超声生物显微镜观察睫状突形态与青光眼的关系

Observation of relationship between morphology of ciliary body and glaucoma with ultrasound biomicroscopy

目的利用超声生物显微镜(UBM)定性、定量研究原发性闭角型青光眼患者的睫状突形态,探索其与青光眼的关系。方法浅前房组为80例>40岁前房深度浅患者,包括急性闭角型青光眼(AACG)患者28例,慢性闭角型青光眼(CACG)患者26例,可疑房角关闭(PACS)者26例。对照组为80例相同年龄段前房深度正常患者。对双眼进行UBM检查,记录上、鼻、下、颞4个象限睫状突矢状和冠状切面扫查图像,测量睫状突高度(CPH)、睫状突厚度(CPT)、睫状突间距(CPI)、睫状突数量(CPN)、A角以及α角。进一步比较上述生物学参数在浅前房组与对照组间的差异、AACG、CACG以及PACS亚组间的差异、PACS亚组与对照组间的差别,并对A角与α角进行相关性分析。结果浅前房组较对照组CPH、CPT测值增加,CPI、CPN、A角以及α角测值减小(P<0.05)。CACG与PACS亚组的CPH、CPN差异无统计学意义,其余各组数据差异均有统计学意义(P<0.05)。PACS亚组较对照组CPH测值增加,CPI、CPN、A角以及α角测值减小(P<0.05),α角与A角呈正相关。结论原发性闭角型青光眼患者睫状突形态有明显变化,超声检测其参数可能成为早期筛查原发性闭角型青光眼的较敏感指标之一。

Objective To observe the relationship between morphology of ciliary body and glaucoma with ultrasound biomicroscopy （UBM）. Methods Eighty shallow-anterior chamber patients and 80 normal-anterior chamber patients were enrolled as shallow-anterior chamber group and control group,respectively. All patients were greater than 40 years old. The shallow-anterior chamber group included 28 patients of acute angle-closure glaucoma （AACG subgroup）,26 patients of chronic angle-closure glaucoma （CACG subgroup）,and 26 patients of primary angle-closure suspects （PACS subgroup）. Both eyes of all patients were checked with UBM,and position of each eye on sagittal and coronal section of superior,nasal,inferior and temporal were recorded. Then ciliary process height （CPH）,ciliary process thickness （CPT）,ciliary process interval （CPI）,ciliary process number （CPN）,A angle and α angle were measured. Furthermore,the difference between shallow-anterior chamber group and control group,the difference between AACG,CACG and PACS subgroup were compared,as well as the difference between PACS subgroup and control group,and the correlation between A angle and α angle was analyzed. Results Compared with control group,CPH and CPT of shallow-anterior chamber group increased,while CPI,CPN,A angle and α angle decreased （P〈0.05）. Except CPH and CPN between CACG and PACS subgroup,there were significant differences of parameters between subgroup of AACG,CACG and PACS （P〈0.05）. CPH of PACS subgroup increased than those of control group,while CPI,CPN,A angle and α angle decreased （P〈0.05）. There was positive correlation between A angle and α angle. Conclusion Morphologic parameters of ciliary process may be sensitive indexes which can early screen primary angle-closure glaucoma.