原发性闭角青光眼的激发试验——Ⅰ.“低头俯卧暗光读书”试验

The Provocative Test of Primary Angle-Closure Glaucoma

长期以来,眼科学者精心设计许多闭角激发试验,但效果仍未能令人满意。至今还常用的传统暗室试验和散瞳试验阳性率低于50％(Becket和Thompson,1958),在缓慢发展的病例常显阴性,并且散瞳试验不安全。近10年来应用的俯卧试验(Hyams,1968)操作简易,阳性率高,是比较理想的一种闭角激发试验。散瞳,饮水、缩瞳三重试验(Kirsch,1965)和新福林、匹罗卡品,托品酰胺试验(Mapstone,1976)阳性率虽高,但操作复杂、费时,不易推广。因此,寻求一种安全,简易而又阳性率高的试验,实属必要。

A kind of provocative test in angle-closure glaucoma introduced here. The method of this test is to let the patient lying in prone position with the head inclined downward, and reading in dark light for 1 hour. It is known as "lower head-prone-dark light-reading test" . We believe it is a simple, safe and effective method. Recently, we have used this method to examine normal and glaucoma tou s individuals. In 123 eyes of normal group, only 1 eye (0.75%) had increased intraocular pressure above 11mmHg after the test. In 115 eyes of simple glaucoma group, 5 eyes (4.35%) and in 146 eyes of angle-closure glaucoma group, 60 eyes (41.1%) . We have reviewed the pathogenesis relating to the test. We believe the rise of tension and the closure of the angle is due to multifactorial effects, the main cause is perhaps the increase of pupillary block.