摘要
目的探讨明、暗光线下超声活体显微镜（UBM）检查在发现前房角关闭中的作用。方法系列病例研究。选择50岁及以上的浅前房和具有解剖的窄前房角人群作为研究对象。应用Van Herick法对受检人群进行周边前房深度检查，对其中周边前房深度≤1／3角膜厚度者进行前房角镜检查，确定是否为解剖的窄前房角者。对解剖的窄前房角患眼进行明、暗光线下UBM检查，分别观察受检眼上方、颞上方、颞侧、颞下方、下方、鼻下方、鼻侧和鼻上方8个检查部位有无前房角关闭，评估具有解剖的窄前房角患眼前房角关闭率。从UBM图像中测量前房角开放距离。应用SPSS 12．0统计软件包，对研究数据进行分析。明、暗光线下前房角关闭率比较采用配对X^2检验，前房角开放距离的比较采用Wilcoxon检验，以P〈0．05作为差异有统计学意义。结果符合人选条件的共有194例（379只眼）患者。以受检眼计算，在明、暗光线下UBM检查发现的前房角关闭率分别为26．1％和69．7％，显示暗光线下前房角关闭率明显增高，两者间差异有统计学意义（X^2=159．148，P=0．000）。明、暗光线下均以上方的前房角关闭率最高，分别为21．4％和58．6％。周边前房深度越浅，前房角关闭率越高。周边前房深度〈1／4角膜厚度眼在暗光线下前房角关闭率高达98．3％。在明或暗光线下，上、下、鼻、颞4个象限之间前房角开放距离的差异均有统计学意义（Z=-7．471，-15．407，-16．237，-16．782；P=0．000）。上方象限前房角开放距离最小，前房角关闭率最高。结论周边前房越浅，明、暗光线下前房角关闭率越高。明、暗光线下UBM检查是在临床和大规模人群中早期发现前房角关闭的有效和可行方法。
Objective To evaluate the prevalence of appositional angle closure in eyes with a shallow peripheral anterior chamber （AC） and the anatomic narrow chamber angle by photopic and scotopic ultrasonic biomieroscopy （UBM）. Methods Prospective case series study. 379 eyes of 194 consecutive patients with the shallow peripheral AC and the anatomic narrow chamber angle, which was determined by Van Herick technique and gonioscopy, were collected from the clinic and an epidemiological study. The presence of appositional angle closure and the angle-opening distance （AOD） was determined with photopie and scotopic ultrasound UBM in eight positions. The prevalence of appositional angle closure and AOD calculated by photopic and scotopic ultrasound biomicroscopy were campared. Paired X^2 test and Wilcoxon test （SPSS 12.0） were used to determine any significant differences at P 〈 0.05. Results The prevalence of appositional angle closure was found at least one position in 264 eyes （69.7%） by seotopic UBM and in 99 （26. 1% ） eyes by photopic UBM. The prevalence of appositional angle closure was significantly higher by scotopic UBM than by photopic UBM （X^2 =159.148 ,P=0.000 respectively）, and was the highest in superior quadrant. The narrower AC was, the higher prevalence of appositional angle closure occurred. Furthermore, 98.3% of patients with peripheral AC〈1/4 corneal thickness （CT） were found to have an appositional angle closure by scotopie UBM. The AOD varied significantly among the four quadrants and was significantly narrower by scotopic UBM than by photopic UBM （Z=-7.471, -15. 407, -16.237, -16.782;P=0. 000 ） . AOD in superior quadrant was narrowest with highest of the prevalence of appositional angle closure. Conclusions The prevalence of appositional angle closure varied with the depth of AC and can be effectively detected by photopic and scotopic UBM, more preferably by scotopic UBM at the clinic and the mass screening.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2009年第1期8-13,共6页
Chinese Journal of Ophthalmology
基金
国家科学技术部“十五”科技攻关项目（2004BA720A13）
