合并近视的原发性开角型青光眼眼血流动力学研究

A study of ocular hemodynamics in primary open angle glaucoma with myopia

目的：利用彩色多普勒血流显像研究合并近视的原发性开角型青光眼（Ｐｒｉｍａｒｙ Ｏｐｅｎａｎｇｌｅ Ｇｌａｕｃｏｍａｗｉｔｈ Ｍｙｏｐｉａ，ＭＰＯＡＧ）眼部血流动力学变化。方法：对３８ 例６３ 只合并近视（平均－６．９２ ±３ ．７９Ｄ）高眼压性（ 平均眼压３２ ．００±９．３６ｍｍＨｇ）ＰＯＡＧ、３２ 例５１ 只单纯原发性开角型青光眼（Ｓｉｍｐｌｅ Ｐｒｉｍａｒｙ Ｏｐｅｎａｎｇｌｅ Ｇｌａｕｃｏｍａ，ＳＰＯＡＧ） 、１５ 例３０ 只正常眼分别测量眼动脉、视网膜中央动脉、睫状后动脉的收缩期血流峰值速度（ＰＳＶ） 、舒张末期血流速度（ＥＤＶ） 、阻力指数（ＲＩ） 。结果：①与正常组比较：ＭＰＯＡＧ组及ＳＰＯＡＧ组视网膜中央动脉及睫状后动脉的ＲＩ升高（ Ｐ＜０．０５，Ｐ＜０ ．０１） ；ＭＰＯＡＧ 组眼动脉的ＥＤＶ值减低（Ｐ＜０．０５） 。②与ＳＰＯＡＧ 组比较：ＭＰＯＡＧ组眼动脉ＥＤＶ值明显减低（Ｐ＜ ０．０１）。结论：ＭＰＯＡＧ 患者眼部血流速度减低，血管阻力升高，有血流灌注不足的表现。提示眼压及血管因素在高眼压性ＭＰＯＡＧ 的视功能损害中均起着重要作用。

Objective:We used color Doppler flow imaging to study ocular hemodynamics in patients with primary open angle glaucoma and myopia (M-POAG).Methods:63 eyes of 38 cases with M-POAG,51 eyes of 32 cases with simple primary open angle glaucoma (SPOAG),and 30 eyes of 15 normal subjects were studied.Peak systolic velocity(PSV),end diastolic velocity(EDV),and resistance index(RI) of the ophthalmic artery(OA),the central retinal artery(CRA),and the posterior ciliary artery(PCA) were compared for the 3 groups.Results:Compared to normal subjects,the patients with M-POAG and SPOAG showed a significant increase (P< 0.05,0.01) in the mean RI of the CRA and the PCA,and a decrease (P<0.05) in the mean EDV of the OA with M-POAG.Compared with the SPOAG group,patients with M-POAG showed a significant decrease in the mean EDV of the OA (P<0.01).Conclusion:In patients with M-POAG,there appears to be an association between decreased mean flow velocity and an increased mean resistive index in the ocular vasculature.Factors relating to both intraocular pressure and vasculature have an important role in the pathogenesis of glaucoma with hypertension M-POAG.