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黏多糖贮积症患者疑似青光眼的评估与诊断

Assessment and diagnosis of suspected glaucoma in patients with mucopolysaccharidosis.

作者信息

Ashworth Jane, Flaherty Maree, Pitz Susanne, Ramlee Azura

机构信息

Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

出版信息

Acta Ophthalmol. 2015 Mar;93(2):e111-7. doi: 10.1111/aos.12607.

Abstract

PURPOSE

The mucopolysaccharidoses (MPS) are a group of rare lysosomal storage disorders, characterized by the accumulation of glycosaminoglycans within multiple organ systems including the eye. This study aimed to determine the prevalence of glaucoma in patients with MPS, as well as the characteristics, diagnosis and management of patients with MPS and glaucoma.

METHODS

A multicentre retrospective case-note review was carried out by ophthalmologists from four tertiary referral centres to identify patients with MPS who had been treated for glaucoma. Clinical ophthalmological data were collected using standardized data collection forms.

RESULTS

Fourteen patients were identified (27 eyes) of 294 patients with MPS. The prevalence of glaucoma ranged from 2.1% to 12.5%. The median age at diagnosis of glaucoma was 8 years. Diagnostic evaluation of glaucoma was incomplete in many patients: intraocular pressure was documented in all eyes, but optic disc appearance was only assessed in 67%, central corneal thickness in 26%, visual fields in 19% and iridocorneal angle in 15%.

CONCLUSIONS

Patients with MPS need regular assessment for possible glaucoma including during childhood. Multiple factors contribute to the challenges of assessment, diagnosis and monitoring of glaucoma in these patients.

摘要

目的

黏多糖贮积症(MPS)是一组罕见的溶酶体贮积病,其特征是糖胺聚糖在包括眼部在内的多个器官系统中蓄积。本研究旨在确定MPS患者青光眼的患病率,以及MPS合并青光眼患者的特征、诊断和管理。

方法

来自四个三级转诊中心的眼科医生进行了一项多中心回顾性病例记录审查,以确定接受过青光眼治疗的MPS患者。使用标准化数据收集表收集临床眼科数据。

结果

在294例MPS患者中确定了14例(27只眼)。青光眼的患病率为2.1%至12.5%。青光眼诊断时的中位年龄为8岁。许多患者对青光眼的诊断评估不完整:所有眼睛均记录了眼压,但仅67%的眼睛评估了视盘外观,26%评估了中央角膜厚度,19%评估了视野,15%评估了虹膜角膜角。

结论

MPS患者需要定期评估是否可能患有青光眼,包括在儿童期。多种因素导致对这些患者青光眼的评估、诊断和监测面临挑战。

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