摘要
目的对比观察假性剥脱性青光眼(PXG)、原发性开角型青光眼(POAG)、原发性慢性闭角型青光眼(CPACG)患者巩膜筛板曲率(SLC)的差异并分析其意义。方法回顾性临床研究。2017年6月至2020年12月于浙江省苍南县人民医院(温州医科大学附属苍南医院)眼科中心检查确诊的PXG(PXG组)、POAG(POAG组)和CPACG患者(CPACG组)各30例,共90例90只眼纳入研究。三组患者之间年龄比较,差异有统计学意义(t=17.925,P=0.001);性别构成比(χ^(2)=2.158,P=0.276)、眼压(t=4.993,P=0.078)、眼轴长度(t=1.956,P=0.532)、角膜中央厚度(t=1.407,P=0.724)、视野平均缺损(t=2.725,P=0.496)、视盘视网膜神经纤维层厚度(t=2.185,P=0.492)比较,差异均无统计学意义(P>0.05)。采用频域光相干断层扫描深部增强成像(OCT EDI)技术测量患眼平均以及0°、30°、60°、90°、120°、150°SLC,并计算SLC指数(SLCI)、SLC深度(SLCD)。组间定量资料比较采用独立样本t检验;计数资料比较采用χ^(2)检验。单变量和多变量logistic回归分析进行相关性分析。结果OCT EDI检查结果显示,PXG、CPACG患眼SLC明显陡峭,POAG患眼SLC相对平坦。除150°这一角度外,PXG组、CPACG组患眼其余6个角度SLCI、SLCD均较POAG组增高,差异均有统计学意义(P<0.05)。而PXG组、CPACG组7个角度SLCI、SLCD比较,差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,平均SLCI[比值比(OR)=1.498,95%可信区间(CI)1.137~2.018,P=0.001]、年龄(OR=1.074,95%CI 1.019~1.143,P=0.016)与PXG发生显著相关;平均SLCI(OR=1.625,95%CI 1.192~1.997,P=0.001)、眼压(OR=1.383,95%CI 1.106~1.993,P=0.012)与CPACG发生显著相关。POAG组(β=0.143,95%CI 0.032~0.208,P=0.016)、CPACG组(β=0.132,95%CI 0.079~0.315,P=0.043)眼压与平均SLCI相关;PXG组所有因素与SLCI均无相关(P>0.05)。结论与POAG比较,PXG、CPACG患眼SLC更陡峭且与疾病发生相关。
Objective To observe the differences in scleral lamina curvature(SLC)of patients with pseudoexfoliation glaucoma(PXG),primary open-angle glaucoma(POAG),and primary chronic angle-closure glaucoma(CPACG)were compared and analyzed and their significance was analyzed.Methods A retrospective clinical study.From June 2017 to December 2020,30 PXG(PXG group),POAG(POAG group)and CPACG patients(CPACG group)diagnosed at Eye Center of Cangnan County people's Hospital of Zhejiang Province(Cangnan Hospital Affiliated to Wenzhou Medical University)were included in the study.The age difference between the three groups of patients was statistically significant(t=17.925,P=0.001);gender composition ratio(χ^(2)=2.158,P=0.276),intraocular pressure(t=4.993,P=0.078),and axial length(t=1.956,P=0.532),central corneal thickness(t=1.407,P=0.724),average visual field defect(t=2.725,P=0.496),optic disc retinal nerve fiber layer thickness(t=2.185,P=0.492)in comparison,the differences were not statistically significant(P>0.05).The frequency-domain optical coherence tomography deep-enhanced imaging(OCT EDI)technology was used to measure the average and 0°,30°,60°,90°,120°,150°SLC of the affected eyes,and calculate the SLC index(SLCI)and SL curve depth(SLCD).Quantitative data comparison between groups used independent sample t test.Count data comparison usedχ^(2) test.Univariate and multivariate logistic regression analysis were used for correlation analysis.Results The results of OCT EDI examination showed that the SLC of eyes with PXG and CPACG was significantly steep,while the SLC of eyes with POAG was relatively flat.Except for the angle of 150°,the other 6 angles of SLCI and SLCD in the PXG group and CPACG group were higher than those in the POAG group,and the differences were statistically significant(P<0.05).However,there was no statistically significant difference between PXG group and CPACG group for 7 angles of SLCI and SLCD(P>0.05).Logistic regression analysis showed that the average SLCI[odds ratio(OR)=1.498,95%confidence interval(CI)1.137-2.018,P=0.001],age(OR=1.074,95%CI 1.019-1.143,P=0.016)was significantly correlated with PXG;mean SLCI(OR=1.625,95%CI 1.192-1.997,P=0.001),intraocular pressure(OR=1.383,95%CI 1.106-1.993,P=0.012)was significantly correlated with CPACG.POAG group(β=0.143,95%CI 0.032-0.208,P=0.016),CPACG group(β=0.132,95%CI 0.079-0.315,P=0.043)intraocular pressure was correlated with mean SLCI;all factors of PXG group were correlated with SLCI without correlation(P>0.05).Conclusion Compared with POAG,the SLC of eyes with PXG and CPACG is steeper and related to disease occurrence.
作者
李正义
苏婷婷
陈宝伟
华峰
Li Zhengyi;Su Tingting;Chen Baowei;Hua Feng(Department of Ophthalmology,Cangnan County people's Hospital(Cangnan Hospital Affiliated to Wenzhou Medical University),Wenzhou 325800,China)
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2021年第6期437-443,共7页
Chinese Journal of Ocular Fundus Diseases
关键词
青光眼
开角型
青光眼
闭角型
筛板曲率
Glaucoma,open-angle
Glaucoma,angle-closure
Lamina curvature
作者简介
通信作者:华峰,Email:huaf766@126.com。
