Lin Shufen, Zuo Chengguo, Liu Yuan, Xiao Hui, Fang Lei, Su Yihua, Chen Liming, Lin Mingkai, Ling Yunlan, Liu Xing
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Med (Lausanne). 2021 Nov 3;8:772578. doi: 10.3389/fmed.2021.772578. eCollection 2021.
The purpose of this study was to analyze the ocular biometric parameters of primary angle-closure disease (PACD) in younger patients and compare them with those of elderly patients. This clinic-based, cross-sectional study included 154 eyes of 154 patients with PACD, consisting of 77 eyes of patients aged 40 years or younger and 77 eyes of patients older than 40. The PACD case definition was compatible with the ISGEO definition. Anterior segment parameters were measured by ultrasound biomicroscopy, axial length (AL) and lens thickness (LT) were measured by A-scan ultrasonography measurements, and the thickness of the retina and choroid were measured by optical coherence tomography. The differences in ocular biometric parameters between different age groups were compared by independent sample tests or Mann-Whitney tests, and the correlation between the parameters and age was analyzed. Compared to older PACD patients, the lens vault(LV),LV/LT and subfoveal choroidal thickness (SFCT) of younger patients were larger, while the peripheral and mean iris thickness (IT), trabecular-ciliary angle (TCA), ciliary body thickness (CBT), AL and LT were smaller (all < 0.01). There was no significant difference in anterior chamber depth, anterior chamber width, pupil diameter, angle opening distance at 500 μm from the scleral spur, anterior chamber angle and iris convexity between the two groups (all > 0.05). AL, LT, IT, TCA and CBT were positively associated with age (all < 0.001), while LV and SFCT were negatively associated with age ( = 0.027 and < 0.001, respectively). Compared with elderly patients, younger PACD patients had more anteriorly positioned lenses, thinner and more anteriorly rotated ciliary bodies, thicker choroids, and shorter axial length. These characteristics might be important anatomical bases for the earlier onset of PACD and the higher risk of malignant glaucoma after filtering surgery.
本研究的目的是分析年轻患者原发性闭角型青光眼(PACD)的眼部生物测量参数,并与老年患者的参数进行比较。这项基于临床的横断面研究纳入了154例PACD患者的154只眼,其中40岁及以下患者的77只眼和40岁以上患者的77只眼。PACD病例定义与ISGEO定义相符。前段参数通过超声生物显微镜测量,眼轴长度(AL)和晶状体厚度(LT)通过A超超声测量,视网膜和脉络膜厚度通过光学相干断层扫描测量。通过独立样本检验或曼-惠特尼检验比较不同年龄组眼部生物测量参数的差异,并分析参数与年龄之间的相关性。与老年PACD患者相比,年轻患者的晶状体拱高(LV)、LV/LT和黄斑下脉络膜厚度(SFCT)更大,而周边和平均虹膜厚度(IT)、小梁-睫状体角(TCA)、睫状体厚度(CBT)、AL和LT更小(均P<0.01)。两组之间前房深度、前房宽度、瞳孔直径、距巩膜突500μm处的房角开放距离、前房角和虹膜凸度无显著差异(均P>0.05)。AL、LT、IT、TCA和CBT与年龄呈正相关(均P<0.001),而LV和SFCT与年龄呈负相关(分别为P = 0.027和P<0.001)。与老年患者相比,年轻PACD患者的晶状体位置更靠前,睫状体更薄且向前旋转,脉络膜更厚,眼轴长度更短。这些特征可能是PACD较早发病和滤过性手术后恶性青光眼风险较高的重要解剖学基础。