义(均P=0.000),POAG组的CCT值较PACG、NTG及对照组均增加(P=0.046、0.000、0.040),NTG组及PACG组与对照组间CCT值的差异均无统计学意义(P=0.950、0.060).PACG组、POAG组、NTG组及OHT组AST值分别为(0.593±0.050)、(0.600±0.050)、(0.592士0.060)、(0.610±0.060) mm,对照组为(0.604±0.060) mm,5个组间AST的差异无统计学意义(F=0.700,P=0.590).PACG组的眼轴长度短于其他各组,差异均有统计学意义(均P=0.000).POAG组和NTG组患者的CCT与AST呈正相关(POAG:r=0.445,P=0.008;NTG:r=0.400,P=0.014). 结论 不同类型青光眼患者的CCT不同,AST无明显不同；POAG患者及NTG患者的CCT与AST变化间可能存在一定的正相关.
揹景 鞏膜厚度與青光眼關繫密切,不同類型青光眼的臨床特點不同,其鞏膜厚度可能存在一定差異,但目前的相關研究結果有一定爭議. 目的 研究各種類型的青光眼患者前部鞏膜厚度(AST)、中央角膜厚度(CCT)和眼軸長度間的關繫.方法 採用迴顧性描述性研究設計.納入2009年3月至2010年11月就診于北京大學第一醫院眼科門診的連續患者160例,其中原髮性開角型青光眼(POAG) 34例34眼、正常眼壓性青光眼(NTG) 37例37眼、原髮性閉角型青光眼(PACG) 35例35眼及高眼壓癥(OHT) 17例17眼,對照組為早期白內障患者37例37眼.分彆採用超聲角膜測厚儀、眼部A型超聲測量儀測量各組患者的CCT、AST及眼軸長度,採用超聲生物顯微鏡(UBM)測量繫統測量顳側鞏膜突後2 mm處的鞏膜厚度.採用協方差分析法和SNK-q檢驗對各組的測量參數進行比較,用Pearson積矩相關分析和線性迴歸法對上述各組患者AST、CCT及眼軸長度間的關繫進行分析. 結果 PACG組、POAG組、NTG組及OHT組的CCT值分彆為(535.54±5.20)、(550.47±5.28)、(521.61±5.07)和(575.75±7.76) μm,對照組為(535.06±5.06) μm,5箇組間的總體差異有統計學意義(F=9.560,P=0.000),其中OHT組的CCT值較其他各組均增加,差異均有統計學意義(均P=0.000),POAG組的CCT值較PACG、NTG及對照組均增加(P=0.046、0.000、0.040),NTG組及PACG組與對照組間CCT值的差異均無統計學意義(P=0.950、0.060).PACG組、POAG組、NTG組及OHT組AST值分彆為(0.593±0.050)、(0.600±0.050)、(0.592士0.060)、(0.610±0.060) mm,對照組為(0.604±0.060) mm,5箇組間AST的差異無統計學意義(F=0.700,P=0.590).PACG組的眼軸長度短于其他各組,差異均有統計學意義(均P=0.000).POAG組和NTG組患者的CCT與AST呈正相關(POAG:r=0.445,P=0.008;NTG:r=0.400,P=0.014). 結論 不同類型青光眼患者的CCT不同,AST無明顯不同；POAG患者及NTG患者的CCT與AST變化間可能存在一定的正相關.
