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原发性急性闭角型青光眼合并睫状体脉络膜脱离:4例报告及文献复习

Primary acute angle-closure glaucoma complicating ciliochoroidal detachment: report of four cases and review of the literature.

作者信息

Zhang Yan, Wang Chao, Liu Li, Lei Yingqing, He Yue, Yu Ling

机构信息

Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China.

出版信息

Int Ophthalmol. 2018 Dec;38(6):2693-2697. doi: 10.1007/s10792-017-0769-y. Epub 2017 Nov 23.

Abstract

PURPOSE

To describe the ultrasound biomicroscopy (UBM) and B-scan ultrasonography findings and therapeutic approach for ciliochoroidal detachment secondary to acute primary angle-closure glaucoma (APACG) in four patients. We also reviewed the literature.

METHODS

Case report and systematic literature review.

RESULTS

The four patients were referred to our department for further management of APACG. The UBM and B-scan ultrasonography examinations were conducted 2 days after the beginning of medical treatment and demonstrated ciliochoroidal detachment in four eyes of the four patients. The patients all received intravenous infusion of corticosteroid therapy (10 mg dexamethasone once daily for 5-7 days). We reviewed the UBM findings, which confirmed that the ciliochoroidal detachment disappeared. The patients then underwent trabeculectomy combined with peripheral iridotomy surgery. The patients all ultimately recovered very well.

CONCLUSION

APACG with ciliochoroidal detachment is rare and has hidden clinical manifestations, and the pathophysiological mechanism is not yet fully understood. Anti-glaucoma surgery may increase the detachment. UBM and B-scan ultrasounds are useful tools for ciliochoroidal detachment diagnosis in APACG patients before operative treatment.

摘要

目的

描述4例急性原发性闭角型青光眼(APACG)继发睫状体脉络膜脱离的超声生物显微镜(UBM)和B超检查结果及治疗方法。我们还对相关文献进行了回顾。

方法

病例报告及系统性文献回顾。

结果

4例患者因APACG来我院进一步治疗。在药物治疗开始2天后进行了UBM和B超检查,4例患者的4只眼中均显示有睫状体脉络膜脱离。所有患者均接受了静脉注射皮质类固醇治疗(每日1次,10 mg地塞米松,共5 - 7天)。我们回顾了UBM检查结果,证实睫状体脉络膜脱离消失。然后患者接受了小梁切除术联合周边虹膜切开术。所有患者最终恢复良好。

结论

伴有睫状体脉络膜脱离的APACG较为罕见,临床表现隐匿,其病理生理机制尚未完全明确。抗青光眼手术可能会加重脱离。UBM和B超是APACG患者手术治疗前诊断睫状体脉络膜脱离的有用工具。

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