Mérula Rafael Vidal, Cronemberger Sebastião, Diniz Filho Alberto, Calixto Nassim
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Arq Bras Oftalmol. 2008 May-Jun;71(3):321-7. doi: 10.1590/s0004-27492008000300004.
To establish the profile of patients with acute primary angle-closure glaucoma (APACG) and to assess comparatively clinical and morphometric parameters between eyes with APACG and contralateral eyes (CLEs).
Prospective study including patients attended from September 2005 to March 2007.
diagnosis of APACG.
presence of cataract (except for "glaukomflecken") that may cause low visual acuity or myopization, secondary glaucoma, previous APAGC or surgical procedure in the (CLE), no possibility to control the acute crisis of glaucoma clinically, plateau iris. The following were evaluated: incidence of APACG, age, gender, race, family history of glaucoma, corrected visual acuity (CVA) and uncorrected visual acuity (UVA), spherical equivalent (SE), cup/disc ratio (C/D), gonioscopy, keratometry (K), central corneal thickness (CCT), and echobiometric data [anterior central chamber depth (ACCD), axial length (AL), lens thickness (LT)] and relation between lens thickness and axial length (LT/AL).
One thousand and three hundred and forty-three patients were examined from September 2005 to March 2006; 28 (2.1%) had the diagnosis of APACG. The incidence of the APACG was 20.8 cases per 1000 patients. The patients with APACG were manly white women with a negative familial history of glaucoma and with an average age of 59.6 years. When clinical aspects were compared between eyes with APACG and CLEs, statistical significance was observed: UVA (APACG: 0.27 +/- 0.32; CLE: 0.57 +/- 0.33, p=0.000); CVA (APACG: 0.53 +/- 0.44; CLE: 0.88 +/- 0.23, p=0.000); SE (APACG: +0.49 +/- 1.98; CLE: +1.21 +/- 2.03, p=0.007); C/D (APACG: 0.51 +/- 0.28; CLE: 0.42 +/- 0.20; p=0.031). Also, by gonioscopy, eyes with APACG demonstrated more frequently angle closure than CLEs. The eye of the crisis showed the following characteristics: average K of 45.21 +/- 1.96 D, average CCT of 534.46 +/- 34.15 mm, average ACCD of 2.43 +/- 0.28 mm, average AL of 21.68 +/- 0.96 mm, average LT 4.85 +/- 0.32 mm and average LT/AL of 2.24 +/- 0.16. The CLE presented average K of 44.92 +/- 1.86 D, average CCT of 533.18 +/- 31.41 microm, average ACCD of 2.51 +/- 0.29 mm, average AL of 21.82 +/- 0.92 mm, average LT 4.85 +/- 0.36 mm and average LT/AL of 2.23 +/- 0.18. There were statistically significant differences only in two parameters (K and ACCD) when affected and the CLE were compared.
The incidence of the APACG was 20.8/1000. It was more frequent in white women, leu kodermics, without family history of glaucoma and with an age average of 59.6 years. The eyes with APACG showed, with statistical significance, worse visual acuity, higher C/D, lower hypermetropic SE, higher average K, and lower ACCD than CLEs.
确立急性原发性闭角型青光眼（APACG）患者的概况，并比较APACG患眼与对侧眼（CLEs）的临床和形态学参数。
前瞻性研究，纳入2005年9月至2007年3月就诊的患者。
APACG诊断。
存在可能导致视力低下或近视化的白内障（“青光眼斑”除外）、继发性青光眼、既往APAGC或（CLE）有手术史、临床上无法控制青光眼急性发作、高原虹膜。评估以下指标：APACG发病率、年龄、性别、种族、青光眼家族史、矫正视力（CVA）和未矫正视力（UVA）、等效球镜度（SE）、杯盘比（C/D）、前房角镜检查、角膜曲率计测量值（K）、中央角膜厚度（CCT）、超声生物测量数据[中央前房深度（ACCD）、眼轴长度（AL）、晶状体厚度（LT）]以及晶状体厚度与眼轴长度的关系（LT/AL）。
2005年9月至2006年3月共检查1343例患者；28例（2.1%）诊断为APACG。APACG发病率为每1000例患者20.8例。APACG患者主要为白人女性，青光眼家族史阴性，平均年龄59.6岁。比较APACG患眼与CLEs的临床情况时，观察到统计学差异：UVA（APACG：0.27±0.32；CLE：0.57±0.33，p = 0.000）；CVA（APACG：0.53±0.44；CLE：0.88±0.23，p = 0.000）；SE（APACG：+0.49±1.98；CLE：+1.21±2.03，p = 0.007）；C/D（APACG：0.51±0.28；CLE：0.42±0.20；p = 0.031）。此外，通过前房角镜检查，APACG患眼比CLEs更频繁出现房角关闭。急性发作眼表现出以下特征：平均K值为45.21±1.96 D，平均CCT为534.46±34.15 mm，平均ACCD为2.43±0.28 mm，平均AL为21.68±0.96 mm，平均LT为4.85±0.32 mm，平均LT/AL为2.24±0.16。CLE平均K值为44.92±1.86 D，平均CCT为533.18±31.41微米，平均ACCD为2.51±0.29 mm，平均AL为21.82±0.92 mm，平均LT为4.85±0.36 mm，平均LT/AL为2.23±0.18。比较患眼与CLEs时，仅在两个参数（K和ACCD）上存在统计学显著差异。
APACG发病率为20.8/1000。在白人女性、白皮肤、无青光眼家族史且平均年龄59.6岁的人群中更常见。与CLEs相比，APACG患眼在视力、C/D、远视性SE较低、平均K值较高和ACCD较低方面具有统计学显著差异。
