摘要
背景巩膜厚度与青光眼关系密切，不同类型青光眼的临床特点不同，其巩膜厚度可能存在一定差异，但目前的相关研究结果有一定争议。目的研究各种类型的青光眼患者前部巩膜厚度（AST）、中央角膜厚度（CCT）和眼轴长度间的关系。方法采用回顾性描述性研究设计。纳入2009年3月至2010年11月就诊于北京大学第一医院眼科门诊的连续患者160例，其中原发性开角型青光眼（POAG）34例34眼、正常眼压性青光眼（NTG）37例37眼、原发性闭角型青光眼（PACG）35例35眼及高眼压症（OHT）17例17眼，对照组为早期白内障患者37例37眼。分别采用超声角膜测厚仪、眼部A型超声测量仪测量各组患者的CCT、AST及眼轴长度，采用超声生物显微镜（UBM）测量系统测量颞侧巩膜突后2mlTl处的巩膜厚度。采用协方差分析法和SNK．q检验对各组的测量参数进行比较，用Pearson积矩相关分析和线性回归法对上述各组患者AST、CCT及眼轴长度问的关系进行分析。结果PACG组、POAG组、NTG组及OHT组的CCT值分别为（535．54-＋5．20）、（550．47-＋5．28）、（521．61±5．07）和（575．75±7．76）txm，对照组为（535．06±5．06）Ixm，5个组间的总体差异有统计学意义（F=9．560，P=0．000），其中OHT组的CCT值较其他各组均增加，差异均有统计学意义（均P=0．000），POAG组的CCT值较PACG、NTG及对照组均增加（P=0．046、0．000、0．040），NTG组及PACG组与对照组间CCT值的差异均无统计学意义（P=0．950、0．060）。PACG组、POAG组、NTG组及OHT组AST值分别为（0．593±0．050）、（0．600±0．050）、（0．592±0．060）、（0．610±0．060）mm，对照组为（0．604-t-O．060）mm，5个组间AST的差异无统计学意义（F=0．700，P=0．590）。PACG组的眼轴长度短于其他各组，差异均有统计学意义（均P=0．000）。POAG组和NTG组患者的CCT与AST呈正相关（POAG：r=0．445，P=0．008；NTG：r=0．400，P=0．014）。结论不同类型青光眼患者的CCT不同，AST无明显不同；POAG患善碍NTr由善的rr．
Background A close relation between sclera thickness and glaucoma has been determined. Clinical features vary in different types of glaucoma patients, which hints that the scleral thickness might be distinct among these patients. Objective The aim of this study was to investigate the differences of central corneal thickness（CCT） ,anterior seleral thickness（ AST） and axial length in glaucomatous patients. Methods This study was approved by the Ethic Commission of First Hospital of Peking University. Written informed consent was obtained from each individual prior to the examination. A retrospective descriptive study was designed. One hundred and sixty consecutive patients were recruited from March, 2009 to November, 2010 in First Hospital of Peking University, including 35 eyes with primary angle closure glaucoma（PACG） （35 cases） ,34 eyes with primary open-angle glaucoma （POAG） （34 cases）,37 eyes with normal tension glaucoma（NTG） （37 cases）and 17 eyes of ocular hypertension （OHT） （17 cases）. Thirty-seven eyes of 37 subjects with incipient cataract served as the control group. CCT and ocular axial length were measured with ultrasonic pachymeter and A-scan unit, respectively, and AST at the temporal quadrant 2 mm posterior to the scleral spur was measured by ultrasonic biomieroscopy （UBM）. The measuring parameters among different groups were compared by analysis of covariance, and the correlations of AST, CCT with ocular axial length were analyzed using Pearson linear correlation and linear regression. The differences and correlation of CCT,AST and AL among five groups were analyzed. Results The CCT values in PACG group,POAG group, NTG group, OHT group and control group were （ 535.54 ＋ 5.20 ）, （ 550.47 -＋ 5.28 ）, （ 521.61 -＋ 5.07 ）, （ 575.75 _＋7.76 ） and （ 535.06 ＋5.06 ） μm, respectively, showing a significant difference among them （ F = 9. 560, P = 0. 000 ） , and the CCT value of OHT group was increased in comparison with POAG group, PACG group, NTG group and control group（ all P = 0. 000）. The CCT of the POAG group was thicker than that in the PACG group, NTG group and control group（P=0. 046,0. 000,0. 040）. No significant difference was found in CCT among NTG group,PACG group and control group（ P=0. 950,0. 060）. The AST values of PACG group, POAG group, NTG group, OHT group and control group were（0.593＋0.050）, （0.600＋_0.050）, （0.592_＋0.060）, （0.610_＋0.060） and（0.604_＋0.060） ram, respectively, showing a insignificant difference among them （ F = 0. 700, P = 0. 590 ）. The axial length in the patients with PACG was shorter than that of the POAG group, NTG group, OHT group and control group （ all P = 0. 000 ）. The Pearson correlation analysis showed significantly positive correlation between CCT and AST in POAG group and NTG group（r=0. 445 ,P=0. 008 ;r=0. 400,P=0. 014）. Conclusions This study confirms that there is dissimilarity in CCT hut not in AST among different types of glaucomatous patients. The changes of CCT and AST are consistent in POAG and NTG patients.
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2013年第3期249-253,共5页
Chinese Journal Of Experimental Ophthalmology
关键词
巩膜厚度
中央角膜厚度
眼轴长度
超声生物显微镜
青光眼
Scleral thickness
Central corneal thickness
Axial length
Ultrasound biomicroscopy
Glaucoma
