玻璃体悬韧带及其与原发性闭角型青光眼前房角特征的关系。

Vitreous Zonule and its Relation to Anterior Chamber Angle Characteristics in Primary Angle Closure.

机构信息

Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.

出版信息

J Glaucoma. 2019 Dec;28(12):1048-1053. doi: 10.1097/IJG.0000000000001387.

DOI:10.1097/IJG.0000000000001387

PMID:31633619

Abstract

PRECIS

Primary angle-closure (PAC) eyes with no vitreous zonule (VZ) appear to have a narrower angle despite similar lens vault and iris configuration than eyes with visible VZ.

PURPOSE

To assess the clinical significance of the VZ in PAC.

METHODS

Medical records of 91 eyes of 91 participants with PAC or PAC glaucoma were retrospectively reviewed. Anterior segment parameters were measured using anterior segment optical coherence tomography; presence of the VZ was assessed with ultrasound biomicroscopy. Parameters were compared between eyes with vitreous zonule group (VZG) and no vitreous zonule group (NVZG). Factors associated with VZ presence were determined using logistic regression analysis.

RESULTS

The NVZG was more likely to have PAC glaucoma than PAC (51.4% vs. 25.0%; P=0.010) and use more glaucoma medications (0.77 vs. 0.36; P=0.004) than the VZG. The NVZG had a smaller anterior chamber area than the VZG (13.6 mm vs. 15.1 mm; P=0.020) but there were no significant between-group differences in anterior chamber depth (1.97 vs. 2.08 mm; P=0.119) and lens vault (1.21 vs. 1.13 mm; P=0.337). NVZG had a smaller scleral spur angle (11.5 vs. 17.4 degrees; P<0.001), angle opening distance at 500 μm (AOD500, 105 vs. 168 μm; P<0.001), and trabecular-ciliary process angle (75.7 vs. 81.9 degrees; P=0.029) than VZG. Older age [odds ratio (confidence interval), 1.087 (1.014-1.164); P=0.018], less AOD500 (0.984 (0.975-0.993); P<0.001), and less trabecular-ciliary process angle (0.938 (0.901-0.977); P=0.002) were independently associated with an absence of VZ.

CONCLUSIONS

PAC eyes with no VZ had a narrower angle and required more glaucoma medications than eyes with a VZ.

摘要

尽管晶状体 vault 和虹膜结构相似，但没有玻璃体带（VZ）的原发性闭角型（PAC）眼的前房角度似乎更窄，而有可见 VZ 的眼则更宽。

目的

评估 VZ 在 PAC 中的临床意义。

方法

回顾性分析 91 例 91 只 PAC 或 PAC 青光眼患者的病历资料。使用眼前节光学相干断层扫描测量眼前节参数；使用超声生物显微镜评估 VZ 的存在。比较玻璃体带组（VZG）和无玻璃体带组（NVZG）的眼的参数。使用逻辑回归分析确定与 VZ 存在相关的因素。

结果

NVZG 比 VZG 更有可能患有 PAC 青光眼（51.4% vs. 25.0%；P=0.010），并且使用更多的青光眼药物（0.77 比 0.36；P=0.004）。NVZG 的前房面积小于 VZG（13.6 毫米 vs. 15.1 毫米；P=0.020），但两组之间的前房深度（1.97 毫米 vs. 2.08 毫米；P=0.119）和晶状体 vault（1.21 毫米 vs. 1.13 毫米；P=0.337）无显著差异。NVZG 的巩膜突角（11.5 度 vs. 17.4 度；P<0.001）、500 μm 处的房角开口距离（AOD500，105 微米 vs. 168 微米；P<0.001）和小梁睫状体角（75.7 度 vs. 81.9 度；P=0.029）均小于 VZG。年龄较大（优势比[置信区间]，1.087（1.014-1.164）；P=0.018）、AOD500 较少（0.984（0.975-0.993）；P<0.001）和小梁睫状体角较小（0.938（0.901-0.977）；P=0.002）与 VZ 缺失独立相关。