배경 공막후도여청광안관계밀절,불동류형청광안적림상특점불동,기공막후도가능존재일정차이,단목전적상관연구결과유일정쟁의. 목적 연구각충류형적청광안환자전부공막후도(AST)、중앙각막후도(CCT)화안축장도간적관계.방법 채용회고성묘술성연구설계.납입2009년3월지2010년11월취진우북경대학제일의원안과문진적련속환자160례,기중원발성개각형청광안(POAG) 34례34안、정상안압성청광안(NTG) 37례37안、원발성폐각형청광안(PACG) 35례35안급고안압증(OHT) 17례17안,대조조위조기백내장환자37례37안.분별채용초성각막측후의、안부A형초성측량의측량각조환자적CCT、AST급안축장도,채용초성생물현미경(UBM)측량계통측량섭측공막돌후2 mm처적공막후도.채용협방차분석법화SNK-q검험대각조적측량삼수진행비교,용Pearson적구상관분석화선성회귀법대상술각조환자AST、CCT급안축장도간적관계진행분석. 결과 PACG조、POAG조、NTG조급OHT조적CCT치분별위(535.54±5.20)、(550.47±5.28)、(521.61±5.07)화(575.75±7.76) μm,대조조위(535.06±5.06) μm,5개조간적총체차이유통계학의의(F=9.560,P=0.000),기중OHT조적CCT치교기타각조균증가,차이균유통계학의의(균P=0.000),POAG조적CCT치교PACG、NTG급대조조균증가(P=0.046、0.000、0.040),NTG조급PACG조여대조조간CCT치적차이균무통계학의의(P=0.950、0.060).PACG조、POAG조、NTG조급OHT조AST치분별위(0.593±0.050)、(0.600±0.050)、(0.592사0.060)、(0.610±0.060) mm,대조조위(0.604±0.060) mm,5개조간AST적차이무통계학의의(F=0.700,P=0.590).PACG조적안축장도단우기타각조,차이균유통계학의의(균P=0.000).POAG조화NTG조환자적CCT여AST정정상관(POAG:r=0.445,P=0.008;NTG:r=0.400,P=0.014). 결론 불동류형청광안환자적CCT불동,AST무명현불동；POAG환자급NTG환자적CCT여AST변화간가능존재일정적정상관.
Background A close relation between sclera thickness and glaucoma has been determined.Clinical features vary in different types of glaucoma patients,which hints that the scleral thickness might be distinct among these patients.Objective The aim of this study was to investigate the differences of central corneal thickness(CCT),anterior scleral thickness(AST) and axial length in glaucomatous patients.Methods This study was approved by the Ethic Commission of First Hospital of Peking University.Written informed consent was obtained from each individual prior to the examination.A retrospective descriptive study was designed.One hundred and sixty consecutive patients were recruited from March,2009 to November,2010 in First Hospital of Peking University,including 35 eyes with primary angle closure glaucoma(PACG) (35 cases),34 eyes with primary open-angle glaucoma POAG) (34 cases),37 eyes with normal tension glaucoma(NTG) (37 cases)and 17 eyes of ocular hypertension OHT) (17 cases).Thirty-seven eyes of 37 subjects with incipient cataract served as the control group.CCT and ocular axial length were measured with ultrasonic pachymeter and A-scan unit,respectively,and AST at the temporal quadrant 2 mm posterior to the scleral spur was measured by ultrasonic biomicroscopy (UBM).The measuring parameters among different groups were compared by analysis of covariance,and the correlations of AST,CCT with ocular axial length were analyzed using Pearson linear correlation and linear regression.The differences and correlation of CCT,AST and AL among five groups were analyzed.Results The CCT values in PACG group,POAG group,NTG group,OHT group and control group were (535.54 ± 5.20),(550.47 ± 5.28),(521.61 ± 5.07),(575.75 ± 7.76) and (535.06± 5.06) μm,respectively,showing a significant difference among them (F =9.560,P =0.000),and the CCT value of OHT group was increased in comparison with POAG group,PACG group,NTG group and control group(all P =0.000).The CCT of the POAG group was thicker than that in the PACG group,NTG group and control group(P=0.046,0.000,0.040).No significant difference was found in CCT among NTG group,PACG group and control group(P=0.950,0.060).The AST values of PACG group,POAG group,NTG group,OHT group and control group were(0.593±0.050),(0.600±0.050),(0.592-±0.060),(0.610-±0.060) and(0.604±0.060) mm,respectively,showing a insignificant difference among them (F =0.700,P =0.590).The axial length in the patients with PACG was shorter than that of the POAG group,NTG group,OHT group and control group (all P =0.000).The Pearson correlation analysis showed significantly positive correlation between CCT and AST in POAG group and NTG group(r=0.445,P=0.008;r=0.400,P=0.014).Conclusions This study confirms that there is dissimilarity in CCT but not in AST among different types of glaucomatous patients.The changes of CCT and AST are consistent in POAG and NTG patients.
