山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (6): 112-117.doi: 10.6040/j.issn.1673-3770.0.2020.008

• • 上一篇    

青光眼患者睫状突位置测量及其临床意义

赵栋栋,翟玉喜,路豪豪,张若晨,高建鲁   

  1. 聊城市人民医院/山东第一医科大学附属聊城医院 眼科, 山东 聊城 252000
  • 发布日期:2021-01-11
  • 通讯作者: 高建鲁. E-mail:drgaojianlu@163.com

The position of ciliary processes in glaucoma patients and their clinical significance

ZHAO Dongdong, ZHAI Yuxi, LU Haohao, ZHANG Ruochen, GAO Jianlu   

  1. Department of Ophthalmology, Liaocheng People's Hospital / Liaocheng Hosptial affiliated to Shandong First Medical University, Liaocheng 252000, Shandong, China
  • Published:2021-01-11

摘要: 目的 探讨原发性青光眼患者及正常人睫状突相对位置及其与眼部其他生物学参数的相关性,为经巩膜睫状体光凝精细化治疗提供研究资料。 方法 招募30例原发性青光眼患者和10例年龄匹配的正常对照人群。将青光眼患者分为3组,分别为原发性急性闭角型青光眼(APACG)组(10例),原发性慢性闭角型青光眼(CPACG)组(10例),原发性开角型青光眼(POAG)组(10例)。所有受试者行眼科A型超声及UBM检查,测量相关参数,包括房角开放距离(AOD)、小梁虹膜夹角(TIA)、小梁睫状突夹角(TCA)、睫状突高度(CBTmax)、睫状突体表投影位置(a)、前方深度(ACD)、晶体厚度(LT)、眼轴长度(AL)等眼前节生物学参数。 结果 对照组和POAG组在房角开放距离、小梁虹膜夹角及小梁睫状突夹角方面均大于APACG组和CPACG组(P<0.05),而对照组与POAG组之间、APACG组与CPACG组之间在房角开放距离、小梁虹膜夹角及小梁睫状突夹角方面的差异没有统计学意义。对照组的睫状突高度大于POAG组、APACG组及CPACG组(P<0.05),但是后三者的睫状突高度之间的差异无统计学意义。与正常对照组相比,APACG组的睫状体相对位置最靠前,CPACG组次之,差异均具有统计学意义;而POAG组与对照组在睫状突相对位置方面的差异无统计学意义。此外,前房深度、晶体厚度、眼轴长度、晶状体相对位置与房角开放距离、小梁虹膜夹角、小梁睫状突夹角以及睫状突体表投影位置之间有高度的相关性(P<0.001)。 结论 与原发性开角型青光眼患者及正常人相比,原发性闭角型青光眼患者睫状突体表投影位置偏前。利用UBM可以对青光眼患者睫状突进行定位,便于精确指导经巩膜睫状突光凝。

关键词: 睫状突位置, 眼前节参数, 超生生物显微镜

Abstract: Objective The study aimed to identify the correlation between the position of ciliary processes and other biological parameters in primary glaucoma patients and control group. These data may provide evidence for precise treatment in transscleral cyclophotocoagulation. Methods A total of thirty primary glaucoma patients and ten age matched healthy controls were enrolled in the study. Glaucoma patients were divided into 3 groups; acute primary angle closure glaucoma(APACG), chronic primary angle closure glaucoma(CPACG)and primary open angle glaucoma(POAG). All subjects underwent the A-scan and ultrasound biomicroscopy examinations. The parameters measured included angle open distance(AOD), trabecular-iris angle(TIA), trabecular-ciliary body process angle(TCA), ciliary body process height(CBTmax), the projected position of the ciliary body(a), anterior chamber depth(ACD), lens thickness(LT), axial length(AL). Results Both control group and POAG group are greater than APACG group and CPACG group in parameters of AOD、TIA and TCA, and the differences are statistically significant. However, the differences in AOD、TIA and TCA between control group and POAGand between APACG and CPACG were not statistically significant. The parameters of CBTmax in the control group was higher than that in the POAG, APACG, and CPACG groups(P<0.05), but the differences among POAG, APACG, and CPACG groups were not statistically significantly. Compared to the control group, the position of ciliary body in the APACG group was the most forward, followed by CPACG group, with statistically significant differences. However, the differences of ciliary body position between the POAG group and the control group were not statistically significantly. Furthermore, the parameters of ACD, LT, AL, and the len relative position were highly correlated with parameters of AOD, TIA, TCA, and the ciliary body projected position(P<0.001). Conclusion Compared with normal and POAG patients, the projected position of the ciliary body in PACG patients is forward. UBM can guide precise transscleral cyclophotocoagulation by positioning the ciliary process in glaucoma patients.

