先天性虹膜囊肿10例临床分析

Clinical analysis of primary iris cyst in 10 cases

目的:探讨先天性虹膜囊肿不同时期的临床表现及影像学特征,避免先天性虹膜囊肿继发青光眼期误诊为闭角型青光眼而延误治疗。方法:对10例先天性虹膜临床症状,眼部体征,影像学检查资料进行回顾性分析。其中6例以眼红、眼痛、头痛、视力下降等主诉就诊,疑似闭角型青光眼;2例以眼痛、畏光、流泪、视物模糊等主诉就诊,疑似前葡萄膜炎;2例无症状为体检时发现的。结果:典型患者具有裂隙灯检查前房深浅不一,虹膜局部前凸;前房角镜检查显示局部房角窄,部分或全部关闭;眼压测定10例中有6例患眼眼压高于正常;超声生物显微镜(UBM)检查示虹膜囊肿。结论:先天性虹膜囊肿尤其是色素上皮囊肿发病比较隐蔽,为防止先天性虹膜囊肿进展眼压升高继发青光眼期误诊为闭角型青光眼而行抗青光眼手术,术后眼压再次升高,手术失败,术前一定要明确诊断。

AIM：To investigate the clinical manifestation and imageological characteristics of primary iris cyst.METHODS：The clinical feature and ocular region physical sign of 10 cases with primary iris cysts were retrospectively analyzed.Six cases had chief complaints of red eyes,ocular pain decrease of visual acuity and headache which are usually known as the complaints of angle-closure glaucoma.Two cases had chief complaints of ophthalmalgia,tear shed and obscure to watch thing which are known as the chief complaint of anterior uveitis.Two cases had no complaint,but were only discovered in physical examination.RESULTS：The classical cases had the signs of different depths of anterior chamber,local protrusion of iris in slit lamp examination.In these cases,the anterior chamber angle was closed.The patients usually came with complaints of red eyes and ophthalmalgia.Ultrasound biomicroscope（UBM）showed iris cysts.CONCLUSION：Patients of primary iris cyst are usually misdiagnosed as angle-closure glaucoma.If anti-glaucoma surgery is performed,the surgery may fail and the intraocular pressure may increase.So it is very important to verify the diagnosis of these cases.