Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, Shantou, China.
JAMA Ophthalmol. 2013 Jan;131(1):44-9. doi: 10.1001/jamaophthalmol.2013.567.
To evaluate changes in the speed of pupil constriction and in anterior segment parameters after laser peripheral iridotomy (LPI) in patients with angle closure using anterior segment optical coherence tomography.
In this prospective observational study, videos of pupil and anterior segment changes in response to illumination were captured with real-time video recording using anterior segment optical coherence tomography and were analyzed frame by frame before and after LPI. Customized software was used to measure the speed of pupil constriction and changes in anterior chamber depth and anterior chamber area, as well as iris thickness at 750 μm from the scleral spur, at the sphincter muscle region (0.75 mm from the pupillary margin), and at the mid-iris location (half the distance between the scleral spur and the pupillary margin). Pupil diameter, angle opening distance, and trabecular-iris space area at 500 μm from the scleral spur were determined. The speed of pupil constriction was defined as the rate of pupil diameter change in response to illumination.
Twenty-nine patients were included. Most were Chinese (26 of 29 [90%]) and female (18 of 29 [62%]). The anterior chamber area, angle opening distance at 500 μm from the scleral spur, and trabecular-iris space area at 500 μm from the scleral spur were significantly higher after LPI (P < .001). A significant increase was observed in the speed of pupil constriction after LPI (P < .005). In response to illumination, the rate of change in iris thickness at the sphincter muscle region and at 750 μm from the scleral spur was faster after LPI (P < .05). Similarly, an increase was observed in the speed of change of angle-opening distance at 500 μm from the scleral spur in response to illumination after LPI (P < .05).
In patients with angle closure, changes in dynamic iridopupillary behavior are observed after LPI. The speed of pupillary constriction is faster after LPI.
使用眼前节光学相干断层扫描评估激光周边虹膜切开术（LPI）后瞳孔收缩速度和眼前节参数的变化，以评估闭角型青光眼患者的情况。
在这项前瞻性观察研究中，使用眼前节光学相干断层扫描实时视频记录拍摄瞳孔和眼前节对光照变化的视频，并在 LPI 前后逐帧进行分析。使用定制软件测量瞳孔收缩速度以及前房深度、前房面积、巩膜突 750μm 处虹膜厚度（距瞳孔缘 0.75mm）和虹膜中部（巩膜突和瞳孔缘之间距离的一半）的变化。测量巩膜突 500μm 处瞳孔直径、房角开放距离和小梁虹膜空间面积。瞳孔收缩速度定义为瞳孔直径对光照变化的反应速率。
共纳入 29 例患者。大多数为中国人（29 例中的 26 例[90%]）和女性（29 例中的 18 例[62%]）。LPI 后前房面积、巩膜突 500μm 处房角开放距离和巩膜突 500μm 处小梁虹膜空间面积均显著升高（P<0.001）。LPI 后瞳孔收缩速度显著加快（P<0.005）。LPI 后，瞳孔括约肌区域和巩膜突 750μm 处虹膜厚度的变化率加快（P<0.05）。同样，LPI 后巩膜突 500μm 处房角开放距离对光照变化的变化速度也加快（P<0.05）。
在闭角型青光眼患者中，LPI 后观察到动态虹膜瞳孔行为的变化。LPI 后瞳孔收缩速度加快。
