Moghimi Sasan, Zandvakil Narges, Vahedian Zakieh, Mohammadi Massood, Fakhraie Ghasem, Coleman Anne L, Lin Shan C
Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran; Koret Vision Center, University of California, San Francisco Medical School, San Francisco, California, USA.
Clin Exp Ophthalmol. 2014 Sep-Oct;42(7):615-22. doi: 10.1111/ceo.12285. Epub 2014 Jan 27.
To evaluate different mechanisms of acute angle closure and to compare it with unaffected fellow eyes and primary angle closure suspects using anterior segment optical coherence tomography.
Prospective, cross-sectional.
116 eyes (76 patients) with angle closure disease were included.
Eyes were categorized into three groups: (i) acute angle closure (40 eyes); (ii) fellow eyes of acute angle closure (40 eyes); and (iii) primary angle closure suspect (36 eyes). Complete ophthalmic examinations including gonioscopy, A-scan biometry and anterior segment optical coherence tomography were performed.
Based on the anterior segment optical coherence tomography images, four mechanisms of primary angle closure including pupil block, plateau iris configuration, thick peripheral iris roll and exaggerated lens vault were evaluated among the three subtypes of angle closure disease.
There was a statistically significant difference in the mechanism of angle closure disease among the three groups (P < 0.001). Although the majority of fellow and primary angle closure suspect eyes had pupil block mechanism (77.5% and 75%, respectively), only 37.5% of acute angle closure eyes had dominant pupil block mechanism. The percentage because of exaggerated lens vault was greatest in acute angle closure eyes (50%). Acute angle closure eyes had the shallowest anterior chamber depth (P < 0.001), least iris curvature (P < 0.001) and greatest lens vault (P = 0.003) compared with the other two groups.
A statistically significant difference in the underlying primary angle closure mechanisms among acute angle closure eyes as compared with their fellow eyes and primary angle closure suspect may exist.
利用眼前节光学相干断层扫描技术评估急性闭角的不同机制，并将其与未受影响的对侧眼及原发性闭角型青光眼可疑眼进行比较。
前瞻性横断面研究。
纳入116只患有闭角型青光眼的眼睛（76例患者）。
将眼睛分为三组：（i）急性闭角型青光眼（40只眼）；（ii）急性闭角型青光眼的对侧眼（40只眼）；（iii）原发性闭角型青光眼可疑眼（36只眼）。进行了包括前房角镜检查、A超生物测量和眼前节光学相干断层扫描在内的完整眼科检查。
基于眼前节光学相干断层扫描图像，在闭角型青光眼的三种亚型中评估原发性闭角的四种机制，包括瞳孔阻滞、高原虹膜形态、周边虹膜肥厚和晶状体拱起过度。
三组之间闭角型青光眼的机制存在统计学显著差异（P < 0.001）。虽然大多数对侧眼和原发性闭角型青光眼可疑眼具有瞳孔阻滞机制（分别为77.5%和75%），但只有37.5%的急性闭角型青光眼眼具有主要的瞳孔阻滞机制。晶状体拱起过度导致的比例在急性闭角型青光眼眼中最高（50%）。与其他两组相比，急性闭角型青光眼眼的前房深度最浅（P < 0.001），虹膜曲率最小（P < 0.001），晶状体拱起最大（P = 0.003）。
与对侧眼和原发性闭角型青光眼可疑眼相比，急性闭角型青光眼眼潜在的原发性闭角机制可能存在统计学显著差异。
