匹罗卡品对正常眼压老年人眼前段结构变化的影响

Effect of pilocarpine on structural changes of anterior segment of eye in old people with normal intraocular pressure

目的探讨匹罗卡品对正常眼压老年人眼前段结构变化影响的作用机制,进一步对比窄前房角和宽前房角老年人眼前段结构的形态特征。方法根据房角镜检查,选取具有窄前房角的患者21例(32眼)和宽前房角的正常志愿者20例(30眼),眼压均在正常范围内,使用超声生物显微镜对2组滴10g·L-1匹罗卡品滴眼液前后房角结构指标进行观察并运用专用软件给予测量。结果窄角眼滴匹罗卡品后表现前房深度减小,虹膜厚度变小,小梁虹膜角增加,房角开放距离增加,睫状体厚度增加,虹膜晶状体接触距离增加。宽角眼滴匹罗卡品后表现前房深度减小,虹膜厚度变小,小梁虹膜角减小,房角开放距离减小,睫状体厚度增加,虹膜晶状体接触距离增加。滴匹罗卡品滴眼液前后,2组前房深度、小梁虹膜角、房角开放距离变化差异有显著统计学意义(P<0.01),平均虹膜厚度、虹膜晶状体接触距离和睫状体厚度变化差异无统计学意义(P>0.05)。结论匹罗卡品可以引起窄角眼前房角增宽,其对房角的改变依靠于滴药前房角的状况,它对正常眼压老年人的窄角眼的治疗是有效的。

Objective To investigate the mechanical effects of pilocarpine on structural changes of anterior segment of eye in the old people with normal intraocular pressure （IOP）, and to compare the morphological characteristics of anterior segment structure in old people between those with narrow angle and with open angle. Methods Twenty-one cases （32 eyes） with narrow angle and 20 normal people （30 eyes） with open angle were with normal IOP, and examined by gonioscopy. Changes of the anterior segment of eye before and after dropping 10 g · L^-1 pilocarpine were observed by ultrasound biomicroscopy. Results After dropping 10 g · L^-1 pilocarpine the eyes with narrow angle showed an increase of trabecular-iris angle（TIA） ,angle opening distance （ AnD）, ciliary body thickness （ CBT ）, iris-lens contact distance （ ILCD ）, and a de- crease of anterior chamber depth（ACD）, iris thickness （IT）. The eyes with open angle showed a decrease of TIA,AOD,ACD,IT,and an increase of CBT and ILCD. The differences of ACD,TIA,AOD before and after dropping 10 g · L^-1 pilocarpine were signifi- cant between the two groups （P 〈 0.01 ） ,but the differences of ILCD,IT, CBT were not significant （P 〉 0. 05 ）. Conclusions Pilocarpine can induce the narrow angle widen. The change may depend on the differences of pretreatment structures. Pilocarpine is useful for treating the eyes with narrow angles in old people with normal intraocular nressure.