中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2013年
2期
109-115
,共7页
青光眼,闭角型%眼前半段%体层摄影术,光学相干%解剖学
青光眼,閉角型%眼前半段%體層攝影術,光學相榦%解剖學
청광안,폐각형%안전반단%체층섭영술,광학상간%해부학
Glaucoma,angle-closure%Anterior eye segment%Tomography,optical coherence%Anatomy
目的 利用眼前节相干光断层扫描(AS-OCT)仪定量检测和分析原发性闭角型青光眼(PACG)与正常人的眼前节生物学参数间的差异.方法 回顾性系列病例研究.对2009年12月至2010年12月中山大学中山眼科中心门诊或住院治疗的55例(55只眼)急性PACG患者、63例(63只眼)慢性PACG患者及90例(90只眼)正常人,采用AS-OCT检测其眼前节生物学参数,比较急性PACG、慢性PACG及正常人组间中央前房深度(ACD)、前房宽度(ACW)、前房容积(ACV)、前房角开放距离(AOD)、小梁网与虹膜间面积(TISA)、前房角隐窝面积(ARA)、晶状体厚度(LT)及晶状体矢高(CLR)的差异.采用t检验及单因素方差分析对数据进行统计学分析.结果 急性PACG眼AS-OCT检测参数:ACD(1.81±0.25) mm,ACW(11.30±0.43) mm,AOD 0.039 mm,ARA 0.038 mm2,ACV(72.8±16.04)mm3,TISA 0.017 mm2；慢性PACG的AS-OCT检测参数:ACD(2.02±0.25) mm,ACW(11.49±0.45) mm,AOD 0.042 mm,ARA 0.053 mm2,ACV (83.60±19.49) mm3,TISA0.022 mm2；急慢性PACG的眼前节生物学检测参数均显著小于正常对照眼(P＜0.05),但晶状体参数LT(APACG 5.22±0.38,CPACG 5.06±0.36 mm)和CLR(APACG 1.07±0.26,CPACG 0.94±0.21 mm)显著大于正常对照眼(LT 4.57 ±0.42,CLR 0.39±0.33 mm)(均P＜0.001)；APACG的前房及房角参数小于CPACG(P ＜0.001 ～0.015),晶状体参数LT(P =0.003)和CLR(P ＜0.001)均大于CPACG;APACG发作眼的ACD(1.81±0.25 mm)、AOD(0.039 mm)、TISA(0.017 mm2)和ARA(0.038 mm2)均小于对侧眼(ACD 1.90 ±0.23 mm,AOD 0.005 mm,TISA 0.037 mm2,ARA0.047 mm2) (P ＜0.001 ～0.041),但CLR(1.07 ±0.26 vs.1.01 ±0.23 mm)较对侧眼大(t=1.349,P =0.003),其余参数两者间差异无统计学意义(t=0.574～1.147,P =0.257 ～0.567).结论 PACG的眼前节结构较正常人狭窄,APACG较CPACG有更厚的晶状体厚度及更靠前的晶状体位置,导致房角区结构更为拥挤是构成急性青光眼发作的形态学基础.
目的 利用眼前節相榦光斷層掃描(AS-OCT)儀定量檢測和分析原髮性閉角型青光眼(PACG)與正常人的眼前節生物學參數間的差異.方法 迴顧性繫列病例研究.對2009年12月至2010年12月中山大學中山眼科中心門診或住院治療的55例(55隻眼)急性PACG患者、63例(63隻眼)慢性PACG患者及90例(90隻眼)正常人,採用AS-OCT檢測其眼前節生物學參數,比較急性PACG、慢性PACG及正常人組間中央前房深度(ACD)、前房寬度(ACW)、前房容積(ACV)、前房角開放距離(AOD)、小樑網與虹膜間麵積(TISA)、前房角隱窩麵積(ARA)、晶狀體厚度(LT)及晶狀體矢高(CLR)的差異.採用t檢驗及單因素方差分析對數據進行統計學分析.結果 急性PACG眼AS-OCT檢測參數:ACD(1.81±0.25) mm,ACW(11.30±0.43) mm,AOD 0.039 mm,ARA 0.038 mm2,ACV(72.8±16.04)mm3,TISA 0.017 mm2；慢性PACG的AS-OCT檢測參數:ACD(2.02±0.25) mm,ACW(11.49±0.45) mm,AOD 0.042 mm,ARA 0.053 mm2,ACV (83.60±19.49) mm3,TISA0.022 mm2；急慢性PACG的眼前節生物學檢測參數均顯著小于正常對照眼(P＜0.05),但晶狀體參數LT(APACG 5.22±0.38,CPACG 5.06±0.36 mm)和CLR(APACG 1.07±0.26,CPACG 0.94±0.21 mm)顯著大于正常對照眼(LT 4.57 ±0.42,CLR 0.39±0.33 mm)(均P＜0.001)；APACG的前房及房角參數小于CPACG(P ＜0.001 ～0.015),晶狀體參數LT(P =0.003)和CLR(P ＜0.001)均大于CPACG;APACG髮作眼的ACD(1.81±0.25 mm)、AOD(0.039 mm)、TISA(0.017 mm2)和ARA(0.038 mm2)均小于對側眼(ACD 1.90 ±0.23 mm,AOD 0.005 mm,TISA 0.037 mm2,ARA0.047 mm2) (P ＜0.001 ～0.041),但CLR(1.07 ±0.26 vs.1.01 ±0.23 mm)較對側眼大(t=1.349,P =0.003),其餘參數兩者間差異無統計學意義(t=0.574～1.147,P =0.257 ～0.567).結論 PACG的眼前節結構較正常人狹窄,APACG較CPACG有更厚的晶狀體厚度及更靠前的晶狀體位置,導緻房角區結構更為擁擠是構成急性青光眼髮作的形態學基礎.
