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正视眼中睫状肌麻痹对眼前节结构和巩膜厚度的影响。

Effect of Cycloplegia on Anterior Segment Structures and Scleral Thickness in Emmetropic Eyes.

机构信息

Department of Ophthalmology, Ege University Medical Faculty Hospital, Izmir, Turkey.

出版信息

J Ocul Pharmacol Ther. 2023 Dec;39(10):699-704. doi: 10.1089/jop.2023.0039. Epub 2023 Sep 11.

Abstract

To evaluate the effects of topical cyclopentolate hydrochloride-induced cycloplegia on anterior segment biomechanics in emmetropic eyes using anterior segment-optical coherence tomography (AS-OCT). Twenty-five emmetropic eyes of 25 volunteers were included. All underwent central corneal thickness (CCT) and anterior chamber depth (ACD) measurements. Anterior scleral thickness (AST) was measured at the level of the scleral spur (SS)(AST-0), 1,000 μm posterior of the SS (AST-1), and 2,000 μm posterior of the SS (AST-2) in the nasal and temporal quadrants using AS-OCT. All measurements were repeated after cycloplegia. The mean age was 30.6 ± 12.4 (8-45) years. The mean CCT did not significantly change after cycloplegia ( = 0.7). The mean ACD was significantly increased [3.3 ± 0.2 (2.7-3.9) to 3.7 ± 0.3 (3-4.2) μm;  = 0.001]. In the nasal quadrant, the mean AST-1 and AST-2 were 512.3 ± 34.4 (433-570) and 529.6 ± 34.2 (449-599); decreased to 478 ± 26.8 (423-530) and 486.2 ± 28.3 (422-544) μm, respectively, after cycloplegia ( = 0.00;  = 0.00). In the temporal quadrant, the mean AST-1 and AST-2 were 522.5 ± 24.7 (473-578) and 527.2 ± 39.9 (450-604); decreased to 481.1 ± 33.7 (421-550) and 484.6 ± 26.6 (433-528) μm, respectively ( = 0.00;  = 0.00). There was no significant difference in AST-0 after cycloplegia in both quadrants [from 697.5 ± 46 (605-785) to 709.5 ± 64.7 (565-785) for nasal and from 718.4 ± 40.1 (632-796) to 722.9 ± 60.6 (596-838) for temporal;  = 0.2;  = 0.3, respectively]. After cycloplegia, there was a significant thinning of ASTs posterior to SS and a slight increase in AST in the SS level. ACD deepened after cycloplegia, and there was no significant change in CCT. Cycloplegic agents temporarily inhibit ciliary muscle contraction and may affect anterior segment parameters and sclera. Inhibition of forward-inward movement of the ciliary body by cycloplegia affects ASTs and ACD by causing a change in the mechanical force of the ciliary muscle on the sclera.

摘要

采用眼前节光学相干断层扫描(AS-OCT)评估盐酸环喷托酯滴眼剂诱导的睫状肌麻痹对正视眼眼前节生物力学的影响。纳入 25 名志愿者的 25 只正视眼。所有患者均行中央角膜厚度(CCT)和前房深度(ACD)测量。采用 AS-OCT 在巩膜突(SS)水平(AST-0)、SS 后 1000μm(AST-1)和 2000μm(AST-2)处测量前巩膜厚度(AST),并在鼻侧和颞侧象限进行测量。睫状肌麻痹后重复所有测量。平均年龄为 30.6±12.4(8-45)岁。睫状肌麻痹后 CCT 无显著变化( = 0.7)。ACD 显著增加[3.3±0.2(2.7-3.9)至 3.7±0.3(3-4.2)μm;  = 0.001]。在鼻侧象限,AST-1 和 AST-2 的平均厚度分别为 512.3±34.4(433-570)和 529.6±34.2(449-599)μm,睫状肌麻痹后分别降至 478±26.8(423-530)和 486.2±28.3(422-544)μm( = 0.00;  = 0.00)。在颞侧象限,AST-1 和 AST-2 的平均厚度分别为 522.5±24.7(473-578)和 527.2±39.9(450-604)μm,睫状肌麻痹后分别降至 481.1±33.7(421-550)和 484.6±26.6(433-528)μm( = 0.00;  = 0.00)。睫状肌麻痹后,在两个象限中,AST-0 均无显著差异[鼻侧从 697.5±46(605-785)至 709.5±64.7(565-785),颞侧从 718.4±40.1(632-796)至 722.9±60.6(596-838);  = 0.2;  = 0.3]。睫状肌麻痹后,SS 后段巩膜明显变薄,SS 水平巩膜稍增厚。睫状肌麻痹后 ACD 加深,CCT 无显著变化。睫状肌麻痹剂暂时抑制睫状肌收缩,可能影响眼前节参数和巩膜。睫状肌麻痹导致睫状体向前向内运动受阻,从而改变睫状肌对巩膜的机械力,影响 AST 和 ACD。

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