Key words: Ciliary body position, Parameters of anterior segment in eye, Ultrasound biomicroscop

中图分类号: 

  • R775.9
[1] Cedrone C, Mancino R, Cerulli A, et al. Epidemiology of primary glaucoma: prevalence, incidence, and blinding effects[J]. Prog Brain Res, 2008, 173: 3-14. doi:10.1016/s0079-6123(08)01101-1.
[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] Pavlin CJ, Harasiewicz K, Sherar MD, et al. Clinical use of ultrasound biomicroscopy[J]. Ophthalmology, 1991, 98(3): 287-295. doi:10.1016/S0161-6420(91)32298-X.
[4] 刘磊.眼超声生物显微镜诊断学[M]. 1版.北京:北京科学技术出版社,2002:53-54.
[5] Friedman DS, Gazzard G, Foster P, et al. Ultrasonographic biomicroscopy, Scheimpflug photography, and novel provocative tests in contralateral eyes of Chinese patients initially seen with acute angle closure[J]. Arch Ophthalmol, 2003, 121(5): 633-642. doi:10.1001/archopht.121.5.633.
[6] Nongpiur ME, He MG, Amerasinghe N, et al. Lens vault, thickness, and position in Chinese subjects with angle closure[J]. Ophthalmology, 2011, 118(3): 474-479. doi:10.1016/j.ophtha.2010.07.025.
[7] Bezzina AM. Ultrasound biomicroscopy of anterior segment structures in normal and glaucomatous eyes[J]. Am J Ophthalmol, 1992, 114(4): 516-517. doi:10.1016/s0002-9394(14)71878-1.
[8] Sihota R, Rishi K, Srinivasan G, et al. Functional evaluation of an iridotomy in primary angle closure eyes[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2016, 254(6): 1141-1149. doi:10.1007/s00417-016-3298-x.
[9] 丁波, 过贵元, 孙桂珍, 等. UBM检查对原发性闭角型青光眼房角关闭的诊断价值[J]. 现代中西医结合杂志, 2016, 25(3): 304-306. doi:10.3969/j.issn.1008-8849.2016.03.030.
[10] Wang Z, Chung C, Lin J, et al. Quantitative measurements of the ciliary body in eyes with acute primary-angle closure[J]. Invest Ophthalmol Vis Sci, 2016, 57(7): 3299-3305. doi:10.1167/iovs.16-19558.
[11] He N, Wu L, Qi M, et al. Comparison of ciliary body anatomy between American caucasians and ethnic Chinese using ultrasound biomicroscopy[J]. Curr Eye Res, 2016, 41(4): 485-491. doi:10.3109/02713683.2015.1024869.
[12] Hata M, Hirose F, Oishi A, et al. Changes in choroidal thickness and optical axial length accompanying intraocular pressure increase[J]. Jpn J Ophthalmol,2012,56(6): 564-568.
[13] Pillunat LE, B hm A, Fuisting B, et al. Ultrasound biomicroscopy in pigmentary Glaucoma[J]. Ophthalmologe, 2000, 97(4): 268-271. doi:10.1007/s003470050524.
[14] Wang Z, Chung C, Lin J, et al. Quantitative measurements of the ciliary body in eyes with acute primary-angle closure[J]. Invest Ophthalmol Vis Sci, 2016, 57(7): 3299-3305. doi:10.1167/iovs.16-19558.
