高眼压症中央角膜厚度与眼压关系的临床观察

The clinical research of the relationship between central corneal thickness and intraocular pressure in patients with ocular hypertension

目的评价高眼压症患者中央角膜厚度（CCT）与眼压（IOP）的关系，并探讨CCT在判断高眼压症患者是否给予降眼压药物干预治疗中的临床意义。方法对54例（108只眼）高眼压症患者进行非接触眼压计检测和超声角膜厚度测量，并对校正眼压〈21mmHg的患者31例62只眼（占57．4％）不予降眼压治疗，追踪观察其眼压、视野、视乳头以及视网膜神经纤维层的情况。结果IOP随CCT增加而增高，并呈正相关（CCT每增加100μm，IOP将随之增加2．1mmHg）。对校正眼压〈21mmHg的患者不予降眼压治疗，随访24～36个月，平均30个月，其中1例2只眼出现视野改变，发生率为1．85％。结论中央角膜厚度测量可以作为高眼压症与青光眼进行鉴别诊断，以及判断高眼压症能否发展为青光眼的重要依据，常规测量高眼压症患者的CCT并校正其眼压，对高眼压症患者的合理处置非常重要，对校正眼压〈21mmHg的患者可以不需降压药物干预治疗，仅需密切随访。

Objective To analyze the relationship between central corneal thickness （CCT） and intraocular pressure （IOP） in patients with ocular hypertension （OHT）, and to investigated the clinical significance of the CCT in intervention treatment to ocular hypertension patients. Methods 54 patients （ 108 eyes）of ocular hypertension were exanimated by non-contact tonometer and ultrasonic pachymeter.31 case （62 eyes） with correcting IOPs that less then 2 l mmHg were not treated. The-following indicators were examined： intraocular pressure; visual field; optic papilla and retinal nerve fiber layer. Results The IOP was positively correlated with the CCT. The cases that correcting IOPs that less then 21 mmHg were not treated, the follow-up among 24 to 36 months, mean 30 months. Only one eye developed glaucoma. （ 1.85% ）.Conclusion CCT measurement was an important parameter for the differential diagnosis for ocular hypertension and glaucoma, and CCT was a potent predictive faction for the development of glaucoma. The routine pathymetry-measured central corneal thickness has a significant effect on the clinical management of patients with ocular hypertension, The patients with correcting IOPs that less then 21 mmHg need not treat, only need followed up.