超声生物显微镜在正常人和部分眼外肌病中的应用

The use of ultrasound biomicroscope in normal eye and some diseases of extraocular muscle

目的 研究超声生物显微镜 (ultrasoundbiomicroscope ,UBM )在眼外肌病中的应用方法。 方法 选择正常人 15只眼 ,共同性斜视患者 12例 ( 2 4只眼 ) ,V型斜视 4例 ( 8只眼 ) ,甲状腺相关性免疫眼眶病 (TRIO) 6例 ( 12只眼 ) ,眼外肌缺如 1例 ( 1只眼 ) ,用UBM测量眼 4条直肌止端的位置及厚度。结果 正常人 15只眼的 4条直肌止端的平均厚度分别为 :内直肌 ( 0 .38± 0 .0 6 )mm ,外直肌 ( 0 .40± 0 .10 )mm ,上直肌 ( 0 .36± 0 .0 8)mm ,下直肌 ( 0 .44± 0 .0 5 )mm。上直肌止端厚度比下直肌减少 ,差异有显著性意义 (P =0 .0 0 2 ) ,双眼各同名直肌止端厚度的差异和内、外直肌止端厚度的差异均无显著性意义 ( P >0 .0 5 )。共同性斜视患者各条眼外肌止端厚度与正常人比较 ,除上直肌厚度增加 ,差异有显著性意义外 (P =0 .0 2 8) ,其余差异均无显著性意义 (P >0 .0 5 )。斜视患者的上直肌比下直肌厚度减少 ,差异有显著性意义 (P =0 .0 0 2 )。在V型斜视患者中证实外直肌止端向下偏移 ,而内直肌止端向上偏移。在TRIO患者中证实眼外肌的肌止端有不同程度的增厚。眼外肌缺如时UBM在眼球前部不能探测到眼外肌或仅能测及极薄的高回声。结论 应用UBM并结合其他影像学方法为临床医生研究斜视发病机制提供了?

Objective To study the methods of application of ultrasound biomicroscope (UBM) in the diagnosis and treatment for the diseases of extraocular muscles.Methods The positions and thickness of 4 rectus muscle insertions were measured by UBM in 15 normal eyes,24 eyes of 12 patients with comitant strabismus,8 eyes of 4 cases with V-pattern and 12 eyes of 6 cases with thyroid-related immune orbito-pathy (TRIO).Results In 15 normal eyes,the average thickness of the insertions of 4 rectus muscles (medial,lateral,superior and inferior) were ( 0.38± 0.06)mm,( 0.40± 0.10)mm,( 0.36± 0.08)mm,( 0.44± 0.05)mm,respectively.There were no significant differences in the thickness of the insertions among the same rectus muscles of the bilateral eyes and between the medial and lateral rectus muscles of one eye (P> 0.05),except the thickness of the insertions of the superior rectus muscle thinner than that of the inferior rectus (P= 0.002).In the comparison between the normal eyes and the comitant strabismus eyes,there were no significant differences in thickness of the insertions of rectus muscles (P> 0.05),except the thickening of the superior rectus muscle in the comitant strabismus eye (P= 0.028).In the patients with strabismus,the thickness of the insertion of the superior rectus was thinner than that of the inferior rectus (P= 0.002).It was confirmed that the position of the lateral rectus muscle was deviated downward and the medial rectus muscle was deviated upward in the V pattern strabismus.It was demonstrated that the rectus insertions were increased in thickness in various degrees in TRIO.In cases with the absence of extraocular muscle,only could a very thin reflective echo be detected at the ocular anterior segment by UBM.Conclusions The application of UBM with other images methods may provide more ways for clinicians to study the pathogenesis of strabismus,and help an operator to design strabismus surgery reasonably.