Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan.
Invest Ophthalmol Vis Sci. 2021 Feb 1;62(2):37. doi: 10.1167/iovs.62.2.37.
To evaluate the posture-related change in intraocular pressure (IOP) of eyes with angle-closure disease and the associated factors.
Eyes were prospectively enrolled and divided into three groups: eyes with acute primary angle-closure (APAC), fellow eyes of acute primary angle-closure (FAPAC), and eyes with nonacute primary angle-closure disease (PACD). All of them had been treated with laser peripheral iridotomy. IOP was measured in the sitting, supine, and lateral decubitus positions (LDP) five minutes after posture change. Anterior chamber angle parameters and angle-closure mechanism were evaluated by anterior segment optical coherence tomography.
Forty-four eyes were enrolled into each group. APAC eyes showed more LDP-Sitting IOP increase than fellow eyes (5.7 ± 2.7 vs. 2.2 ± 1.4 mm Hg, P < 0.001) and nonacute PACD eyes (3.6 ± 2.0 mm Hg, P < 0.001). LDP-sitting IOP change was higher in eyes with exaggerated lens vault (having shallow anterior chamber and volcano-like iris-lens configuration) than in those without it (APAC: 6.3 ± 2.6 vs. 3.9 ± 2.1 mm Hg, P = 0.011). Linear regression revealed that LDP-sitting IOP change in the APAC group was negatively associated with angle opening distance (AOD), trabecular iris space area, scleral spur angle, and anterior chamber depth (ACD1000). With multivariable stepwise regression analysis, AOD750 remained statistically significant (beta-coefficient = -8.36, P = 0.014).
APAC eyes had significant posture-related IOP changes, associated with narrower angle structures and exaggerated lens vault.
评估闭角型青光眼患者的眼内压（IOP）与姿势相关的变化及其相关因素。
前瞻性纳入急性原发性闭角型青光眼（APAC）眼、急性原发性闭角型青光眼对侧眼（FAPAC）和非急性原发性闭角型青光眼（PACD）眼。所有患者均行激光周边虹膜切开术治疗。改变体位 5 分钟后，分别测量坐位、仰卧位和侧卧位的眼压。通过眼前节光学相干断层扫描评估前房角参数和闭角机制。
每组纳入 44 只眼。APAC 眼较对侧眼（5.7 ± 2.7 比 2.2 ± 1.4mmHg，P < 0.001）和非急性 PACD 眼（3.6 ± 2.0mmHg，P < 0.001）的 LDP 坐位眼压升高更明显。前房角结构较夸张（浅前房和火山型虹膜晶状体形态）的眼的 LDP 坐位眼压变化高于无此特征的眼（APAC：6.3 ± 2.6 比 3.9 ± 2.1mmHg，P = 0.011）。线性回归显示，APAC 组的 LDP 坐位眼压变化与房角开放距离（AOD）、小梁虹膜空间面积、巩膜突角和前房深度（ACD1000）呈负相关。多元逐步回归分析显示，AOD750 仍具有统计学意义（β系数=-8.36，P = 0.014）。
APAC 眼存在明显的与姿势相关的眼压变化，与较窄的房角结构和前房角结构较夸张有关。
