30岁以下青光眼73例临床分析

Clinical analysis of 73 glaucoma patients under 30 years of age.

目的 探讨 3 0岁以下青光眼的类型 ,构成比 ,临床症状 ,治疗效果及预后。 方法 对海南省人民医院1998年 1月～ 2 0 0 2年 10月收治的 3 0岁以下青光眼患者的临床资料进行回顾性分析总结。 结果 本组病例共 74例 10 8眼。青光眼类型以继发性青光眼为主 ,占 5 6 5 % ,其中又以激素性及外伤性青光眼为多。视野检查 ,视野呈管状或仅存颞侧视岛者达 3 6眼占 72 0 % ;药物治疗后眼压和视力改善不大。 结论 3 0岁以下青光眼中继发性青光眼多于先天性青光眼。这些病人就诊时病程较晚 ,视功能受损重 ,即使能有效控制眼压亦难保护视力。建立某种青少年青光眼的筛查机制、防止滥用激素类药物。

Objective To analyze the classification, ratio, treating effects and prognosis of the glaucoma patients who were younger than 30 years. Methods To analyze the clinic materials of the young glaucoma patients who were treated in our hospital during January 1998 to October 2002. Results 108 eyes of the 74 cases, aged 2 months to 30 years old (averaged 16.6±7.8 years),were observed. Secondary glaucoma, which was mainly consisted of sterokd glaucoma and those due to eye trauma, was 56.5%. Congenital glaucoma was 43.5%. Only 50 eyes could be examined the visual fieid and 36 eyes of them (72%) showed the tube field or the temporal visual island. Only 77 eyes could be seen the fundues and the cup/disc rate of 55 eyes (71.4%)was larger than 0.7.78 eyes (72.2%)were performed operations on. The intraocular pressure(IOP) of the 99 eyes(91.7%) was higher than 21 mmHg or TN before treatment. After treatment, it was lower than 21mmHg or TN+1 in 93 eyes(87.7%);The IOP of 13 eyes(12.3%),however,could not be controlled. Pretreatment, corrective visual acuity of 49 eyes(54.4%)was no perception light to 0.05;18 eyes(17%) was 0.05 to 0.3 and 35 eyes (32.4%) was better than 0.3. Post treatment, corrective visual acuity of 44 eyes (40.7%)was no perception light to 0.05;19 eyes (17.6%)was 0.05 to 0.3 and 39 eyes(36.1%)were better than 0.3. Conclusion The ratio of the secondary glaucoma was higher than the congenital one in the persons who were younger than 30 years. Early diagnosis was diffcult and the visual functions were usually damaged severely in these patients. To establish a kind of glaucoma screening system in young persons will be useful for early diagnosis. To avoid misusing the steroids and prevent eye trauma will reduce effectively the prevalence of the glaucoma in this age.