高眼压症的角膜厚度分析与临床处理

The analysis of corneal central thickness in ocular hypertension and its clinical significance

目的评价高眼压症中角膜厚度的作用及其临床处理。方法对39例(75眼)高眼压症者进行回顾性研究,包括CCT及IOP测量,视野、房角镜、裂隙灯及眼底检查。根据CCT值对眼压进行校正,并对校正眼压>21mmHg者行药物干预,眼压降低25%～30%为靶眼压。结果CCT最厚为684.6μm,最薄为532.5μm,均值为588μm。眼压值最高为27.4mmHg,最低为22.3mmHg,均值为23.5mmHg。校正后眼压最大值为24.3mmHg,最小为17.6mmHg,均值为20.1mmHg。校正后眼压均低于校正前。校正前后眼压变化值≥3mmHg。对校正后眼压>21mmHg的31眼行药物干预后眼压下降达到靶眼压,其眼压值为14.21～17.96mmHg。随访时间1～4年。失去随访7例(12眼),2年后有2例(4眼)出现视野鼻侧阶梯状缺损。结论对高眼压症者应测量其CCT并校正眼压,对校正眼压大于21mmHg者须行药物干预,使其控制在靶眼压水平并密切随访。

Objective To analyze the effect of corneal central thickness（CCT） in ocular hypertension and its clinical managements. Methods 39 cases （75 eyes） of ocular hypertension were investigated. The examinations included CCT. IOP and visual field measuring, gonioscopy, slit-lamp and fundus checking up. The IOPs were corrected according the CCT readings and the correcting IOPs that above 21mmHg were managed by medicines for decreasing the IOPs. It was the target IOP that was decreased 25% -30%. Results The thickest CCT was 684.6μm and thinnest was 532-5μm, the average was 588μm. The highest IOP was 27.4 mmHg and lowest was 22.3mmHg, the average was 23.5mmHg. The highest correcting IOP was 24.3mmHg and lowest was 17.6mmHg, the average was 20. 1mmHg. All the correcting IOP were low than non-correcting. The change was ≥ 3 mmHg during pre and post-correctively. The correcting IOPs of 3 leyes that were above 21mmHg have been decreased to target after giving medicine treatment. The IOPs were 14.21 mmHg - 17.96 mmHg. The time of following up were 1-4 years. There were 7 cases（12 eyes） lost following up and 2 cases（4 eyes） appeared nasal step defective visual field in 2 years. Conclusion The CCT must be measured for the persons who have ocular hypertension and their IOPs must be corrected, too. The correcting IOPs that above 21mmHg must be managed by medicine to control them in the level of target IOPs. It is important that closing follow up.