Kim Hyung Chul, Cho A Ran, Lew Helen
Department of Ophthalmology, Bundang CHA Hospital, CHA University, Seongnam, Korea.
Seoul St. Mary's Eye Hospital, Suwon, Korea.
Korean J Ophthalmol. 2015 Feb;29(1):1-6. doi: 10.3341/kjo.2015.29.1.1. Epub 2015 Jan 22.
To investigate the diagnostic effectiveness of dacryoscintigraphy in children with tearing; to evaluate tear clearance rate as a diagnostic factor of dacryoscintigraphy in children with tearing; and to analyze the results of treatment according to dacryoscintigraphic findings in children with tearing.
Between January 2010 and April 2014, 176 eyes of 88 children with tearing (49 boys and 39 girls; mean age, 23.81 ±14.67 months; range, 12 to 72 months) were studied retrospectively. Of these, 37 of 88 children with tearing were bilateral cases, and 51 were unilateral cases. None of the patients had a history of craniofacial disorder or trauma. The chief complaint of tearing with or without eye discharge and delivery mode, past history of neonatal conjunctivitis, syringing, or probing were collected from parents, grandparents, or previous hospital data. The drainage pattern of the nasolacrimal duct was analyzed, and the clearance rate of 50 µCi 99m technetium pertechnetate was measured by dacryoscintigraphy.
According to the dacryoscintigraphy results, 98 of 125 eyes (78.4%) with tearing showed nasolacrimal obstruction and 29 of 51 eyes (56.9%) without tearing showed patency. There was a significant difference between tearing eyes and normal eyes (p = 0.001). The clearance rate difference after 3 and 30 minutes was 16.41 ± 15.37% in tearing eyes and 23.57 ±14.15% in normal eyes. There was a significant difference between epiphoric eyes and normal eyes (p = 0.05). Based on the dacryoscintigraphic findings, nasolacrimal-duct obstruction was treated with probing or silicone-tube intubation. The majority of patients showed symptom improvement (75.2%) during the two months of follow-up.
Dacryoscintigraphy is a non-invasive method of qualitatively and quantitatively diagnosing nasolacrimal duct obstruction in children with tearing.
探讨泪道闪烁造影对泪溢患儿的诊断效能;评估泪液清除率作为泪溢患儿泪道闪烁造影诊断因素的价值;并根据泪道闪烁造影结果分析泪溢患儿的治疗效果。
回顾性研究2010年1月至2014年4月期间88例泪溢患儿(男49例,女39例;平均年龄23.81±14.67个月;范围12至72个月)的176只眼。其中,88例泪溢患儿中37例为双侧病例,51例为单侧病例。所有患者均无颅面疾病或外伤史。从父母、祖父母或既往医院资料中收集有无溢泪伴或不伴眼部分泌物的主要症状以及分娩方式、新生儿结膜炎病史、冲洗或探通情况。分析鼻泪管的引流模式,并通过泪道闪烁造影测量50µCi高锝[99mTc]酸盐的清除率。
根据泪道闪烁造影结果,125只泪溢眼中98只(78.4%)显示鼻泪管阻塞,51只无泪溢眼中29只(56.9%)显示通畅。泪溢眼与正常眼之间存在显著差异(p = 0.001)。泪溢眼3分钟和30分钟后的清除率差异为16.41±15.37%,正常眼为23.57±14.15%。溢泪眼与正常眼之间存在显著差异(p = 0.05)。根据泪道闪烁造影结果,鼻泪管阻塞采用探通或硅胶管插管治疗。大多数患者在随访的两个月内症状改善(75.2%)。
泪道闪烁造影是一种定性和定量诊断泪溢患儿鼻泪管阻塞的非侵入性方法。