食管胃十二指肠镜检查对眼压的影响。
The Effect of Esophagogastroduodenoscopy on Intraocular Pressure.
作者信息
De Bernardo Maddalena, Santonicola Antonella, Gioia Marco, Vitiello Livio, Cione Ferdinando, Pagliarulo Sergio, Iovino Paola, Rosa Nicola
机构信息
Eye Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081 Salerno, Italy.
Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081 Salerno, Italy.
出版信息
J Clin Med. 2024 Feb 21;13(5):1224. doi: 10.3390/jcm13051224.
BACKGROUND
Esophagogastroduodenoscopy (EGD) is an endoscopic examination of the upper gastrointestinal tract that requires insufflation with gas, leading to intra-abdominal hypertension (IAH). There is evidence suggesting that IAH positively correlates with intracranial pressure (ICP) and possibly with intraocular pressure (IOP). The aim of this study was to examine the effect of a routine screening EGD on the IOP.
METHODS
In this observational study, 25 patients were recruited; 15 males with a mean age of 50 ± 18 years and 10 females with a mean age of 45 ± 14 years. EGD was conducted under sedation in 21 subjects. Both eyes' IOP measurements were performed using Tonopen Avia in the sitting and left lateral decubitus positions before sedation and the start of EGD, and subsequently in the left lateral decubitus position when the endoscope reached the duodenum (D2) and at the end of the procedure. The final measurement was performed in the sitting position 10 min after the end of the procedure.
RESULTS
The mean IOP in the sitting position was 15.16 ± 2.27 mmHg, and in the left lateral decubitus position, 15.68 ± 2.82 mmHg. When the gastroscope entered the D2, it was 21.84 ± 6.55 mmHg, at the end of the procedure, 15.80 ± 3.25 mmHg, and 10 min later, 13.12 ± 3.63 mmHg. There was a statistically significant IOP increase when the gastroscope entered the duodenum ( < 0.01). At the end of the gastroscopy, the IOP significantly decreased compared to the one registered when the gastroscope entered the D2 ( < 0.001) and it became similar to the values measured before the EGD, in the same left lateral decubitus position ( > 0.05).
CONCLUSION
Significant changes in IOP were observed during the EGD. IOP fluctuations during EGD should be taken into account, especially in patients that need repeated EGDs during their life or in patients with glaucoma. Further studies are needed to better understand the short-effect and long-effect influence of an IOP increase in these patients.
背景
食管胃十二指肠镜检查（EGD）是对上消化道进行的内镜检查，需要注入气体，从而导致腹腔内高压（IAH）。有证据表明，IAH与颅内压（ICP）呈正相关，可能还与眼压（IOP）有关。本研究的目的是探讨常规筛查EGD对IOP的影响。
方法
在这项观察性研究中，招募了25名患者；15名男性，平均年龄50±18岁，10名女性，平均年龄45±14岁。21名受试者在镇静状态下进行EGD。在镇静和EGD开始前，以及在内镜到达十二指肠（D2）时和检查结束时，分别在坐位和左侧卧位使用托诺笔Avia测量双眼的IOP。最后一次测量在检查结束后10分钟的坐位进行。
结果
坐位时的平均IOP为15.16±2.27 mmHg，左侧卧位时为15.68±2.82 mmHg。当胃镜进入D2时，IOP为21.84±6.55 mmHg，检查结束时为15.80±3.25 mmHg，10分钟后为13.12±3.63 mmHg。当胃镜进入十二指肠时，IOP有统计学意义的升高（<0.01）。胃镜检查结束时，IOP与胃镜进入D2时记录的值相比显著降低（<0.001），并且在相同的左侧卧位下变得与EGD前测量的值相似（>0.05）。
结论
在EGD期间观察到IOP有显著变化。应考虑EGD期间IOP的波动，特别是在一生中需要重复进行EGD的患者或青光眼患者中。需要进一步研究以更好地了解IOP升高对这些患者的短期和长期影响。
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