青光眼睫状体炎综合征超声生物显微镜图像特征

Ultrasound Biomicroscopic Characteristics of Posner-Schlossman Syndrome

【目的】研究青光眼睫状体炎综合征患者超声生物显微镜(UBM)图像特征,从而对其发病机制作初步的探讨。【方法】收集22例青光眼睫状体炎综合征患者,在炎症活动期作双眼UBM检查,检查内容包括前房、房角、后房、睫状体、玻璃体基底部,并将检查结果与临床表现相联系。【结果】22例患者发病时眼压[平均(40.6±13.3)mmHg],24～62mmHg,裂隙灯显微镜检查均可见角膜背羊脂状沉着物,4眼(18.2%)有房水混浊。除1例对侧眼UBM表现正常外,21例双眼UBM图像均显示为轻重不等的前部及中间葡萄膜炎的表现,而眼压升高眼炎症渗出往往较对侧眼多,房水混浊和睫状体水肿多见于眼压升高眼。【结论】UBM可以显示青光眼睫状体炎综合征中睫状体炎症的情况,大部分单眼眼压升高者对侧眼也有睫状体炎改变,表明青光眼鄄睫状体炎综合征可能是双眼前部和中间葡萄膜炎性疾病,炎症较重眼可以引起小梁网炎症或房水分泌增多从而导致眼压升高。

To investigate the ultrasound biomicroscopic (UBM) characteristics of Posner-Schlossman syndrome and its pathogenesis. Twenty-two patients were enrolled in this study. UBM examinations were performed for their eyes in anterior chamber and its angle, posterior chamber, ciliary body, and base part of hyaloid body at the active stage of the inflammation. The findings were compared with the clinical manifestations.The intraocular pressure (IOP) was (40.6±13.3) mmHg(24-62) mmHg, when the disease was onset. Keratic precipitates (KP) were found in all 22 diseased eyes and Tyndall's sign in anterior chamber was seen in only 4 eyes (18.2%) by slit lamp microscope. Bilateral anterior and intermediate uveitis was detected by UBM in all cases except one showing normal image in his contralateral eye. And the exudation in the glaucomatous eyes was usually more severe than that in the contralateral eyes. Aqueous turbidity and ciliary body edema were more frequently found in the glaucomatous eyes.[Conclusion] Inflammation of ciliary body in Posner-Schlossman syndrome can be demonstrated by UBM. The majority of the patients with unilaterally increased IOP also showed cyclitis in the contralateral eye, suggesting Posner-Schlossman syndrome may be a kind of bilateral anterior and intermediate uveitis. There may be trabeculitis or increased aqueous production in the eye with more severe inflammation which can lead to increased IOP.