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急性原发性闭角型青光眼后的葡萄膜渗漏:一项回顾性病例系列研究。

Uveal effusion following acute primary angle-closure: a retrospective case series.

作者信息

Yang Jian-Gang, Li Jian-Jun, Tian Hua, Li Yan-Hong, Gong Yu-Jing, Su An-Le, He Na

机构信息

Xi'an Eye Hospital, Xi'an First Hospital, Xi'an 710002, Shaanxi Province, China.

Department of Ophthalmology, Xian XD Group Hospital, Xi'an 710077, Shaanxi Province, China.

出版信息

Int J Ophthalmol. 2017 Mar 18;10(3):406-412. doi: 10.18240/ijo.2017.03.13. eCollection 2017.

Abstract

AIM

To evaluate the morphological changes in anterior segment in Chinese patients with uveal effusion (UE) after the attack of acute primary angle-closure (APAC) using ultrasound biomicroscopy (UBM), and to assess the clinical course and prognosis of the disease.

METHODS

In a retrospective case series, 26 eyes in 26 consecutive patients diagnosed with UE after the treatment of intraocular pressure (IOP)-lowering medication for the attack of APAC were enrolled. The unaffected fellow eyes served as controls. The morphological changes were observed by ultrasonography, slit lamp microscopy and gonioscopy. UBM was used to assess the degree and extent of effusion based on the analysis of parameters associated with UE.

RESULTS

The mean IOP was 9.2 (SD 2.1) mm Hg at the diagnosis of UE after IOP-lowering medication, while 14.1 (SD, 2.6) mm Hg in the fellow eyes (=0.000). The anterior chamber depth (ACD) (=0.000), angle opening distance at 500 µm (AOD500) (<0.01) and anterior chamber angle (ACA) (<0.05) were decreased significantly, while ciliary body thickness (CBT) (<0.05) increased significantly in UE eyes. UE grade analysis showed 7 eyes in grade 1, 9 eyes in grade 2, and 10 eyes in grade 3. Quadrant scores were performed of 4 eyes in 1 quadrant, 3 eyes in 3 quadrants, and 19 eyes in 4 quadrants. There was the positive correlation between grade and quadrant score (=0.644, =0.000). The effusion on all eyes were recovered after medication, which mean IOP was 13.9 (SD, 2.8) mm Hg.

CONCLUSION

UE is a frequent complication in Chinese patients after the attack of APAC, partially associated with hypotony. The severity of UE is correlation with height of effusion, extent of detachment, and shallower ACD.

摘要

目的

采用超声生物显微镜(UBM)评估中国葡萄膜渗漏(UE)患者在急性原发性闭角型青光眼(APAC)发作后的眼前节形态变化,并评估该疾病的临床病程及预后。

方法

在一项回顾性病例系列研究中,纳入了26例连续诊断为APAC发作后经降眼压药物治疗后出现UE的患者的26只眼。未受影响的对侧眼作为对照。通过超声检查、裂隙灯显微镜检查和前房角镜检查观察形态变化。基于与UE相关参数的分析,使用UBM评估渗漏的程度和范围。

结果

在使用降眼压药物后诊断为UE时,平均眼压为9.2(标准差2.1)mmHg,而对侧眼为14.1(标准差2.6)mmHg(P = 0.000)。UE眼的前房深度(ACD)(P = 0.000)、500μm处房角开放距离(AOD500)(P < 0.01)和前房角(ACA)(P < 0.05)显著降低,而睫状体厚度(CBT)(P < 0.05)显著增加。UE分级分析显示,1级7只眼,2级9只眼,3级10只眼。象限评分显示,1个象限4只眼,3个象限3只眼,4个象限19只眼。分级与象限评分之间存在正相关(P = 0.644,P = 0.000)。用药后所有眼的渗漏均恢复,平均眼压为13.9(标准差2.8)mmHg。

结论

UE是中国患者APAC发作后的常见并发症,部分与低眼压有关。UE的严重程度与渗漏高度、脱离范围和ACD变浅相关。

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