山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (6): 108-111.doi: 10.6040/j.issn.1673-3770.0.2019.579

• • 上一篇    

屏气对非接触眼压计测量值的影响

宋丽华1,陶远2,崔凤华2,郭媛媛2,王红3   

  1. 1. 东营市东营区人民医院 眼科, 山东 东营 257000;
    2. 济南市第二人民医院 眼科, 山东 济南 250022;
    3. 山东大学齐鲁医院 眼科, 山东 济南 250012
  • 发布日期:2021-01-11
  • 通讯作者: 王红. E-mail:Dr.wanghong@163.com

Influence of breath holding on intraocular pressure measured by non-contact tonometry

SONG Lihua1, TAO Yuan2,CUI Fenghua2, GUO Yuanyuan2, WANG Hong3   

  1. 1. Department of Ophthalmology, People's Hospital of Dongying District, Dongying 257000, Shandong, China;
    2. Department of Ophthalmology, Second People's Hospital of Ji'nan, Jinan 250022, Shandong, China;
    3. Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2021-01-11

摘要: 目的 探讨屏气对非接触眼压计测量结果的影响。 方法 对非青光眼患者60例(60眼)分别于常规状态,屏气10 s后及屏气30 s后行非接触眼压计测量眼压,分析不同状态下的眼压测量值差异以及其相关关系。 结果 受试者60眼测量结果常规平静呼吸状态下60眼眼压均处于正常眼压区间,屏气10 s后眼压测量值有3眼高于正常值,无低于正常值者,屏气30 s后眼压测量值有22眼高于正常值,无低于正常值者。屏气10 s后与正常状态测量眼压值呈升高状态,差异有统计学意义(P<0.05),屏气30 s后与屏气10 s后及常规平静呼吸状态下测量眼压呈现升高状态,差异有统计学意义(P<0.05)。非接触眼压计测量值与屏气时间存在相关关系,屏气后测量值变化与屏气时间也存在相关关系,即屏气时间越久,眼压越高。而屏气后测量值变化与患者年龄、性别、角膜厚度、角膜曲率无相关关系。 结论 使用非接触眼压计测量眼压时,应嘱患者避免屏气,以免使测量值受到干扰,如果因为紧张等因素患者无法完全配合,那么也应当在屏气动作10 s之内完成测量眼压,此时的影响要显著低于更长时间屏气对眼压测量值的干扰。

关键词: 眼压, 屏气, 非接触眼压计

Abstract: Objective To explore the effect of breath holding on intraocular pressure measured by non-contact tonometry. Methods The intraocular pressure of 60 eyes of 60 patients were measured by non-contact tonometry, in the breathing state and after breath holding for 10 and 30 s. Further, the difference and correlation of the measured intraocular pressure among different breathing states were analyzed. Results In the calm breathing state, the intraocular pressure of all 60 eyes was in the normal range. After breath holding for 10 and 30 s, the intraocular pressure of three 22 eyes exceeded the normal range, respectively. The intraocular pressure was significantly higher after breath holding for 10 s than that in the calm breathing state(P<0.05)and after breath holding for 30 s than that after breath holding for 10 s or in the calm breathing state(P<0.05). There was a correlation between the intraocular pressure measured by non-contact tonometry and the breath holding time and between changes in the intraocular pressure measured after breath holding and the breath holding time. The longer the breath holding time, the higher was the intraocular pressure. There was no correlation between changes in the intraocular pressure and the patients' age, sex, corneal thickness, or corneal curvature. Conclusion When measuring intraocular pressure by non-contact tonometry, patients should be advised to avoid breath holding and interferences. For patients with poor breath-hold performance due to stress or other factors, the intraocular pressure should be measured within 10 s of breath holding. The effect of breath-holding time of 10 s was significantly lower than that of longer breath-holding times on intraocular pressure measurements.

