论文部分内容阅读
目的观察急性闭角型青光眼视网膜神经纤维层(RNFL)厚度在发病后不同时间段的变化特征。设计前瞻性病例系列。研究对象2007-2009年就诊的急性闭角型青光眼单眼发病者35例35眼。方法入选患者经过临床治疗后眼压控制正常,利用相干光断层扫描(Stratus OCT3)技术在发病后2周、3个月、6个月和12个月进行双眼RNFL扫描,并对发作眼压与RNFL厚度进行相关性分析。主要指标RNFL厚度。结果发作后2周发作眼RNFL明显较对侧眼增厚,分别为(141.85±25.22)μm、(112.95±10.54)μm(P=0.000);第3个月时两眼没有差异,RNFL厚度分别为(112.38±16.15)μm、(112.26±16.04)μm(P=0.966);6个月时发作眼较对侧眼稍薄,分别为(101.22±14.06)μm、(108.65±15.03)μm(P=0.021);12个月时发作眼明显较对侧眼薄,分别为(92.29±13.05)μm、(106.77±14.90)μm(P=0.000)。发作眼在观察期内RNFL进行性变薄(F=51.48,P=0.000),而对侧眼则无显著改变(F=1.599,P=0.192)。早期(3个月内)眼压越高,RNFL越厚(r=0.692,P=0.000),但在12个月RNFL的变化中,发作眼压与之无显著相关(r=0.242,P=0.081)。结论急性闭角型青光眼发作眼缓解后RNFL仍进行性丢失,发作时眼压的高低并不是决定最终病变的惟一因素;对侧眼在12个月的观察中也存在一定程度RNFL损害,其临床意义有待进一步研究。
Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness in acute angle-closure glaucoma at different time points after onset. Design prospective case series. Participants 35 patients (35 eyes) with unilateral monocular acute angle-closure glaucoma treated in 2007-2009. Methods The patients undergoing ophthalmic surgery received normal intraocular pressure (IOP) control after they were clinically treated. RNFL scanning was performed at 2, 3, 6 and 12 months after onset of disease using coherent light tomography (Stratus OCT3) technique. The intraocular pressure RNFL thickness correlation analysis. The main indicator RNFL thickness. Results The RNFL of the onset eye was thicker (141.85 ± 25.22 μm) and (112.95 ± 10.54) μm (P = 0.000) than the contralateral eye at 2 weeks after the onset of attack, respectively. There was no difference between the two eyes at the third month and RNFL thickness (112.38 ± 16.15) μm and (112.26 ± 16.04) μm, respectively (P = 0.966). At 6 months, the onset eyes were slightly thinner than the contralateral eyes (101.22 ± 14.06 μm, (108.65 ± 15.03) μm, P = 0.021). The onset eye was significantly thinner at 12 months (92.29 ± 13.05) μm and (106.77 ± 14.90) μm, respectively (P = 0.000). RNFL progressively thinned during the observation period (F = 51.48, P = 0.000), while the contralateral eye showed no significant change (F = 1.599, P = 0.192). The higher the intraocular pressure in the early stage (3 months), the thicker the RNFL (r = 0.692, P = 0.000). However, there was no significant correlation between the intraocular pressure and RNFL at 12 months (r = 0.242, P = 0.081). CONCLUSION: The RNFL is still lost after the onset of acute angle-closure glaucoma. The intraocular pressure is not the only factor that determines the final lesion at the time of onset. The contralateral eye also has a certain level of RNFL impairment in 12-month observation. The meaning needs further study.