Akagi Tadamichi, Nakanishi Hideo, Yoshimura Nagahisa
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Am J Ophthalmol Case Rep. 2016 Jun 29;3:54-60. doi: 10.1016/j.ajoc.2016.06.006. eCollection 2016 Oct.
To investigate the effects of intraocular pressure (IOP) reduction on the eyeball shape in highly myopic eyes with high IOP.
This study included patients with an axial length ≥26.5 mm and high IOP ≥22 mmHg after receiving maximum medication, with successful trabeculectomy by a single surgeon, and who underwent swept-source optical coherence tomography (SS-OCT) examinations on preoperative and postoperative ≥3 months periods. Eight eyes of 7 patients were included in the analysis. The morphological changes in the eyeball that occurred pre- and post-operation were analyzed from the SS-OCT images.
In 6 out of 8 examined eyes, the following apparent morphological changes in the posterior pole and/or peripapillary sclera were postoperatively detected on SS-OCT images: peripapillary scleral shrinkage, decrease in the lamina cribrosa depth, flattening of the peripapillary scleral insertion into the optic disc, decrease in the angle of the scleral protrusion temporal to the optic disc, and inhomogeneous change in scleral curvature of the posterior pole.
We found that the shape of some eyes with high myopia and high IOP changed owing to the decrease in IOP. Eyeball deformities may be affected by high IOP, and IOP reduction might reduce scleral deformation in highly myopic eyes with high IOP.
探讨降低眼压对高眼压高度近视眼眼球形态的影响。
本研究纳入眼轴长度≥26.5 mm且在接受最大药物治疗后眼压≥22 mmHg的患者,这些患者由单一外科医生成功实施小梁切除术,并在术前及术后≥3个月接受扫频源光学相干断层扫描(SS-OCT)检查。分析了7例患者的8只眼。从SS-OCT图像分析手术前后眼球发生的形态学变化。
在8只受检眼中,有6只眼在术后的SS-OCT图像上检测到后极部和/或视乳头周围巩膜出现以下明显的形态学变化:视乳头周围巩膜收缩、筛板深度减小、视乳头周围巩膜插入视神经盘处变平、视神经盘颞侧巩膜突出角度减小以及后极部巩膜曲率不均匀变化。
我们发现,部分高眼压高度近视眼的眼球形态因眼压降低而发生改变。眼球畸形可能受高眼压影响,降低眼压可能会减少高眼压高度近视眼的巩膜变形。