摘要
目的分析目前临床上普遍采用的24 h眼压测量策略对于一日眼压波动的代表性。方法纳入2018年9月~2019年1月,我院门诊诊断为“可疑青光眼”的患者,对其进行24 h眼压测量。测量时间点为:0:00,2:00,5:00,7:00,8:00,10:00,11:00,14:00,16:00,18:00,20:00,22:00,称为策略1。其中,5:00,7:00,10:00,14:00,18:00,22:00作为策略2的测量时间点;8:00,11:00,14:00,16:00作为策略3的测量时间点。分别将策略2和策略3与作为金标准的策略1进行比较。采用Goldmann压平眼压计由同一名测量者完成测量。结果共纳入41例患者82眼。策略1、策略2和策略3的峰值眼压分别为:21.09±4.15 mmHg、20.54±4.10 mmHg和19.91±4.38 mmHg,差异有统计学意义(P<0.05);谷值眼压分别为:13.93±3.38 mmHg、14.63±3.49 mmHg和15.46±3.63 mmHg,差异有统计学意义(P<0.05)。策略1和策略2峰值眼压的共现性为74.39%,策略1和策略3峰值眼压的共现性为43.90%。策略2和策略3对于发现24 h眼压波动幅度的敏感性分别为55.56%和36.11%。结论对于可疑青光眼患者,一日4次或6次眼压测量无法精确的反映出眼压波动的幅度,容易造成漏诊。
Objective To investigate accuracy of the currently used strategies for intraocular pressure measurements for reflecting actual 24-hour intraocular pressure fluctuations.Methods From September,2018 to January,2019,the patients with a suspected diagnosis of primary open angle glaucoma at our hospital were prospectively enrolled to receive 24-hour intraocular pressure monitoring using a Goldmann tonometer.With the intraocular pressure measurements at 0:00,2:00,5:00,7:00,8:00,10:00,11:00,14:00,16:00,18:00,20:00,and 22:00 as the gold standard(strategy 1),we compared the measurements taken at 5:00,7:00,10:00,14:00,18:00,and 22:00(strategy 2)and at 8:00,11:00,14:00,and 16:00(strategy 3)for their accuracy in reflecting 24-h intraocular pressure fluctuations.Results A total of 41 patients(82 eyes)were enrolled in this study.The peak intraocular pressures measured using the 3 strategies were 21.09±4.15 mmHg,20.54±4.10 mmHg,and 19.91±4.38 mmHg,respectively,showing significant differences among them(P<0.05).The trough intraocular pressures measured by the 3 strategies were also significantly different(13.93±3.38 mmHg,14.63±3.49 mmHg,and 15.46±3.63 mmHg,respectively;P<0.05).The co-occurrence of the peak intraocular pressure was 74.39%between strategies 1 and 2 and 43.90%between strategies 1 and 3.The sensitivity of strategies 2 and 3 for detecting 24-h intraocular pressure fluctuations was 55.56%and 36.11%,respectively.Conclusions For suspected cases of glaucoma,intraocular pressure measurements at 4 and 6 time points of a day can not precisely reflect the actual range of intraocular pressure fluctuations,and may lead to a missed diagnosis of glaucoma.
作者
秦佳音
王熙娟
李明武
任泽钦
QIN Jiayin;WANG Xijuan;LI Mingwu;REN Zeqin(Department of Ophthalmology,Peking University International Hospital,Beijing 102206,China)
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2021年第1期107-110,共4页
Journal of Southern Medical University
基金
北京大学国际医院院内科研基金(YN2019QN12)。
关键词
24
h眼压
测量策略
临床研究
前瞻性
24-hour intraocular pressure
monitoring strategies
clinical study
prospective study
