摘要
病理性高眼压和较大的昼夜眼压波动是青光眼视神经损害进展的重要危险因素.眼压具有波动性,正常人眼压波动的峰值多出现于凌晨,这种波动与体位、眼灌注压、眼轴等有关.正常眼压性青光眼患者眼压波动是视野进展的重要危险因素,且经24小时眼压监测发现大部分眼压是存在异常的,因此需根据其昼夜眼压曲线明确诊断和针对性治疗;原发性开角型青光眼患者昼夜眼压波动规律与正常人相似,眼压高峰多在夜间,但波动范围可能比正常人大,且双眼的波动呈明显的一致性;激光周边虹膜切开术后的慢性闭角型青光眼患者的昼夜眼压波动较大,其眼压波动与基线眼压和房角粘连程度呈正相关.与激光和药物相比,小梁切除术更有利于控制长期和昼夜的眼压波动.抗青光眼药物中前列腺素类药物是控制昼夜眼压波动效果最好的滴眼剂.
Pathological ocular phypertension and larger diurnal fluctuation of intraocular pressure （IOP） are important risk factors of the progressive damages of glaucomatous vision field.In normal person,the IOP is fluctuant during 24 hours and the peak is in the early morning.The diurnal IOP fluctuation is associated with postures,eye perfusion pressure,axial lengths and so on.The IOP fluctuations is very important risk factors for the progressive damage of vision field in the patients with normal-tension glaucoma,who usually showed abnormal IOP by 24-hour intraocular monitoring and then can be diagnosed and treated according to the curve of diurnal IOP.In primary open angle glaucoma patients,the regular pattern of the diurnal IOP fluctuation is similar to that of normal people,the pressure peak is also in the night,but diurnal IOP range is probably wider and the fluctuation of both eyes is obviously consistent.In chronic angle-closure glaucoma patients after laser peripheral iridotomy,the diurnal IOP fluctuation is larger,and positively associated with the baseline pressure and the degree of angle adhesion.Compared with laser and drugs,trabeculectomy is more advantageous to the long-time IOP and diurnal IOP fluctuation controlling.Prostaglandin analog is the best medicine choice for the controlling of the diurnal IOP fluctuations.
出处
《国际眼科纵览》
2013年第6期388-391,396,共5页
International Review of Ophthalmology
基金
天津市卫生局资助项目（2011KZl03）
关键词
眼压
青光眼
昼夜波动
intraocular pressure
glaucoma
diurnal fluctuation
