高眼压症原发性开角型青光眼及正常眼压性青光眼患者的24小时眼压分布规律

Distribution patterns of diurnal intraocular pressure in primary open-angle glaucoma,ocular hypertension and normal tension glaucoma patients

目的 通过24 h眼压监测探讨原发性开角型青光眼(POAG)、高眼压症(OHT)、及正常眼压性青光眼(NTG)眼压分布规律。方法 回顾性分析2019年1月至2021年1月期间于广东省中医院住院并完成24 h眼压监测的177例患者(354眼),根据24眼压监测结果、角膜厚度、视神经OCT、视野及房角镜等检查结果,将患者分为对照组46例(92眼)、POAG组63例(126眼)、OHT组40例(80眼)及NTG组28例(56眼),进而统计分析不同组患者24 h眼压分布规律。结果 从眼压的峰值和谷值分布来看:(1)对照组和OHT组的眼压曲线有着类似的分布模式,眼压峰值集中在[6:00-8:00)这一时间段,而POAG组和NTG组也有着类似的分布模式,眼压峰值集中在[10:00-12:00);(2)4组患者的最低眼压分布相似,大部分集中分布在[20:00-4:00)这一时段。从眼压的波动来看:POAG组(10.1±3.7)mmHg和OHT组(11.1±3.5)mmHg的眼压波动要明显大于对照组(6.2±1.8)mmHg和NTG组(7.4±2.0)mmHg,且差异有统计学意义(P均<0.05,POAG与NTG P=0.001,OHT与NTG P<0.001),但POAG组和OHT组之间差异无统计学意义(P=0.154)。结论 眼压节律的改变可能也是青光眼发病机制中的重要一环。

Objective To investigate the distribution pattern of intraocular pressure in primary open-angle glaucoma(POAG),ocular hypertension(OHT),and normal tension glaucoma(NTG)by 24 hours monitoring.Methods A retrospective analysis was performed on 177 patients(354 eyes)hospitalized in Guangdong Hospital of Traditional Chinese Medicine from January 2019 to January 2021,who accomplished a completed 24-hour intraocular pressure monitoring.According to the results of 24-hour intraocular pressure monitoring,corneal thickness,optic nerve OCT,visual field,and angle microscopy,the patients were divided into 4 groups:46 patients(92 eyes)in the control group,63 patients(126 eyes)in the POAG group,40 cases(80 eyes)in the OHT group,and 28 cases(56 eyes)in NTG group.The distribution pattern of intraocular pressure in different groups was analyzed.Results According to the distribution of peak and valley values of intraocular pressure:①the IOP curve of the control group and the OHT group had a similar distribution pattern,and the peak values concentrated in the period of[6:00-8:00),while the POAG group and the NTG group also shared a similar distribution pattern,and the peak values concentrated in the period of[10:00-12:00).②The distribution of the valley IOP in the four groups was analogous,and the valley values are concentrated in the period of[20:00-4:00).According to the fluctuation of diurnal IOP:the intraocular pressure fluctuation in the POAG group(10.1±3.7)mmHg and OHT group(11.11±3.5)mmHg was significantly higher than that in control group(6.2±1.8)mmHg and NTG group(7.4±2.0)mmHg,and the differences were statistically significant(all P<0.05,POAG vs NTG P=0.0014,OHT vs NTG P<0.0001).However,there was no significant difference between the POAG group and the OHT group(P=0.154).Conclusion The change in IOP rhythm may be an important part of the pathogenesis of glaucoma.