Gramer Eugen, Reiter Constantin, Gramer Gwendolyn
Department of Ophthalmology, University Würzburg, Würzburg, Germany.
Eur J Ophthalmol. 2012 Jan-Feb;22(1):104-10. doi: 10.5301/EJO.2011.8318.
To evaluate the following in patients with aniridia: age at first examination at the University Eye Hospital and age at diagnosis of glaucoma; visual acuity; frequency of family history of aniridia; and frequency of ocular and general diseases associated with aniridia.
This was a consecutive examination of 30 unrelated patients with aniridia and retrospective evaluation of ophthalmologic, pediatric, and internal findings. The relative frequency of age at glaucoma diagnosis within decades was evaluated for the 20 patients with aniridia and glaucoma. Statistical analysis was performed using the Mann-Whitney test.
Relative frequency of the age of patients with aniridia at time of glaucoma diagnosis within the following decades was as follows: from birth to 9 years: 15%, 10-19: 15%, 20-29: 15%, 30-39: 15%, 40-49: 35%, and 50-59: 5%. Visual acuity in the better eye of 20/100 or less was found in 60%. Family history of aniridia was found in 33.3% of patients, with 1-4 relatives with aniridia. A total of 76.7% of patients had congenital cataract, and 66.7% had glaucoma. Mean maximum intraocular pressure of the 20 patients with glaucoma was 35.9 mmHg in the right and 32.6 mmHg in the left eye. A total of 53.3% had nystagmus, 26.6% corneal opacifications, 16.7% bilateral lens dislocation upwards, 6.7% optic nerve hypoplasia, 3.3% poor foveal development, and 3.3% Wilms tumor.
Up to the age of 40 years, 15% of patients were diagnosed with glaucoma per age decade. Frequent bilateral glaucoma and similar bilateral height of intraocular pressure suggest a genetic glaucoma disposition with malformation at Schlemm canal, besides possible sequential anatomic changes in the chamber angle. Associated ocular abnormalities limit visual prognosis.
评估无虹膜患者的以下情况:在大学眼科医院首次检查的年龄和青光眼诊断年龄;视力;无虹膜家族史的频率;以及与无虹膜相关的眼部和全身性疾病的频率。
对30例无亲缘关系的无虹膜患者进行连续检查,并对眼科、儿科和内科检查结果进行回顾性评估。对20例患有无虹膜和青光眼的患者,评估其在数十年内青光眼诊断时年龄的相对频率。采用曼-惠特尼检验进行统计分析。
在接下来的数十年内,无虹膜患者青光眼诊断时年龄的相对频率如下:出生至9岁:15%,10 - 19岁:15%,20 - 29岁:15%,30 - 39岁:15%,40 - 49岁:35%,50 - 59岁:5%。60%患者较好眼的视力为20/100或更低。33.3%的患者有1 - 4名亲属患有无虹膜的无虹膜家族史。76.7%的患者患有先天性白内障,66.7%的患者患有青光眼。20例青光眼患者右眼平均最大眼压为35.9 mmHg,左眼为32.6 mmHg。53.3%的患者有眼球震颤,26.6%有角膜混浊,16.7%有双侧晶状体向上脱位,6.7%有视神经发育不全,3.3%有黄斑发育不良,3.3%有威尔姆斯瘤。
在40岁之前,每十年有15%的患者被诊断为青光眼。频繁的双侧青光眼和相似的双侧眼压高度表明,除了房角可能的连续性解剖变化外,存在与施莱姆管畸形相关的遗传性青光眼倾向。相关的眼部异常限制了视觉预后。