使用手持式眼压计评价侧卧位时不同头位对原发性开角型青光眼患者眼压的影响

Assessment of the Impact of Various Head Positions on Intraocular Pressure in Patients with Open-angle Glaucoma in Lateral Decubitus Position Using the Handheld Tonometer

目的使用手持式眼压计评价原发性开角型青光眼(POAG)患者侧卧位时不同头位对眼压(IOP)的影响。方法纳入2022年2—12月在浙江省台州医院眼科就诊的POAG患者40例。由同一名研究者在下午6:00—8:00使用手持式回弹眼压计测量患者IOP。首先,测量患者仰卧位10 min后IOP,然后,测量患者左或右侧卧位时头高位、头平位、头低位10 min后IOP。比较患者依赖侧眼和非依赖侧眼的侧卧位时不同头位IOP。比较患者侧卧位依赖侧眼和仰卧位同侧眼的不同头位IOP。比较患者侧卧位非依赖侧眼和仰卧位同侧眼的不同头位IOP。比较患者依赖侧眼的侧卧位时不同头位IOP。结果患者依赖侧眼的左侧卧位和右侧卧位时不同头位IOP高于非依赖侧眼,差异有统计学意义(P<0.05)。患者依赖侧眼的左侧卧位和右侧卧位时头平位、头低位IOP高于仰卧位同侧眼,差异有统计学意义(P<0.05);患者左侧卧位和右侧卧位依赖侧眼和仰卧位同侧眼的头高位IOP比较,差异无统计学意义(P>0.05)。患者左侧卧位非依赖侧眼的头低位IOP高于仰卧位同侧,差异有统计学意义(P<0.05);患者左侧卧位和右侧卧位依赖侧眼和仰卧位同侧眼的其他头位IOP比较,差异无统计学意义(P>0.05)。患者依赖侧眼的左侧卧位和右侧卧位时头平位和头低位IOP高于头高位,差异有统计学意义(P<0.05);患者依赖侧眼的左侧卧位和右侧卧位时头低位IOP高于头平位,差异有统计学意义(P<0.05)。结论选取适当头位有助于缓解POAG患者因侧卧位导致的依赖侧IOP升高。

Objective To evaluate the effects of different head positions on intraocular pressure(IOP)in patients with primary open Angle glaucoma(POAG)by using a handheld tonometer.Methods Forty patients with POAG admitted to the ophthalmology department of Taizhou Hospital,Zhejiang Province from February to December 2022 were included.Patients'IOP was measured by the same investigator using a handheld rebound tonometer between 6:00 PM and 8:00 PM.First,the IOP was measured after 10 min in the supine position.Then,the IOP was measured after 10 min in the left/right decubitus position in the head height,head horizontal position,and head lower position.The IOP of different head positions was compared in lateral decubitus with and without lateral eye dependence.The IOP of patients in lateral decubitus position dependent on lateral eye and supine position same eye were compared.The IOP of different head positions were compared between the independent lateral eye and the same eye in the supine position.The IOP of different head positions was compared when patients were in lateral decubitus position with lateral eye dependence.Results The IOP of patients with different head positions in left and right decubitus of dependent lateral eyewas higher than that in independent lateral eye,and the difference was statistically significant(P<0.05).The IOP of the left and right decubitus dependent lateral eye was higher than thatof the same eye in supine position,and the differences were statistically significant(P<0.05);There was no statistical significance in the head height IOP of patients in left decubitus positionand right decubitus position depending on the lateral eye and the same eye in supine position(P>0.05).The IOP of the head position in the left decubial position was higher than that on thesame side of the supine position,and the difference was statistically significant(P<0.05);Therewas no significant difference in IOP between left decubitus position and right decubitus positiondepending on other head positions of the same eye and supine position(P>0.05).The IOP inhead horizontal and head low position was higher than that in head high position in left and rightdecubitus with lateral eye dependence,and the difference was statistically significant(P<0.05);The IOP was higher in the left and right decubitus positions than in the horizontal head position,and the difference was statistically significant(P<0.05).Conclusion The appropriate headposition can help alleviate the dependent IOP elevation in POAG patients due to lateral decubitus.