超声生物显微镜在急性前葡萄膜炎治疗中的监测价值

Quantitative assessment by ultrasound biomicroscopy in the treatment of acute anterior uveitis

目的 观察急性前葡萄膜炎（AAU）治疗前后眼前节的UBM扫描图像特点,评价UBM在AAU治疗中的监测价值.方法 前瞻性观察性研究.温州医科大学附属眼视光医院45例（45眼）AAU患者纳入研究,炎症程度为中至重度.患者于治疗前以及当裂隙灯显微镜观察到患眼前房细胞和玻璃体细胞消失时行UBM检查,测量房角开放角度（AA500）、房角开放距离（AOD500）和睫状体厚度（CBT）等参数.采用配对t检验进行统计学分析.结果 患眼治疗前各个象限的AA500、AOD500、CBT均大于对侧健眼,差异有统计学意义（t=3.752、3.950、5.277、6.350、5.455,P＜0.01）.经过治疗炎症消退后,患眼AA500、AOD500、CBT较治疗前减小（t=-16.990、3.964、5.373、6.360、5.629,P＜0.01）,和对侧健眼比较差异无统计学意义（t=-0.189、-0.296、-0.371、-1.693、-0.811,P＞0.05）.结论 AAU患者的AA500、AOD500和CBT在炎症的发展和消退过程中发生动态变化,UBM可实时监测AAU治疗前后眼前节结构的变化规律,为AAU的诊治提供客观依据.

Objective To investigate dynamic changes in the ocular anterior segment in patients with acute anterior uveitis （AAU） using ultrasound biomicroscopy （UBM） and to assess the evaluation of UBM during the treatment of AAU.Methods In this prospective,observational study,45 eyes from 45 patients with moderate to severe AAU were examined.UBM was performed before （within 5 days of AAU attack） and after treatment of AAU （no anterior chamber cells or vitreous cells were observed by slit lamp microscopy）.Angle opening angle （AA~）,angle opening distance （AOD^0）,and ciliary body thickness （CBT） were measured.The results were analyzed by paired t-test.Results Before treatment,the AA^0,AOD^0 and CBT values in each quadrant of the eyes with AAU were significantly higher than those in normal contralateral eyes （t=3.752,3.950,5.277,6.350,5.455,P〈0.01）.With treatment,the inflammation was controlled gradually 4-6 weeks after AAU onset.AA^0,AOD^0 and CBT values of eyes with AAU were significantly reduced （t=-16.990,3.964,5.373,6.360,5.629,P〈0.01）,and there were no significant differences compared to normal contralateral eyes （t=-0.189,-0.296,-0.371,-1.693,-0.811,P〉0.05）.Conclusion UBM reveals dynamic morphologic changes in the ocular anterior segment structure before and after treatment in patients with AAU.This could provide important information in the development and treatment of AAU.