摘要
目的观察原发性急性闭角型青光眼(acute primary closure-angle glaucoma,APACG)急性发作后视网膜神经纤维层厚度(Retinal nerve fiber layer thickness,RNFLT)和视盘血流的变化。设计前瞻性比较性病例系列。研究对象抚顺市眼病医院2017年1月至2017年6月APACG急性发作的患者41例。方法急性发作41眼为观察组,同一批患者未发作41眼为对照组。在眼压控制正常后1周、3个月、6个月用Spectralis OCT测量盘周RNFLT、AngioVue OCT测量盘周血管密度(vessel density,VD)。采用广义估计方程比较不同观察时间点指标的差异性;Pearson相关分析探索RNFLT和盘周VD的相关性。主要指标盘周RNFLT值、盘周VD值。结果发作眼1周时颞侧、颞上方、颞下方RNFLT较对侧眼明显增厚(P均<0.001);3个月时鼻上方、鼻下方RNFLT明显低于对侧眼(P均<0.001);6个月时鼻侧、鼻上方、鼻下方RNFLT明显低于对侧眼(P=0.011、0.000、0.000)。发作眼3个月、6个月与1周各参数自身相比,各象限RNFL厚度均明显变薄(P均<0.001)。发作眼盘周VD于1周、3个月、6个月随访过程中呈持续下降,3个月、6个月视盘鼻侧VD均较1周明显下降(P=0.001、0.001);视盘颞上方、颞下方、鼻上方及颞侧VD均持续下降,6个月较1周明显下降(P=0.007、0.011、0.013、0.008)。发作眼较对侧眼盘周VD各个参数均明显下降(P均<0.05)。1周时盘周VD和对应象限的RNFLT无相关性(P均>0.05),而在3个月与6个月时两者的变化具有相关性(P均<0.05)。结论APACG急性发作眼压控制后早期RNFLT增厚,3~6个月持续变薄。盘周VD在半年内持续下降,且盘周VD与RNFLT整体变化趋势一致。
Objective To observe the changes of retinal nerve fiber layer thickness(RNFLT)and optic disc blood flow after the first attack of acute primary angle-closure glaucoma(APACG).Design Prospective comparative case series.Participants 41 cases with acute onset of APACG during January 2017 and June 2017 in Fushun Eye Hospital.Methods The acute attack 41 eye was the observation group,and the fellow 41 eye was the control group.RNFLTs of peripapilla were measured by Spectralis OCT and vascular density(VD)were measured by angiovue OCT at 1 week,3 months and 6 months after IOP control.The differences of the RNFLTs and VDs at different observation time points were compared with generalized estimation equation.The correlation between RNFLT and peripheral VD were explored with Pearson correlation analysis.Main Outcome Measures peripapilla RNFLT,peripapilla VD.Results The temporal,superior temporal,inferior temporal RNFL in the acute attack eye were thicker than those in the lateral eye at 1 week(all P<0.05).The superior nasal and inferior nasal RNFLTs were significantly lower than those in the fellow eye in 3 month(all P<0.001).The nasal,superior nasal and inferior nasal RNFLTs were significantly lower than those in the fellow eye in 6 month(P=0.011,0.000,0.000).Compared with the self-follow-up of each parameter in the acute attack eye at 3 months,6 months and 1 week,the RNFLTs in all quadrants was significantly thinner(all P<0.001).The peripapilla VD of the acute attack eye in 1 week,3 month,6 month of follow-up showed a continuous decline.The peripapilla nasal VD in 3 month and 6 month were significantly lower than 1 week(P=0.001,0.001).The peripapilla superior temporal,inferior temporal,superior nasal and temporal VD continued to decline,6 month compared with 1 week significantly decreased(P=0.007,0.011,0.013,0.008).The parameters of the peripapilla VD were significantly decreased in the acute attack eye than in the lateral eye,and the difference was statistically significant(all P<0.05).The Pearson correlation analysis in
作者
姜晶
贾超
王新宇
徐威
张妍
Jiang Jing;Jia Chao;Wang Xinyu;Xu Wei;Zhang Yan(Fushun Eye Hospital,Fushun Liaoning 113008,China)
出处
《眼科》
CAS
2020年第1期26-31,共6页
Ophthalmology in China
关键词
原发性急性闭角型青光眼
视网膜神经纤维层厚度
视盘血流
acute primary angle-closure glaucoma
retinal nerve fiber layer thickness
blood flow of the optic disc
