急性闭角型青光眼急性发作后继发睫状体脉络膜脱离的临床观察

Clinical Study of Choroidal or Ciliary Detachment after Acute Episode Period in Primary Acute Angle-closure Glaucoma

目的观察急性闭角型青光眼急性发作缓解后继发睫状体脉络膜脱离的眼压和前房深度的变化,探讨继发性睫状体脉络膜脱离发生的原因。方法对2007年1月-2008年4月在我院住院的160例（160眼）急性闭角型青光眼的临床资料进行回顾性分析,超声生物显微镜（UBM）检查发现,40例（40眼）急性闭角型青光眼急性发作缓解后继发睫状体或脉络膜脱离,5例（5眼）临床前期眼检出睫状体脉络膜脱离;测量急性发作前后和睫状体脉络膜脱离时的眼压和前房深度,并进行统计学分析。结果发作缓解后无睫状体脉络膜脱离组的眼压为（12±5.2）mmHg（1mmHg=0.133kPa）,中央前房深度为（1.662±0.235）mm,发作缓解继发睫状体脉络膜脱离组眼压为（8.3±3.5）mmHg,中央前房深度为（1.373±0.180）mm。睫状体脉络膜脱离组眼压比无脱离组低,睫状体脉络膜脱离组的前房深度比无脱离组浅,差异均有显著性。结论急性发作眼及临床前期眼在降眼压过程中皆可能发生睫状体脉络膜脱离。急性闭角型青光眼急性发作缓解后眼压过低或前房深度变浅,高度怀疑睫状体脉络膜脱离的可能,其主要原因可能与眼压大幅度快速下降有关。

Objective To observe the changes of intraocular pressure（IOP） and central anterior chamber depth（CAD） in primary acute angle-closure glaucoma（PACG） with ciliary or choroidal detachment after acute episode period.To study the causes leading to ciliary or choroidal detachment.Methods The clinical data of 160 patients（160 eyes） with PACG between January 1,2007 and April 30,2008 were studyed retrospectively.With ultrasound biomicroscopy（UBM） ciliary or choroidal detachment was detected in 40 patients（40 eyes） after acute episode period and 5 eyes with preclinical phase.Intraocular pressure（IOP） and CAD were measured for analyzing in PACG with ciliary or choroidal detachment after acute episode period.Results IOP was（12±5.2）mmHg and CAD was（1.662 ±0.235）mm in eyes without ciliary or choroidal detachment after acute episode period,and IOP was（8.3±3.5）mmHg and CAD was（1.373±0.180）mm in eyes with ciliary or choroidal detachment.IOP and CAD in eyes with ciliary or choroidal detachment were significantly decreased compared with that without ciliary or choroidal detachment.Conclution Ciliary or choroidal detachment maybe detected in eyes after acute episode period and that in preclinical phase in PACG patients.It is suggested that secondary ciliary or choroidal detachment is related to rapid reduction of IOP.