摘要
目的观察原发性视网膜色素变性(RP)合并青光眼患者的临床特征。方法回顾性临床研究。2008年6月至2020年3月于四川大学华西医院眼科检查确诊的诊断中包含"原发性视网膜色素变性(RP)"的2432例患者4794只眼纳入研究。其中,单纯RP 2364例4679只眼(97.2%,2364/2432),RP合并青光眼68例115只眼(2.80%,68/2432)。所有患眼均行最佳矫正视力(BCVA)、眼压检查。BCVA检查采用国际标准视力表进行,统计时换算为最小分辨角对数(logMAR)视力。对随访资料完整的40例RP合并青光眼患者67只眼进行分析,观察不同青光眼类型占比、logMAR BCVA、眼压等临床特点以及治疗方式和治疗后眼压控制情况。以治疗后眼压≤21 mm Hg(1 mm Hg=0.133 kPa)为眼压控制;>21 mm Hg为眼压未控制。结果随访资料完整者40例67只眼中,原发性开角型青光眼5例7只眼(10.45%,7/67),闭角型青光眼(ACG)56例58只眼(86.57%,58/67),新生血管性青光眼4例4只眼(5.97%,4/67);其中2例2只眼同时合并ACG及新生血管性青光眼。ACG 58只眼中,急性ACG 17只眼(25.37%,17/67),慢性ACG 21只眼(31.34%,21/67),可疑房角关闭2只眼(2.99%,2/67),晶状体脱位继发ACG 8只眼(11.94%,8/67),慢性ACG抗青光眼手术后人工晶状体移位5只眼(7.46%,5/67),真性小眼球继发青光眼5只眼(7.46%,5/67)。患眼logMAR BCVA 3.50、<3.50~>2.00、≤2.00~≥1.30、<1.30~>1.00、≤1.00~0.52、<0.52分别为9(13.43%,9/67)、30(44.78%,30/67)、7(10.45%,7/67)、4(5.97%,4/67)、11(16.42%,11/67)、6(8.96%,6/67)只眼,其对应平均眼压分别为(32.31±11.67)、(30.15±14.85)、(28.17±13.19)、(31.50±17.25)、(18.71±8.85)、(14.12±4.25)mm Hg。67只眼中,行手术、单纯药物、周边虹膜激光打孔治疗分别为37(55.22%,37/67)、18(26.86%,18/67)、6(8.96%,6/67)只眼;放弃治疗6只眼(8.96%,6/67)。治疗后,眼压控制37只眼(55.22%,37/67),未控制19只眼(28.36%,19/67),失访11只眼(16.42%,11/67)。手术后发生恶性青光眼3只眼(8.11%,3/37),�
Objective To observe the clinical characteristics of primary retinitis pigmentosa(RP)complicated with glaucoma.Methods A retrospective clinical study.From June 2008 to March 2020,the diagnosis of primary RP were included in the diagnosis confirmed by the eye examination of West China Hospital of Sichuan University included 4794 eyes of 2432 patients.Among them,4679 eyes(97.2%,2364/2432)were in 2364 cases with RP alone,and 115 eyes were in 68 cases with RP combined with glaucoma(2.80%,68/2432).All affected eyes underwent best corrected visual acuity(BCVA)and intraocular pressure examination.The BCVA examination was carried out using the international standard visual acuity chart,which was converted into the logarithmic minimum angle of resolution(logMAR)visual acuity during statistics.The 67 eyes of 40 patients with RP and glaucoma with complete follow-up data were analyzed to observe the proportion of different glaucoma types,logMAR BCVA,intraocular pressure and other clinical characteristics,as well as treatment methods and post-treatment intraocular pressure control.After treatment,the intraocular pressure≤21 mm Hg(1 mm Hg=0.133 kPa)was regarded as intraocular pressure(IOP)control;>21 mm Hg was regarded as uncontrolled IOP.Results Among the 67 eyes of 40 cases with complete follow-up data,5 cases(7 eyes)with primary open-angle glaucoma(10.45%,7/67),56 cases(58 eyes)with angle-closure glaucoma(ACG)(86.57%,58/67),4 cases(4 eyes)with neovascular glaucoma(5.97%,4/67),2 of them had both ACG and neovascular glaucoma.Among 58 ACG eyes,17 eyes were acute ACG(25.37%,17/67),21 eyes were chronic ACG(31.34%,21/67),and 2 eyes were suspicious angle closure(2.99%,2/67),lens dislocation secondary to angle-closure glaucoma in 8 eyes(11.94%,8/67),chronic angle-closure glaucoma after anti-glaucoma surgery,intraocular lens shift in 5 eyes(7.46%,5/67),5 eyes(7.46%,5/67)secondary to glaucoma with true small eyeballs.The logMAR BCVA 3.50 of the affected eye,<3.50->2.00,≤2.00-≥1.30,<1.30->1.00,≤1.00-0.52,<0.52 were 9(13.43%,9/
作者
田雪莲
唐莉
张鑫
林红
史吟雯
Tian Xuelian;Tang Li;Zhang Xin;Lin Hong;Shi Yinwen(Department of Ophthalmology,National Clinical Research Center for Geriatrics,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第6期423-428,共6页
Chinese Journal of Ocular Fundus Diseases
基金
四川省科技计划项目(2020YJ0289)
国家老年疾病临床医学研究中心(四川大学华西医院)一般项目(Z2018B17)。
