Zhang Yang, Zhao Jia-Liang, Yang Yuan-Quan
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2009 Jan;45(1):8-13.
To evaluate the prevalence of appositional angle closure in eyes with a shallow peripheral anterior chamber (AC) and the anatomic narrow chamber angle by photopic and scotopic ultrasonic biomicroscopy (UBM).
Prospective case series study. 379 eyes of 194 consecutive patients with the shallow peripheral AC and the anatomic narrow chamber angle, which was determined by Van Herick technique and gonioscopy, were collected from the clinic and an epidemiological study. The presence of appositional angle closure and the angle-opening distance (AOD) was determined with photopic and scotopic ultrasound UBM in eight positions. The prevalence of appositional angle closure and AOD calculated by photopic and scotopic ultrasound biomicroscopy were compared. Paired chi2 test and Wilcoxon test (SPSS 12.0) were used to determine any significant differences at P < 0.05.
The prevalence of appositional angle closure was found at least one position in 264 eyes (69.7%) by scotopic UBM and in 99 (26.1%) eyes by photopic UBM. The prevalence of appositional angle closure was significantly higher by scotopic UBM than by photopic UBM (xhi2 = 159.148, P = 0.000 respectively), and was the highest in superior quadrant. The narrower AC was, the higher prevalence of appositional angle closure occurred. Furthermore, 98.3% of patients with peripheral AC < 1/4 corneal thickness (CT) were found to have an appositional angle closure by scotopic UBM. The AOD varied significantly among the four quadrants and was significantly narrower by scotopic UBM than by photopic UBM (Z = - 7.471, - 15.407, - 16.237, -16.782; P = 0.000). AOD in superior quadrant was narrowest with highest of the prevalence of appositional angle closure.
The prevalence of appositional angle closure varied with the depth of AC and can be effectively detected by photopic and scotopic UBM, more preferably by scotopic UBM at the clinic and the mass screening.
通过明视和暗视超声生物显微镜(UBM)评估周边前房浅和房角解剖学狭窄的眼中并发性房角关闭的患病率。
前瞻性病例系列研究。从临床和一项流行病学研究中收集了194例连续患者的379只周边前房浅且房角解剖学狭窄的眼睛,房角狭窄由Van Herick技术和前房角镜检查确定。在八个位置用明视和暗视超声UBM确定并发性房角关闭的存在及房角开放距离(AOD)。比较明视和暗视超声生物显微镜计算得出的并发性房角关闭患病率及AOD。采用配对卡方检验和Wilcoxon检验(SPSS 12.0)确定P<0.05时的任何显著差异。
暗视UBM发现264只眼(69.7%)至少在一个位置存在并发性房角关闭,明视UBM发现99只眼(26.1%)存在。暗视UBM检测到的并发性房角关闭患病率显著高于明视UBM(卡方值分别为159.148,P=0.000),且在上象限最高。周边前房越窄,发生并发性房角关闭的患病率越高。此外,暗视UBM发现周边前房<1/4角膜厚度(CT)的患者中有98.3%存在并发性房角关闭。四个象限的AOD差异显著,暗视UBM下的AOD明显比明视UBM下窄(Z=-7.471,-15.407,-16.237,-16.782;P=0.000)。上象限的AOD最窄,且并发性房角关闭的患病率最高。
并发性房角关闭的患病率随周边前房深度而变化,明视和暗视UBM均可有效检测,在临床和大规模筛查中更推荐使用暗视UBM。