健康受试者饮水试验前后的前房形态变化

Changes of anterior chamber morphology after water drinking test in healthy subjects

目的 观察健康受试者饮水试验前后眼压及前房形态的变化。设计 前瞻性病例系列。研究对象 20~31岁的健康受试者23例（23眼）。方法 所有受试者上午8：00-10：00在5min内饮水1000 ml，于饮水前、饮水后15、30、45、60 min时Goldmann压平眼压计测量眼压，Pentacam三维眼前段分析仪测量前房形态。主要指标 眼压、前房容积、前房角角度、中央前方深度。结果 饮水前及饮水后15、30、45、60 min的平均眼压分别为（12.3±1.5）、（15.8±1.3）、（17.6±1.5）、（14.7±1.4）、（13.3±1.6）mm Hg（P=0.000），饮水后30 min眼压升高最明显（P=0.000）。饮水前及饮水后15、30、45、60 min的平均前房容积分别为（198.6±30.6）、（190.6±28.2）、（189.1±26.6）、（195.0±27.9）、（197.4±29. 6）＆mu;l （P=0.000），饮水后30 min前房容积减小最明显（P=0.000）。饮水前及饮水后15、30、45、60 min的平均前房角角度分别为38.3±3.6＆deg;、37.8±3.7＆deg;、36.7±3.3＆deg;、37.1±3.7＆deg;、37.5±3.8＆deg;（P=0.000），饮水后30min前房角度减小最明显（P=0.000）。饮水前及饮水后15、30、45、60 min的平均中央前房深度分别为（2.66±0.37）、（2.67±0.36）、（2.64±0.33）、（2.68±0.33）、（2.706±0.39）mm （P=0.370）。Pearson相关分析显示饮水后眼压升高与前房容积呈负相关（P=0.041），与中央前房深度无明显相关性（P=0.550）。结论 大量饮水可导致前房容积减少、前房角变窄，推测与血液低渗造成的脉络膜膨胀有关。

Objective To observe the changes of the intraocular pressure （IOP） and anterior chamber morphology after water drinking test （WDT） in healthy volunteers. Design Prospective case series. Participants 23 healthy volunteers （23 eyes） aged 20-31 years-old. Methods All subjects underwent IOP（with Goldmann applanation tonometry） and anterior chamber morphology（with Pentacam three-dimensional anterior segment analyzer） measurement before and 15, 30, 45, 60 minutes after water drinking test（WDT）（drinking 1000 ml water within 5 minutes）. Main Outcome Measures IOP, anterior chamber volume （AV）, anterior chamber angle （ACA）, central anterior chamber depth （CACD）. Results The IOP before and at 15, 30, 45, 60 min after WDT was 12.3±1.5, 15.8±1.3, 17.6±1.5, 14.7±1.4, 13.3±1.6 mmHg, respectively （P=0.000）. The peak IOP was at 30 min after WDT （P=0.000）. The AV before and at 15, 30, 45, 60 min after WDT was 198.6±30.6, 190.6±28.2, 189.1±26.6, 195.0±27.9, 197.4 ±29.6 ＆mu;l, respectively （P=0.000））. The minimum of AV was at 30 min after WDT （P=0.000）. The ACA before and at 15, 30, 45, 60 min after WDT was 37.8±3.7＆deg;, 36.7±3.3＆deg;, 37.1±3.7＆deg;, 37.5±3.8＆deg;, respectively （P=0.000）. The minimum of ACA was at 30 min after WDT （P=0.000）. The CACD before and at 15, 30,45, 60 min after WDT was 2.66±0.37, 2.67±0.36, 2.64±0.33, 2.68±0.33, 2.706±0.39 mm, respectively （P=0.370）. There was a significant correlation between the changes of IOP and AV（P=0.041）. Conclusion The water drinking test can significantly decrease the anterior chamber volume and anterior chamber angle. The expansion of choroid caused by blood low permeability may play an important role in this process. （Ophthalmol CHN, 2013, 22： 30-33）