Key words: Intraocular pressure, Breath holding, Non-contact tonometer

中图分类号: 

  • R775.9
[1] 崔浩,王宁利. 眼科学[M]. 2版. 北京: 人民卫生出版社, 2014: 163.
[2] 中华医学会眼科学分会青光眼学组. 中国原发性闭角型青光眼诊治方案专家共识(2019年)[J]. 中华眼科杂志, 2019, 55(5): 325-328. doi:10.3760/cma.j.issn.0412-4081.2019.05.002.
[3] 葛玲, 王霜玲. 青少年非接触性眼压测量值的影响因素分析[J]. 眼视光学杂志, 2008, 10(5): 342-345. doi:10.3760/cma.j.issn.1674-845X.2008.05.007. GE Ling, WANG Shuangling. The factors influencing the intraocular pressure measurements obtained with non-contact tonometer in juveniles[J]. Chinese Journal of Optometry & Ophthalmology, 2008, 10(5): 342-345. doi:10.3760/cma.j.issn.1674-845X.2008.05.007.
[4] 李红锋, 欧阳君, 屈晓勇. Goldmann眼压计与非接触眼压计测量青光眼患者眼压的对比分析[J]. 国际眼科杂志, 2015, 15(1): 144-145. doi:10.3980/j.issn.1672-5123.2015.1.43. LI Hongfeng, OUYANG Jun, QU Xiaoyong. Comparison of two methods of tonometry in Glaucoma patients: Goldmann applanation tonometer and non-contact tonometer[J]. International Eye Science, 2015, 15(1): 144-145. doi:10.3980/j.issn.1672-5123.2015.1.43.
[5] 秦丽敏, 刘铁城, 戴英丽,等. 体位变化对正常眼与青光眼眼压的影响[J]. 解放军医学院学报, 2014, 35(2): 124-126, 145. doi:10.3969/j.issn.2095-5227.2014.02.007. QIN Limin, LIU Tiecheng, DAI Yingli, et al. Effect of posture on intraocular pressure in normal and Glaucoma patients[J]. Academic Journal of Chinese Pla Medical School, 2014, 35(2): 124-126, 145. doi:10.3969/j.issn.2095-5227.2014.02.007.
[6] 史策, 夏丽坤. 角膜屈光术后眼压测量方法及影响因素的研究进展[J]. 中华眼视光学与视觉科学杂志, 2019, 21(4): 316-320. doi:10.3760/cma.j.issn.1674-845X.2019.04.014. SHI Ce, XIA Likun. Research progress on intraocular pressure measurements and influencing factors after corneal refractive surgery[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2019, 21(4): 316-320. doi:10.3760/cma.j.issn.1674-845X.2019.04.014.
[7] 张青蔚, 翟长斌, 张晶,等. 两种非接触眼压计临床应用效果及其关联因素的临床研究[J]. 中华眼科医学杂志(电子版), 2019, 9(3): 140-145. doi:10.3877/cma.j.issn.2095-2007.2019.03.003. ZHANG Qingwei, ZHAI Changbin, ZHANG Jing, et al. Comparisons on the correlation and agreement between two non-contact tonometers[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 9(3): 140-145. doi:10.3877/cma.j.issn.2095-2007.2019.03.003.
[8] Vera J, Perez-Castilla A, Redondo B, et al. Influence of the breathing pattern during resistance training on intraocular pressure[J]. Eur J Sport Sci, 2020, 20(2): 157-165. doi:10.1080/17461391.2019.1617354.
[9] Zhang Z, Wang XL, Jonas JB, et al. Valsalva manoeuver, intra-ocular pressure, cerebrospinal fluid pressure, optic disc topography: Beijing intracranial and intra-ocular pressure study[J]. Acta Ophthalmol, 2014, 92(6): e475-e480. doi:10.1111/aos.12263.
[10] 张秀兰. 青光眼研究的机遇与挑战[J]. 中华实验眼科杂志, 2019, 37(6): 401-404. doi:10.3760/cma.j.issn.2095-0160.2019.06.001. ZHANG Xiulan. Opportunities and challenges for Glaucomaresearch[J]. Chinese Journal of Experimental Ophthalmology, 2019, 37(6): 401-404. doi:10.3760/cma.j.issn.2095-0160.2019.06.001.
