Glaucoma Center of Excellence, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Invest Ophthalmol Vis Sci. 2012 Sep 21;53(10):6393-402. doi: 10.1167/iovs.12-10224.
To study change in choroidal thickness (CT) after water drinking test (WDT), comparing angle closure (AC) to open angle (OA) eyes.
Before and 30 minutes after drinking 1 L of water, 88 glaucoma subjects underwent measurements of CT by spectral domain-optical coherence tomography, IOP, blood pressure (BP), axial length (AL), and anterior chamber depth (ACD).
Baseline CT was significantly greater in AC than in OA eyes (P = 0.002). After WDT, BP, IOP, and AL increased significantly (all P ≤ 0.0001). Mean CT increased significantly in the AC group (5.6 μm, P = 0.04, n = 40) and among 80 subjects whose IOP rose > 2 mm Hg (responders; 3.2 μm, P = 0.048), but not in the OA group or among all subjects (2.5 μm increase overall, <1% of baseline CT, P = 0.10). ACD decreased in AC (-18 μm, P = 0.07), but not in OA eyes (+3 μm, P = 0.74). AC eyes had a significantly greater IOP increase after WDT than OA eyes (P = 0.002, multivariate regression). Among responders, CT increased more in those with larger diastolic perfusion pressure increase and in AC compared to OA eyes (P = 0.04 and P = 0.053, respectively, multivariate regression).
A significant increase in CT and a decrease in ACD after WDT were observed in AC but not in OA eyes, and IOP increased significantly more in AC than in OA eyes, suggesting that the dynamic behavior of the choroid may play a role in the AC process. IOP increase after the WDT was not fully explained by CT increase.
研究在饮水试验(WDT)后脉络膜厚度(CT)的变化,比较闭角型(AC)和开角型(OA)眼。
88 名青光眼患者在饮用 1 升水前后 30 分钟,通过谱域光学相干断层扫描、眼压(IOP)、血压(BP)、眼轴长度(AL)和前房深度(ACD)测量 CT。
基线时,AC 眼的 CT 明显大于 OA 眼(P = 0.002)。WDT 后,BP、IOP 和 AL 均显著升高(均 P ≤ 0.0001)。AC 组的平均 CT 明显增加(5.6 μm,P = 0.04,n = 40),在 80 名眼压升高 > 2 mmHg 的受试者(应答者;3.2 μm,P = 0.048)中,而在 OA 组或所有受试者中(总体增加 2.5 μm,占基线 CT 的不到 1%,P = 0.10)则没有。AC 眼的 ACD 减少(-18 μm,P = 0.07),但 OA 眼没有(+3 μm,P = 0.74)。WDT 后 AC 眼的 IOP 升高明显大于 OA 眼(P = 0.002,多元回归)。在应答者中,CT 增加更多的是舒张压灌注压增加较大的患者和 AC 眼与 OA 眼相比(P = 0.04 和 P = 0.053,多元回归)。
AC 眼在 WDT 后 CT 显著增加,ACD 减少,而 OA 眼则没有,AC 眼的 IOP 升高明显大于 OA 眼,提示脉络膜的动态行为可能在 AC 过程中起作用。WDT 后 IOP 的升高不能完全用 CT 的增加来解释。