高眼压症校正昼夜眼压分析及随访

Analysis and follow-up of diurnal correction high intra ocular pressure

目的探讨分析不同中央角膜厚度的高眼压症患者校正昼夜眼压及临床处理及随访结果。方法对2007年5月到2013年7月在静安区中心医院眼科就诊的112例（216只眼）高眼压症患者，按中央角膜厚度（CCT）值分为A、B两组，对昼夜眼压值进行校正，并绘制校正眼压曲线图，对以下三种情况视为异常眼压，予以药物干预：（1）昼夜校正峰值眼压≥23mmHg；（2）昼夜眼压波动38mmHg；（3）24h校正峰值眼压21—23mmHg，且具有青光眼高危因素。结果A组：CCT≤560μm（552．09±12．25）μm组76只眼中眼压异常的39只眼（51．3％）；B组：CCT〉560μm（595．12±18．26）μm组140只眼中眼压异常的23只眼（16．43％），A组和B组CCT差异有统计学意义P〈0．05（t=2．231，P=0．000）。A组和B组眼压异常率差异有统计学意义P〈0．05（Х^2=29．19，P=0．000）。随访21个月至6年，平均（4．6±1．2）年，随访期间未治疗161只眼中视野异常6只眼，占3．73％；治疗50只眼中2只眼视野异常，占4．0％。结论对于高眼压症患者根据CCT校正昼夜眼压测定，并绘制曲线图，对于峰值眼压及眼压波动异常的患者，予以药物干预，控制至靶眼压并密切随访，则能减少青光眼的漏诊、误诊。

Objective To evaluate the correction circadian intraocular pressure and clinical treat- ment analysis. Methods Retrospectively analyzed 112 cases （216 eyes） of ocular hypertension pa- tients in our hospital from May 2007 to July 2013, and were divided into group A, B according to the central corneal thickness （CCT） values. The circadian IOP values were recorded and corrected. The correcting IOP curve drawing, the following three situations as abnormal intraocular pressure, drug intervention： （1） the diurnal correction peak IOP ≥ 23mmHg; （2） the diurnal fluctuation IOP 〉1 8mmHg; （3） 24h correction peak IOP 21-23mmHg, and has the high risk factors of glauco- ma. Results In group A： CCT ≤560μm （552.09±12.25）μm, 39 eyes out of 76 eyes （51.3%） had abnormal intraocular pressure; group B： CCT〉560 μm （595.12±18.26）μm 23 eyes out of 140 eyes （16.43%）, there was statistical significance between group A and group B as of the difference CCT （t =2.231, P =0.000）; the abnormal rate of intraocular pressure difference was statistically significant （Х^2=29.19, P =0.000）. Followed up time was of 21 months to 6 years, averaged （4.6±1.2） years, Six out of untreated 161 eyes had vision abnormalities during the follow-up period, accounted for 3.73%; 2 eyes out of treated 50 eyes had vision abnormal, accounted for 4%. Conclusions For those with high IOP patients, it is necessary to use CCT correction for determining the circadian IOP measurement, and draw the graph. For those with abnormal peak IOP and fluctuation IOP pa- tients, drug intervention, control to the target lOP and close follow-up of glaucoma are necessary to reduce missed diagnosis, misdiagnosis.