激光周边虹膜切开术治疗不同原发性闭角型青光眼机制的白种人眼前节参数的变化。
Changes in Anterior Segment Parameters After Laser Peripheral Iridotomy in Caucasian Eyes With Different Primary Angle Closure Mechanisms.
机构信息
Singapore Eye Research Institute and Singapore National Eye Centre.
Duke-NUS Medical School.
出版信息
J Glaucoma. 2023 Oct 1;32(10):820-825. doi: 10.1097/IJG.0000000000002282. Epub 2023 Jul 31.
PRCIS
Subgrouping of angle closure mechanisms based on the swept-source optical coherence tomography images may help to identify the predominant underlying anatomic mechanism, evaluate personal treatment, and improve the better outcomes.
PURPOSE
The purpose of this study was to evaluate changes in anterior segment parameters in Caucasian eyes with different angle closure mechanisms before and after laser peripheral iridotomy (LPI).
METHODS
Sixty-six subjects underwent swept-source optical coherence tomography (CASIA, Tomey Corporation) angle imaging in the dark before and 7 days after LPI. On the basis of the baseline swept-source optical coherence tomography images, the eyes were categorized into 4 angle closure mechanisms, namely pupillary block (PB), plateau iris configuration (PIC), thick peripheral iris (TPI), and large lens vault (LLV). Sixteen out of 128 cross-sectional images (11.25 degrees apart) per volume scan were selected for analysis. We used a generalized estimating equation to compare quantitative parameters among angle closure mechanisms and between before and after LPI after adjusting the intereye correlation.
RESULTS
The mean age of subjects was 67.7±9.2 years, with the majority being female (82.2%). One hundred twenty-nine eyes (67 primary angle closure suspects, 34 primary angle closure, and 28 primary angle closure glaucoma) were categorized into PB (n=71, 55%), PIC (n=40, 31%), TPI (n=14, 10.9%), and LLV (n=4, 3.1%). Anterior chamber depth was the shallowest in the LLV, followed by TPI, PB, and PIC group at baseline. Widening of the angle and reduction of the iris curvature (IC) due to LPI were observed in all groups (all P <0.01). When compared to the PB group, the LPI-induced angle widening in the TPI group was significantly less even though the iris curvature reduction in the TPI group was greater (all P <0.05).
CONCLUSIONS
In patients with angle closure, anterior segment morphology and LPI-induced angle widening were different among the various angle closure mechanisms.
PRCIS
根据扫频源光学相干断层扫描图像对闭角机制进行分组，有助于确定主要潜在解剖机制，评估个体治疗并改善预后。
目的
本研究旨在评估不同闭角机制的白人眼前节参数在激光周边虹膜切开术（LPI）前后的变化。
方法
66 例患者在暗室中接受扫频源光学相干断层扫描（CASIA，Tomey 公司）角度成像，在 LPI 后 7 天进行。根据基线扫频源光学相干断层扫描图像，将眼睛分为 4 种闭角机制，即瞳孔阻滞（PB）、平坦虹膜形态（PIC）、厚周边虹膜（TPI）和大晶状体穹窿（LLV）。每个容积扫描中，从 16 个横截面图像（间隔 11.25 度）中选择 16 个进行分析。使用广义估计方程比较 LPI 前后不同闭角机制之间和不同闭角机制之间的定量参数，同时调整眼间相关性。
结果
受试者的平均年龄为 67.7±9.2 岁，其中大多数为女性（82.2%）。129 只眼（67 只原发性闭角可疑眼、34 只原发性闭角眼和 28 只原发性闭角青光眼）分为 PB（n=71，55%）、PIC（n=40，31%）、TPI（n=14，10.9%）和 LLV（n=4，3.1%）。在基线时，前房深度在 LLV 中最浅，其次是 TPI、PB 和 PIC 组。在所有组中，LPI 导致的角度增宽和虹膜曲率（IC）减小均观察到（均 P <0.01）。与 PB 组相比，TPI 组的 LPI 诱导的角度增宽明显较小，尽管 TPI 组的虹膜曲率减小更大（均 P <0.05）。
结论
在闭角患者中，不同闭角机制的眼前节形态和 LPI 诱导的角度增宽不同。
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