Department of Ophthalmology, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
Acta Ophthalmol. 2020 Sep;98(6):e685-e690. doi: 10.1111/aos.14363. Epub 2020 Jan 30.
To explore the relationships between episcleral hemangioma distribution patterns and trabeculotomy prognosis in young Sturge-Weber syndrome (SWS) patients.
Sturge-Weber syndrome-induced glaucoma patients less than 4 years of age who underwent trabeculotomy in our Ophthalmology Department from February 2016 to June 2017 were included. Every patient could be divided into simple episcleral vascular abnormal network (SEVAN) or multiple episcleral vascular abnormal network (MEVAN) groups according to their episcleral hemangioma patterns. The intraocular pressure (IOP) was recorded during follow-up until the last visit.
Fifty eyes (forty-six patients) of SWS were included. Mean age of surgery was 12.6 ± 15.1 months (range 1-47 months). Twenty-six eyes were in the SEVAN group, while 24 eyes were in the MEVAN group. There were no significant differences between the two groups in demographic data before surgery (p > 0.05). IOPs at 12 months (p = 0.013) and 24 months (p = 0.002) were significantly different between the two groups. At the 24-month follow-up, the cumulative proportions of trabeculotomy success in the SEVAN and MEVAN groups were 89.7% and 36.0%, respectively. Patients with MEVAN and larger preoperative corneal diameter (per 0.5 mm) were more likely to experience failed trabeculotomy (hazards ratio [HR], 7.997 [95% CI, 1.640-38.996], p = 0.010; 1.853 [95% CI, 1.128-3.042], p = 0.015).
Hemangiomas exhibited different distribution patterns between SEVAN and MEVAN. Trabeculotomy had a poorer prognosis in young SWS patients with MEVAN than in those with SEVAN. In addition to anterior chamber angle anomalies, vascular factors may contribute to the aetiology of SWS early-onset glaucoma.
探讨婴幼儿 Sturge-Weber 综合征（SWS）患者巩膜血管瘤分布模式与小梁切开术预后的关系。
纳入 2016 年 2 月至 2017 年 6 月在我院眼科接受小梁切开术的年龄小于 4 岁的 SWS 相关性青光眼患者。根据巩膜血管瘤模式，每位患者可分为单纯型巩膜血管异常网络（SEVAN）或多型巩膜血管异常网络（MEVAN）组。在最后一次随访期间，记录眼压（IOP）。
纳入 46 例（50 只眼）SWS 患者。手术时平均年龄为 12.6 ± 15.1 个月（范围 1-47 个月）。26 只眼为 SEVAN 组，24 只眼为 MEVAN 组。两组患者术前一般资料比较，差异无统计学意义（P＞0.05）。两组患者术后 12 个月（P＝0.013）和 24 个月（P＝0.002）的 IOP 差异均有统计学意义。24 个月随访时，SEVAN 组和 MEVAN 组小梁切开术成功率的累积比例分别为 89.7%和 36.0%。MEVAN 组和术前角膜直径较大（每增加 0.5mm）的患者小梁切开术更可能失败（风险比[HR]分别为 7.997[95%CI，1.640-38.996]，P＝0.010；1.853[95%CI，1.128-3.042]，P＝0.015）。
SEVAN 和 MEVAN 之间的血管瘤表现出不同的分布模式。MEVAN 型婴幼儿 SWS 患者小梁切开术预后较 SEVAN 型差。除前房角异常外，血管因素可能也是 SWS 早发性青光眼的病因之一。