목적 이용안전절상간광단층소묘(AS-OCT)의정량검측화분석원발성폐각형청광안(PACG)여정상인적안전절생물학삼수간적차이.방법 회고성계렬병례연구.대2009년12월지2010년12월중산대학중산안과중심문진혹주원치료적55례(55지안)급성PACG환자、63례(63지안)만성PACG환자급90례(90지안)정상인,채용AS-OCT검측기안전절생물학삼수,비교급성PACG、만성PACG급정상인조간중앙전방심도(ACD)、전방관도(ACW)、전방용적(ACV)、전방각개방거리(AOD)、소량망여홍막간면적(TISA)、전방각은와면적(ARA)、정상체후도(LT)급정상체시고(CLR)적차이.채용t검험급단인소방차분석대수거진행통계학분석.결과 급성PACG안AS-OCT검측삼수:ACD(1.81±0.25) mm,ACW(11.30±0.43) mm,AOD 0.039 mm,ARA 0.038 mm2,ACV(72.8±16.04)mm3,TISA 0.017 mm2；만성PACG적AS-OCT검측삼수:ACD(2.02±0.25) mm,ACW(11.49±0.45) mm,AOD 0.042 mm,ARA 0.053 mm2,ACV (83.60±19.49) mm3,TISA0.022 mm2；급만성PACG적안전절생물학검측삼수균현저소우정상대조안(P＜0.05),단정상체삼수LT(APACG 5.22±0.38,CPACG 5.06±0.36 mm)화CLR(APACG 1.07±0.26,CPACG 0.94±0.21 mm)현저대우정상대조안(LT 4.57 ±0.42,CLR 0.39±0.33 mm)(균P＜0.001)；APACG적전방급방각삼수소우CPACG(P ＜0.001 ～0.015),정상체삼수LT(P =0.003)화CLR(P ＜0.001)균대우CPACG;APACG발작안적ACD(1.81±0.25 mm)、AOD(0.039 mm)、TISA(0.017 mm2)화ARA(0.038 mm2)균소우대측안(ACD 1.90 ±0.23 mm,AOD 0.005 mm,TISA 0.037 mm2,ARA0.047 mm2) (P ＜0.001 ～0.041),단CLR(1.07 ±0.26 vs.1.01 ±0.23 mm)교대측안대(t=1.349,P =0.003),기여삼수량자간차이무통계학의의(t=0.574～1.147,P =0.257 ～0.567).결론 PACG적안전절결구교정상인협착,APACG교CPACG유경후적정상체후도급경고전적정상체위치,도치방각구결구경위옹제시구성급성청광안발작적형태학기출.
Objective To quantitatively measure and evaluate the ocularanterior segment parameters in different subtypes of primary angle-closure glaucoma (PACG) using anterior segment optical coherence tomography (AS-OCT).Methods This retrospective study collected Fifty-five subjects (55 eyes) with APACG,63 (63 eyes) with chronic primary angle-closure glaucoma (CPACG) and 90 (90 eyes) normal controls from December 2009 to December 2010 in Zhongshan Ophthalmic Center.ASOCT examinationwas performed on all patients and the anterior segment parameters were recorded including:central anterior chamber depth (ACD),anterior chamber width (ACW),anterior chamber volume (ACV),angle opening distance (AOD),trabecular iris area (TISA),angle recess area (ARA),lens thickness (LT) and crystalline lens rise (CLR).The differences of parameters between APACG,CPACG and normal controls were compared.Results The anterior segment parameters of APACG and CPACG were significantly (P ≤ 0.001) smaller,respectively,than those of normal controls (PACG: ACD 1.81 ± 0.25 mm,ACW 11.30 ±0.43 mm,AOD 0.039 mm,ARA 0.038 mm2,ACV 72.8 ± 16.04 mm3,TISA 0.017 mm2,Mean ± SD,and CPACG: ACD 2.02 ± 0.25,ACW 11.49 ± 0.45,AOD 0.042,ARA 0.053,ACV 83.60 ± 19.49,TISA 0.022 vs.normal: ACD 2.70 ± 0.35,ACW 11.81 ± 0.47,AOD 0.260,ARA 0.197,ACV 148.52 ± 31.89,TISA 0.100).The LT and CLR of PACG were significantly (P ＜ 0.001) larger,respectively,than that of normal controls (LT: APACG 5.22 ± 0.38,CPACG 5.06 ± 0.36 mm,CLR: APACG 1.07 ± 0.26,CPACG 0.94 ±0.21 mm vs.normal: LT 4.57 ± 0.42,CLR 0.39 ± 0.33 mm).Compared with CPACG,the anterior segment parameters of APACG were significantly(P ＜ 0.001-0.015) decreased,but the LT (P =0.003) and CLR were significantly (P ＜ 0.001) increased.Compared with APACG-fellow eyes,the anterior segment parameters of APACG-attacked eyes were significantly (P ＜ 0.001-0.041) decreased (Fellow-eye: ACD 1.90 ±0.23 mm,AOD 0.045 mm,TISA 0.037 mm2,ARA 0.047 mm2 vs.attached-eye: ACD 1.81 ± 0.25,AOD 0.039,TISA 0.017 and ARA 0.038),while CLR was significantly (t =1.349,P =0.043) increased (fellow-eye: 1.01 ± 0.23 mm vs.Attached-eye: 1.07 ± 0.26).There was no significant difference in the other AS-OCT parameters between APACG-attacked eyes and fellow eyes (t =0.574-1.147,P =0.257-0.567).Conclusions Our results indicated a more crowding anterior segment configurationin PACG than that in normal controls and a more anterior located and thicker lensin APACG than that in CPACG,which constitute a morphological basis of acute attack.
