Pentacam三维前房分析仪在原发性闭角型青光眼诊断中的应用

Application of Pentacam in the diagnosis for primary angle closure glaucoma

目的分析Pentacam三维前房分析仪测量原发性闭角型青光眼(PACG)与正常组前房形态参数。方法65例急性PACG患者,70例慢性PACG患者,75例正常组行Pentacam检查,记录前房轴深(ACD)、平均和最小前房角(ACA)、前房容积(ACV),进行分析。结果正常组测量值均大于PACG组,差异有统计学意义(P<0.05)。正常组ACD、ACV女性较男性前房浅(P<0.05)、前房容积小(P<0.05);各年龄组间ACD、ACV差异有统计学意义(P<0.05)。ACA与性别、年龄无相关性(P>0.05)。急性PACG组ACD与ACV线性相关(R2=0.40,P<0.05);慢性PACG组数据间有相关性(P<0.01);正常组ACD与ACV相关(R2=0.85,P<0.01),ACD与ACA线性相关(P<0.05)。结论Pentacam检查为PACG早期诊断提供依据,对青光眼患者随访和正常人群筛查有重要临床应用价值。

Objective Pentacam three dimension anterior eye segment analysis system is a new optical imaging technique. This study was to assess the outcome of anterior chamber measurements with Pentacam three dimension anterior eye segment analysis system in the primary angle closure glaucoma （PACG） and normal eyes and provide principle of follow-up for the diagnosis and screening of patients. Methods A total of 210 eyes with PACG were studied including 65 eyes with acute PACG,70 eyes with chronic PACG and 75 normal eyes. Anterior chamber depth （ACD） , mean and minimum anterior chamber angle（ACA） and anterior chamber volume （ACV） were evaluated with Pentacam examination. Anteiior chamber measurements were performed for three times to assess the reproducibility of Pentacam system. Results The ACD values from patients with different types of PACG and normal eyes were as follows： （1.84±0.13 ） mm for acute PACG, （ 1.93 ± 0. 16） mm for chronic PACG and （2.70 ± 0. 22）mm for normal subjects, indicating a shallow ACD in the eyes with PACG compared with normal eyes. The mean ACA values was （22.91 ±5.89） o for acute PACG, （26.96 ±7.46）° for chronic PACG and（32.19 ± 15.06）° for normal eyes,presenting a narrow ACA in the eyes compared with normal. The mean ACV value in acute PACG eyes, chronic PACG eyes and normal eyes was （ 76.40 ±14.58 ） mm^3 , （ 82. 36±16.07 ）mm^3 and （ 158.2± 28.69 ） mm^3 , respectively. The good reliability and reproducibility was seen in the measurement of ACD and ACV by Pentacam,and the outcomes of ACD and ACV measurement were correlated with gender and age （ P 〈 0. 05 ）. The repeatability of ACA measurement was relatively poor. Excellent correlation was found between ACD and ACV for chronic PACG （R^2 = 0. 87 ,P 〈0.01）. ACD and mean ACV showed moderate correlation for acute PACG （R^2=0.40, P〈 0. 05）. There was no statistical correlation between ACV and ACA for various groups（P 〉 0.05 ）. Conclusion Pentacam is a reliable way for the the measurement of anterior chamber different parameters. It can offer the criteria for the early diagnosis of PACG in clinic.