Nguyen Diem-Trang, Giocanti-Aurégan Audrey, Benhatchi Nassima, Greliche Nicolas, Beaussier Helene, Sustronck Pierre, Hammoud Sirine, Jeanteur Marie-Nathalie, Kretz Gilles, Abitbol Olivia, Lachkar Yves
Ophthalmology Department, Necker-Enfants Malades Hospital, Paris, France.
Ophthalmology Department, Avicenne Hospital, 125 rue de Stalingrad, 93000, Bobigny, France.
Int Ophthalmol. 2020 Jan;40(1):195-203. doi: 10.1007/s10792-019-01171-z. Epub 2019 Oct 1.
A role of the choroid has been suggested in the pathophysiology of angle closure. We assessed the choroidal thickness (CT) in Caucasian patients with primary angle closure (PAC) and in a subgroup of patients with plateau iris using swept-source optical coherence tomography (SS-OCT) compared to normal eyes.
This prospective cohort study in a hospital-based population in a tertiary center compared consecutive patients with PAC to healthy controls. A subgroup analysis of patients with plateau iris was also performed. Choroidal thickness was measured by SS-OCT in the subfoveal area (SFCT) and at 1- and 3-mm eccentricity superiorly, inferiorly, nasally and temporally from the fovea.
Compared to the 25 eyes of 13 control patients [7 women, mean (SD) age, 56.6 (15.7) years], the 45 eyes of 25 patients with PAC [15 women, mean (SD) age, 55.7 (10.7) years] had a significantly increased SFCT. SFCT was 355.36 μm (SD 85.97) in PAC eyes versus 286.08 μm (SD 98.09) in control eyes (p = 0.009). The CT was also significantly increased compared to control eyes in other macular areas (p < 0.05), except at 3 mm temporal to the fovea. In the plateau iris subgroup, a not significant (except 3 mm nasal to the fovea) trend toward an increased CT was observed in all studied macular areas compared to control eyes.
In eyes of Caucasian patients with PAC, the CT is increased compared to controls. Increased CT could contribute to the pathophysiology of PAC with a possible choroidal expansion and dysfunction of choroidal ganglion cells.
脉络膜在闭角型青光眼的病理生理学中所起的作用已被提出。我们使用扫频光学相干断层扫描（SS-OCT）评估了白种人原发性闭角型青光眼（PAC）患者以及高原虹膜患者亚组的脉络膜厚度（CT），并与正常眼进行比较。
这项在三级中心基于医院人群的前瞻性队列研究，将连续的PAC患者与健康对照进行比较。还对高原虹膜患者进行了亚组分析。通过SS-OCT测量黄斑中心凹下区域（SFCT）以及从中心凹向上、向下、鼻侧和颞侧1毫米和3毫米偏心度处的脉络膜厚度。
与13名对照患者的25只眼（7名女性，平均（标准差）年龄56.6（15.7）岁）相比，25名PAC患者的45只眼（15名女性，平均（标准差）年龄55.7（10.7）岁）的SFCT显著增加。PAC患眼中的SFCT为355.36μm（标准差85.97），而对照眼中为286.08μm（标准差98.09）（p = 0.009）。除了在中心凹颞侧3毫米处，其他黄斑区域的CT与对照眼相比也显著增加（p < 0.05）。在高原虹膜亚组中，与对照眼相比，在所有研究的黄斑区域观察到CT有增加的趋势，但不显著（中心凹鼻侧3毫米处除外）。
在白种人PAC患者眼中，CT比对照眼增加。CT增加可能通过脉络膜扩张和脉络膜神经节细胞功能障碍，对PAC的病理生理学产生影响。
