急性闭角型青光眼急性发作后视网膜神经纤维层的变化

Changes of retinal nerve fiber layer following acute primary angle closure glaucoma

目的:观察急性闭角型青光眼发作缓解后视网膜神经纤维层厚度的变化规律。方法:36例急性闭角型青光眼发作患者在治疗缓解后2、4、8、12周测量平均神经纤维层厚度及上方、颞侧、下方、鼻侧神经纤维层厚度,分别与对照眼比较并分析发作眼神经纤维层厚度随时间的变化。结果:视网膜神经纤维层厚度2周和4周时发作眼和对侧眼比较差异无统计学意义(P>0.05);发作眼各次测量的结果表明,伴随访时间的延长各个象限的神经纤维层厚度逐渐变薄,其中2周较4、8、12周比较差异有统计学意义(P<0.001),其余各周之间差异无统计学意义(P>0.05)。结论:急性闭角型青光眼单次发作缓解后对视网膜神经纤维层造成损害,这种损害主要发生于下方,在眼压缓解后8周内仍继续进展。

Objective. To investigate changes in thickness of retinal nerve fiber layer （RNFL） fol- lowing acute primary angle closure （APAC）. Methods. A total of 36 patients that experienced acute pri- mary angle closure glaucoma were recruited in this study. Average thickness of the nerve fiber layer, as well as thickness above the temporal side, below the nasal side were measured in these patients 2 weeks, weeks, 8 weeks and 12 weeks after remission. The detected thickness of involved eyes were compared with that of the healthy ones in order to analyze the changes over time. Results. There were no significant difference in RNFL thickness between the attacked eyes and the control eyes 2 weeks and 4 weeks after re- mission. But the thickness become thinner over time, showing significant difference between week 2 and week 4, 8 and 12 （P all〈0.05）. Conclusion. After an episode attacks of APAC the RNFL thickness become thinner continually mainly in inferior quadrant during the first 8 weeks after the attack.