[15] 陈施言, 吴玲玲. 睫状体解剖特点对原发性房角关闭影响的研究进展[J]. 中华眼科杂志, 2018, 54(9): 716-720. doi:10.3760/cma.j.issn.0412-4081.2018.09.019. CHEN Shiyan, WU Lingling. Effect of anatomic features of ciliary body on primary angle closure[J]. Chinese Journal of Ophthalmology, 2018, 54(9): 716-720. doi:10.3760/cma.j.issn.0412-4081.2018.09.019.
[16] 李璐瑶, 于泳, 刘晨伟,等. 急性原发性闭角型青光眼睫状体位置参数的变化与房角狭窄的相关性研究[J]. 眼科新进展, 2018, 38(6): 552-555. doi:10.13389/j.cnki.rao.2018.0129. LI LuYao, YU Yong, LIU Chenwei, et al. Changes in location parameters of the ciliary body and its correlation with narrow angle in patients with acute primary angle closure Glaucoma[J]. Recent Advances in Ophthalmology, 2018, 38(6): 552-555. doi:10.13389/j.cnki.rao.2018.0129.
[17] 王宁利, 刘文, 陈伟蓉, 等. 超声生物显微镜在我国眼科领域的应用研究[J]. 中华眼科杂志, 2001, 37(6): 471-475. doi:10.3760/j:issn:0412-4081.2001.06.026.
[18] Gaasterland DE, Pollack IP. Initial experience with a new method of laser transscleral cyclophotocoagulation for ciliary ablation in severe Glaucoma[J]. Trans Am Ophthalmol Soc, 1992, 90: 225-243; discussion 243-6.
[19] Brancato R, Carassa RG, Bettin P, et al. Contact transscleral cyclophotocoagulation with diode laser in refractory Glaucoma[J]. Eur J Ophthalmol, 1995, 5(1): 32-39.
[20] Gupta N, Weinreb RN. Diode laser transscleral cyclophotocoagulation[J]. J Glaucoma, 1997, 6(6): 426-429.
[21] 谢瞻, 杨晴, 王飞. 两种不同参数透巩膜睫状体光凝术的疗效及安全性比较[J]. 国际眼科杂志, 2019, 19(10): 1771-1774. doi:10.3980/j.issn.1672-5123.2019.10.32. XIE Zhan, YANG Qing, WANG Fei. Comparison of efficacy and safety of two different parameters of transscleral cyclophotocoagulation[J]. International Eye Science, 2019, 19(10): 1771-1774. doi:10.3980/j.issn.1672-5123.2019.10.32.
[22] Kramp K, Vick HP, Guthoff R. Transscleral diode laser contact cyclophotocoagulation in the treatment of different glaucomas, also as primary surgery[J]. Graefe's Arch Clin Exp Ophthalmol, 2002, 240(9): 698-703. doi:10.1007/s00417-002-0508-5.
[23] Cheung JJC, Li KKW, Tang SWK. Retrospective review on the outcome and safety of transscleral diode laser cyclophotocoagulation in refractory Glaucoma in Chinese patients[J]. Int Ophthalmol, 2019, 39(1): 41-46. doi:10.1007/s10792-017-0782-1.
[24] Yap-Veloso MIR, Simmons RB, Echelman DA, et al. Intraocular pressure control after contact transscleral diode cyclophotocoagulation in eyes with intractable Glaucoma[J]. J Glaucoma, 1998,7(5): 319-328. doi:10.1097/00061198-199810000-00006.
[25] Hauber FA, Scherer WJ. Influence of total energy delivery on success rate after contact diode laser transscleral cyclophotocoagulation: a retrospective case review and meta-analysis[J]. J Glaucoma, 2002, 11(4): 329-333. doi:10.1097/00061198-200208000-00009.
[1] 杨玉焕,张婕,张锦鹏,严宏. Pentacam系统监测散瞳对白内障患者手术前后前节参数的影响[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 5-8.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!