年轻可疑青光眼患者临床分析

Clinical analysis of young patients with suspected glaucoma

目的分析年轻可疑青光眼的临床特征以指导临床早期诊断。方法 54例(108眼)≤30岁年轻可疑青光眼患者,分析年龄、性别、症状、眼压和眼底、房角、屈光度、视野、光学相干断层扫描(OCT)结果及确诊情况。结果年轻可疑青光眼男女比例1.57︰1;就诊年龄7~30岁;仅1例有家族史;14例(25.93%)患者伴有眼部症状。所有患者中单纯高眼压型[眼压>21 mm Hg(1 mm Hg=0.133 kPa)]占53.70%(29/54),单纯杯盘比(C/D)异常占18.52%(10/54),两者兼有占27.78%(15/54);近视69眼(63.89%);全部房角开放;视野异常29眼(26.85%);OCT异常39眼(36.11%);排除青光眼21例(38.89%),确诊为开角型青光眼8例(14.81%)。结论年轻可疑青光眼患者发病隐匿,绝大部分症状不典型或无症状,合并近视的患者较多,年轻患者一定要重视眼压和眼底的检查,特别对于屈光不正、视力下降和有危险因素的患者不要忽视行视野和OCT进行详细的排查和密切随访。

Objective To analyze the clinical characteristics of young suspected glaucoma in order to guide early diagnosis. Methods 54 cases(108 eyes) ≤ 30 years of suspected glaucoma were analyzed in terms of age, gender, symptoms, intraocular pressure, fundus, angle, diopter, visual field, optical coherence tomography(OCT) results and diagnosis. Results The male to female ratio of suspected glaucoma was 1.57︰1;the age of treatment was 7-30 years old;only one case had family history;14 cases(25.93%) had ocular symptoms. Among all the patients, 53.70%(29/54) had high intraocular pressure(IOP > 21 mm Hg(1 mm Hg = 0.133 kPa)), 18.52%(10/54) had abnormal cup to disc ratio(C/D), and 27.78%(15/54) had both;69 eyes(63.89%) with myopia;all angles were open;29 eyes(26.85%) with abnormal visual field;39 eyes(36.11%) with abnormal OCT;21 cases(38.89%) of glaucoma were excluded, and 8 cases(14.81%) were diagnosed as open-angle glaucoma. Conclusion Young suspected glaucoma occurs hiddenly,with untypical or no signs mostly, and many with myopia. Attention must be payed to intraocular pressure and fundus examination in young patients, especially to those with ametropia,hypopsia and risk factor, which need visual field and OCT to diagnosis and close follow-up.