高度近视对原发性开角型青光眼临床诊断的影响

Influence of High Myopia on Diagnosis of Primary Open Angle Glaucoma

目的探讨高度近视对原发性开角型青光眼(prim ary open angle glaucom a,,POAG)各种诊断指标的影响,以便提高POAG的早期诊断率,减少漏诊的发生率。方法对25例38眼高度近视合并POAG的各项指标进行回顾性分析。结果只有8眼(21.05%)表现为典型的青光眼视杯,其余均不典型。弥漫性视神经纤维层缺损18眼(47.37%);9眼(23.68%)不易辨认视神经纤维层。12眼表现为晚期青光眼性视野损害(31.58%)。31眼(81.58%)眼压>21mm Hg。结论高度近视可影响POAG的典型体征包括眼压、眼底及视野。认识高度近视合并POAG时的临床特点,有利于提高临床医师对该病的警觉性及早期诊断水平。

Objective To approach the effect of high myopia（HM） on every clinical parameter of primary open angle glaucoma （POAG） , so as to promote the rate of diagnosis of POAG in early stage. Methods 25 cases （38 eyes） of HM with POAG were analysed retrospectively. Results There were 8 eyes （21.05%） with typical glaucomatous cup, others with atypical glaucomatous cup. Suffusive retinal nerve fibre layer defect（RNFLD） was showed in 18 eyes （47.37%）. Retinal nerve fibre layer could not be distinguished in 9 eyes（23.68% ）. There were 12 eyes （31.58%） with glaucomatous visual field defect of late stage. Intraocular pressure of 31 eyes （81.58%） were 〉 21 mm Hg. Conclusion High myopia can effect the typical sign of POAG including intraocular pressure, fundus and visual field. Recognizing the early clinical characteristics of HM with POAG may help us to improve the proficiency of early detection and diagnosis of HM with POAG.