Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital, Great Ormond Street, London, UK.
Ophthalmology. 2011 Nov;118(11):2274-2278.e1. doi: 10.1016/j.ophtha.2011.04.022. Epub 2011 Jul 23.
To identify the sensitivity and specificity of risk factors for the development of glaucoma in patients with port wine stain (PWS).
A retrospective case-control study involving a large cohort of patients with PWS.
A total of 216 patients (total of 252 eyes) with unilateral or bilateral PWS seen in the eye department in Great Ormond Street Hospital, London, United Kingdom.
We studied the anatomic distribution of PWS and the incidence of choroidal hemangioma, episcleral hemangioma, iris heterochromia, and Sturge-Weber syndrome (SWS). We analyzed the sensitivity and specificity of these features as risk factors for glaucoma.
Development of glaucoma.
Mean age at presentation was 2.9 years (3 weeks to 18.8 years). Mean follow-up was 3.2 years (0-15 years). A total of 180 patients (83.3%) had unilateral lesion, and 36 patients (16.7%) had bilateral lesion. Thirty-one patients (14.3%) had isolated V1 lesion, 35 patients had V2 lesion only (16.2%), and 93 patients (43%) had both V1 and V2 involved. On the last visit, 46 eyes (18.3%) in 39 patients had glaucoma; their mean age was 3.25 years. Glaucoma was more common if PWS was bilateral (P=0.0001), both upper and lower lids were involved (P < 0.0001), and episcleral hemangioma (P < 0.0001), iris heterochromia (P=0.004), or choroidal hemangioma (P < 0.0001) was present. Twenty-four patients had SWS; this was significantly associated with upper lid PWS (P=0.001) and bilateral PWS (P=0.0003). Glaucoma was more common in patients with SWS compared with those without (66.7% vs. 18%, P=0.01). Combined upper and lower lid PWS, episcleral hemangioma, SWS, and iris heterochromia are sensitive prognosticators for the development of glaucoma.
Iris heterochromia is associated with the development of early glaucoma in patients with PWS. Patients at high risk of glaucoma should be seen more often in clinic. Patients who do not have combined lid involvement or episcleral hemangioma have a lower risk and can therefore be seen less often in clinic.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
确定葡萄酒色斑（PWS）患者发生青光眼的风险因素的敏感性和特异性。
一项涉及伦敦大奥蒙德街医院眼科就诊的大量 PWS 患者的回顾性病例对照研究。
共有 216 名（共 252 只眼）单侧或双侧 PWS 患者。
我们研究了 PWS 的解剖分布以及脉络膜血管瘤、巩膜血管瘤、虹膜异色和 Sturge-Weber 综合征（SWS）的发生率。我们分析了这些特征作为青光眼风险因素的敏感性和特异性。
青光眼的发展。
就诊时的平均年龄为 2.9 岁（3 周至 18.8 岁）。平均随访时间为 3.2 年（0-15 年）。180 名患者（83.3%）为单侧病变，36 名患者（16.7%）为双侧病变。31 名患者（14.3%）为单纯 V1 病变，35 名患者 V2 病变仅为 16.2%，93 名患者（43%） V1 和 V2 均受累。最后一次就诊时，39 名患者中有 46 只眼（18.3%）患有青光眼，平均年龄为 3.25 岁。如果 PWS 为双侧（P=0.0001）、上下眼睑均受累（P<0.0001）、存在巩膜血管瘤（P<0.0001）、虹膜异色（P=0.004）或脉络膜血管瘤（P<0.0001），则青光眼更常见。24 名患者患有 SWS；这与上眼睑 PWS（P=0.001）和双侧 PWS（P=0.0003）显著相关。与无 SWS 的患者相比，患有 SWS 的患者青光眼更常见（66.7%比 18%，P=0.01）。上眼睑和下眼睑 PWS、巩膜血管瘤、SWS 和虹膜异色是青光眼发生的敏感预测因子。
虹膜异色与 PWS 患者早期青光眼的发展有关。青光眼风险高的患者应更频繁地在诊所就诊。没有上下眼睑受累或巩膜血管瘤的患者风险较低，因此可以较少地在诊所就诊。
作者在本文讨论的材料中没有任何专有或商业利益。
