可疑原发性房角关闭眼不同象限房角形态的对比分析

Comparative analysis of angle morphology in different quadrants of primary angle closure suspect eyes

目的对比分析可疑原发性房角关闭(PACS)眼不同象限房角关闭程度的差异,以及不同象限房角生物学参数定量测量值的差异。设计前瞻性病例系列。研究对象PACS眼112例。方法每人只选择符合入排标准的单眼纳入研究。对入选眼进行房角镜检查,记录房角在上、下、鼻、颞四个象限贴合性关闭状态并进行比较分析。然后对入选眼进行前节相干光断层成像(AS-OCT)检查,对鼻侧和颞侧的房角生物学参数进行测量和对比分析。主要指标四个象限房角贴合性关闭情况,500μm处房角开放距离(AOD500)、500μm小梁网虹膜间面积(TISA500)、虹膜膨隆程度(Icurv)、2000μm处虹膜厚度(IT2000)。结果房角关闭眼上方象限的房角关闭比例(98.21%)高于下方(75.89%)、鼻侧(64.29%)和颞侧(76.79%)(χ^2=40.225,P<0.001)。颞侧象限AOD500处的房角宽度为(0.12±0.06)mm,大于鼻侧的(0.11±0.06)mm(P<0.001)。颞侧象限TISA500为(0.07±0.03)mm2,大于鼻侧的(0.06±0.03)mm2(P=0.008)。颞侧象限Icurv为(0.41±0.11)mm,大于鼻侧的(0.37±0.1)mm(P=0.001)。颞侧象限IT2000为(0.46±0.07)mm,小于鼻侧的(0.49±0.06)mm(P<0.001)。结论PACS眼不同象限房角形态存在差异,上方较其他象限房角更易于关闭,颞侧象限的虹膜较鼻侧更薄、房角较鼻侧更加开放。

Objective To compare the degree of angle closure and the difference of quantitative biological parameters in different quadrants in primary angle closure suspect(PACS)eye.Design Prospective case series.Participants 112 cases of PACS.Methods Only one eye of each subject that met the inclusion criteria was selected for analysis.Firstly,gonioscopy was performed in selected eyes and the angle status of the superior,inferior,nasal and temporal quadrants was recorded and compared.Then the selected eyes were examined by anterior segment optical coherence tomography(AS-OCT),and the biological parameters of anterior chamber angle at nasal and temporal sides were measured and compared.Main Outcome Measures The angle configuration at four quadrants,angle open distance at 500μm(AOD500),trabecular iris area at 500μm(TISA500),iris curvature(Icurv),iris thickness at 2000μm(IT2000)at the nasal and temporal sides.Results The percentage of angle closure in the superior quadrant(98.21%)was higher than that in the inferior quadrant(75.89%),nasal quadrant(64.29%)and temporal quadrant(76.79%)(χ^2=40.225,P<0.001).The width of the temporal angle AOD500(0.12±0.06)mm was larger than that of the nasal side(0.11±0.06)mm(P<0.001),the area of the temporal angle TISA500(0.07±0.03)mm2 was larger than that of the nasal side(0.06±0.03)mm2(P=0.008),the Icurv in the temporal angle(0.41±0.11)mm was larger than that of the nasal side(0.37±0.1)mm(P=0.001)and the IT2000 of temporal angle(0.46±0.07)mm was smaller than that of nasal angle(0.49±0.06)mm(P<0.001).Conclusion The configuration of anterior chamber angle in different quadrants of the same eye is different in PACS eyes.The superior angle was more closed than angle in other quadrants,the iris of temporal angle was thinner than that of nasal angle,and the temporal angle is wider than the nasal one.