[11] 王瑛, 樊宁, 王希振, 等. 非接触式眼压计与Goldmann压平眼压计测量眼压值一致性的Meta分析[J]. 中华实验眼科杂志, 2017, 35(4): 339-343. doi:10.3760/cma.j.issn.2095-0160.2017.04.011. WANG Ying, FAN Ning, WANG Xizhen, et al. Agreement of intraocular pressure measured by noncontact tonometer and Goldmann applanation tonometer: a Meta-analysis[J]. Chinese Journal of Experimental Ophthalmology, 2017, 35(4): 339-343. doi:10.3760/cma.j.issn.2095-0160.2017.04.011.
[12] 李红霞, 樊冬生. 高度近视屈光度、角膜厚度、眼压和眼轴的相关性[J]. 中华眼外伤职业眼病杂志, 2019, 41(5): 369-372. doi:10.3760/cma.j.issn.2095-1477.2019.05.011. LI Hongxia, FAN Dongsheng. Study on the relationship of diopter, central corneal thickness, intraocular pressure and axial length in eyes with high myopia[J]. Chinese Journal of Ocular Trauma and Occupational Eye Disease, 2019, 41(5): 369-372. doi:10.3760/cma.j.issn.2095-1477.2019.05.011.
[13] 李白冰. 角膜生物力学特性与青光眼的关系[J]. 中华实验眼科杂志, 2019, 37(2): 139-143. doi:10.3760/cma.j.issn.2095-0160.2019.02.013. LI Baibing. The associations between corneal biomechanical parameters and Glaucoma[J]. Chinese Journal of Experimental Ophthalmology, 2019, 37(2): 139-143. doi:10.3760/cma.j.issn.2095-0160.2019.02.013.
[14] 叶瑞珍, 许敏, 李学喜, 等. 3~15岁儿童非接触眼压相关因素分析[J]. 中国实用眼科杂志, 2015, 33(7): 740-742. doi:10.3760/cma.j.issn.1006-4443.2015.07.009. YE Ruizhen, XU Min, LI Xuexi, et al. Intraocular pressure and its correlated factors in schoolchildren aged 3 to 15 years[J]. Chinese Journal of Practical Ophthalmology, 2015, 33(7): 740-742. doi:10.3760/cma.j.issn.1006-4443.2015.07.009.
[15] Friberg TR, Sanborn G, Weinreb RN. Intraocular and episcleral venous pressure increase during inverted posture[J]. Am J Ophthalmol, 1987, 103(4): 523-526. doi:10.1016/s0002-9394(14)74275-8.
[16] 王雪梅, 王素珍, 耿桂启. 改良Valsalva动作对颈内静脉充盈度的影响[J]. 复旦学报(医学版), 2015, 42(3): 424-425. doi:10.3969/j.issn.1672-8467.2015.03.025.
[17] Brown JS, Flitcroft DI, Ying GS, et al. In vivo human choroidal thickness measurements: evidence for diurnal fluctuations[J]. Invest Ophthalmol Vis Sci, 2009, 50(1): 5-12.doi:10.1167/iovs.08-1779.
[18] Holló G. Valsalva maneuver and peripapillary OCT angiography vessel density[J]. J Glaucoma, 2018, 27(7): e133-e136. doi:10.1097/ijg.0000000000000983.
[19] Sihota R, Dada T, Gupta V, et al. Narrowing of the anterior chamber angle during Valsalva maneuver: a possible mechanism for angle closure[J]. Eur J Ophthalmol, 2006, 16(1): 81-91. doi:10.1177/112067210601600114.
[20] Palamar M, Dag MY, Yagci A. The effects of Valsalva manoeuvre on Ocular Response Analyzer measurements[J]. Clin Exp Optom, 2015, 98(5): 447-450. doi:10.1111/cxo.12303.
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