单眼发作的原发性急性房角关闭双眼生物学参数差异

Difference of ocular biometric parameters between acute primary angle closure eyes and the fellow eyes

目的:比较单眼发作的原发性急性房角关闭(acute primary angle closure,APAC)患者发作眼与未发作眼眼部生物学参数的差异,分析急性房角关闭发作的可能危险因素。方法:回顾性分析2008年1 月至2020年3月中山眼科中心青光眼科222例45岁以上单眼发作的APAC病例。排除双眼发作、另眼有发作史及晶状体源性、外伤性等继发因素。A超测量晶状体厚度、眼轴长度,超生生物显微镜测前房深度。对单眼发作APAC患者的发作眼与未发作眼眼轴长度、前房深度、晶状体厚度、晶状体相对位置等进行统计学分析。结果:患者发作年龄为(62.57±9.14)岁。发作眼与未发作眼前房深度分别为(1.75±0.27) mm和(1.88±0.31) mm,眼轴长度分别为(22.34±0.80) mm和(22.35±0.83) mm, 晶状体厚度分别为(5.14±0.38) mm和(5.17±0.42) mm,晶状体相对位置分别为0.195和0.198。发作眼前房深度较浅,晶状体相对位置较靠前,差异有统计学意义(均P<0.001),发作眼的眼轴长度、晶状体厚度较未发作眼差异无统计学意义(P>0.05)。APAC发作年龄较小(45~59岁)的患者双眼眼轴均短于发作年龄较大(60~69、70岁以上)的患者;发作年龄70岁以上患者双眼前房深度均较浅,双眼晶状体相对位置均较靠前,差异均有统计学意义(P<0.05)。相关性分析表明APAC发作年龄较小的患者双眼眼轴均较短(P<0.001)。结论:APAC发作眼的前房较浅、晶状体相对位置靠前。短眼轴、女性与不同个体的APAC发作相关。浅前房、晶状体厚、晶状体相对位置靠前可能是高龄人群APAC发作的危险因素。

Objective:To compare the ocular biometric parameters between the acute primary angle closure(APAC)eyes and the fellow eyes as well as the risk factors associated with APAC.Methods:From January 2008 to March 2020,222 monocular APAC patients over 45 years old from the Glaucoma Department of Zhongshan Ophthalmic Center, Sun Yat-sen University were retrospectively studied. Patients with binocular attack, previous attack in the fellow eyes, and secondary factors such as lens-induced and traumatic glaucoma were excluded. Ocular biometric parameters including axial length (AL) and lens thickness (LT) were measured with A-scan ultrasound, while the anterior chamber depth (ACD) was measured by ultrasonic biological microscope. AL, ACD, LT and relative lens position (RLP) were compared between the APAC and the fellows eyes. Results: The average age of onset was (62.57±9.14) years. The ACD was (1.75±0.27) and (1.88±0.31) mm, AL was (22.34±0.80) and (22.35±0.83) mm, LT was (5.14±0.38) and (5.17±0.42) mm, and the RLP was 0.195 and 0.198 for the APAC and the fellow eyes, respectively. Compared with the fellow eyes, the ACD of the APAC eyes was shallower, and the RLP was more anterior (both P<0.001), while the differences of AL and LT were not statistically significant (both P>0.05). Furthermore, AL of patients with a younger age of onset (aged 45 to 59 years) was shorter than that of those with an older age of onset (aged 60 to 69 or over 70 years);patients with an onset age of over 70 years have shallower ACD and more anterior RLP, all statistically significant (P<0.05). In addition, correlation analysis indicated that younger onset age was significantly correlated to shorter axial length of APAC eyes (P<0.001). Conclusion: APAC eyes had shallower ACD and more anterior RLP. Shorter AL and female were associated with APAC attack between individuals. Shallower ACD, thicker lens and more anterior RLP are potential risk factors for APAC among aged population.