应用pentacam眼前节分析仪观察不同瞳孔状态下急性闭角型青光眼患者前房形态变化

Changes of anterior chamber morphology in different pupil size of acute primary angel-closure glaucoma patients using Pentacam

目的:比较急性闭角型青光眼(acute primary angel-closure glaucoma,APACG)患者在瞳孔散大、瞳孔缩小、瞳孔正常状态下前房形态变化。方法:选取APACG患者81例81眼,在瞳孔散大(Time1)、瞳孔缩小(Time2)、瞳孔正常(Time0)状态下,分别用Pentacam测量前房容积(anteriorchamber volume,ACV)、中央前房深度(centralanteriorchamberdepth,CACD)、周边前房深度(peripheral anter iorchamberdepth,PACD)、前房角角度(anter iorchamberangle,ACA),并将这些前房参数进行对比分析。结果:与ACV0相比,ACV1,ACV2均减小,而ACV2较ACV1增加(P<0.01);C ACD 0, C ACD 1, C ACD 2间差异无统计学意义(P> 0. 0 1);与PACD 0相比, PACD 1明显减小,PACD2明显增加,PACD2较PACD1显著增加(P<0.01);与ACA0相比,ACA2明显增加(P<0.01),ACA1变化差异无统计学意义(P>0.01);ACA2与ACA1差异无统计学意义(P>0.01)。结论:PCAD,ACV是反映APACG患者瞳孔大小变化时前房形态敏感指标;患者停用毛果芸香碱眼液后ACV增加证实缩瞳剂并不适合长期使用。

Objective： To observe the changes of anterior chamber morphology in mydriasis（Time1）, miosis（Time2） and normal pupil（Time0） of acute primary angel-closure glaucoma（APACG） patients using Pentacam. Methods： Eighty-one eyes in 81 patients with APACG, aged 51 to 79 years, were included in this study. All subjects with different pupil size were evaluated by Pentacam. We measured the anterior chamber volume（ACV）, central anterior chamber depth（CACD）, peripheral anterior chamber depth（PACD） and anterior chamber angle（ACA）. The Pentacam metrics were compared in three different pupil size under different conditions. Results： ACV1 and ACV2 were significantly lower than ACV0, whereas ACV2 was significantly higher than ACV1（both P〈0.01）. CACD showed no significant changes under different conditions（P〈0.01）. Compared with PACD0, PACD1 was significantly decreased, PACD2 was increased and PACD2 was significantly higher than PACD1. ACA2 was significantly higher than ACA0（P〈0.01）. ACA1 did not change significantly. No significant difference was found between ACA2 and ACA1（P〈0.01）. Conclusion： PCAD and ACV are sensitive parameters to reflect the changes of anterior chamber morphology in three different pupil size of APACG patients, long-term use of pilocarpin eyedrops is not suitable for APACG patients.