原发性急性闭角型青光眼与可疑性原发性房角关闭UBM眼前节相关参数的比较

Comparison of Parameters Related to UBM Anterior Segment between Acute Primary Angle Closure Glaucoma and Suspicious Primary Angle Closure

摘要: 目的：利用超声生物显微镜(UBM)观察正常人、可疑性原发性房角关闭(PACS)与原发性急性闭角型青光眼(APACG)眼前节相关测量参数的不同。方法：将2018年1月~2020年11月在青岛大学附属医院拟行白内障手术的APACG组26例(50眼)、PACS组39例(50眼)和正常对照组32例(50眼)纳入研究。术前除视力、非接触式眼压、眼轴(AL)、眼部超声等常规检查外，还应用UBM观察并定量测量眼前节生物学参数，包括：中央前房深度(ACD)、两端睫状突的最大横径(STS)、晶状体前顶点与睫状突两端最大横径的垂直距离(h)，计算中央前房深度占眼轴长的比例(ACD/AL)和晶状体前顶点与睫状突两端最大横径的垂直距离与睫状突横径比值(h/STS)，以及测量4个钟点位(12点，3点，6点，9点)的AOD500 (角张开距离)、IZD (虹膜小带距离)、IT (虹膜厚度)、TCPA (小梁网睫状突夹角)。结果：APACG组、PACS组及正常对照组三组之间ACD、AL、ACD/AL、h、h/STS、4个钟点位IZD和4个钟点位TCPA测量参数值的比较差异均有统计学意义(P < 0.05)；APACG组、PACS组与正常对照组相比，4个钟点位AOD500的差异均有统计学意义(P < 0.05)，而APACG组和PACS组间相比，差异无统计学意义(P > 0.05)。STS和4个钟点位IT在三组之间比较差异均无统计学意义。结论：UBM可准确观察和测量正常人、APACG组、PACS组相关眼前节参数的差异，提示各组间眼前节解剖结构的差异，对于临床诊断与治疗具有重要临床意义。

Abstract: Aim: To investigate the difference in related parameters of anterior segment between acute primary angle closure glaucoma (APACG) patients, suspicious primary angle closure (PACS) patients and normal patients by ultrasound biomicroscopy (UBM). Methods: From January 2018 to November 2020, 26 patients (50 eyes) with APACG in the ophthalmology department of Qingdao University Affiliated Hospital who underwent phacoemulsification and intraocular lens implantation were selected as the APACG group. 39 patients (50 eyes) with PACS in the ophthalmology department of Qingdao University Affiliated Hospital who underwent phacoemulsification and intraocular lens implantation were selected as the PACS group. 32 patients (50 eyes) who underwent phacoemulsification and intraocular lens implantation were selected as the normal group. In addition to routine preoperative examinations such as visual acuity, non-contact intraocular pressure, axis length (AL), and ocular B-ultrasound examination, UBM examinations were also applied to observe and quantitatively measure the parameters of the anterior segment, including measuring the central anterior chamber depth (ACD), the maximum transverse diameter of the ciliary process at both ends (STS), the vertical distance between the anterior apex of the lens and the maximum transverse diameter at both ends of the ciliary processes (h), and angle-opening distance (AOD500), iris-zonule distance (IZD), iris thickness (IT), trabecular ciliary process angle (TCPA) at four quadrants (superior, nasal, inferior, temporal quadrants). Results: There were significant differences in ACD, AL, ACD/AL, h, h/STS, IZD and TCPA at four quadrants (superior, nasal, inferior, temporal quadrants) between APACG group, PACS group and normal group (P < 0.05). Compared with normal group, APACG group and PACS group had differences in AOD500 at four quadrants (superior, nasal, inferior, temporal quadrants) (P < 0.05); however, there was no significant difference between APACG group and PACS group in AOD500 at four quadrants (superior, nasal, inferior, temporal quadrants) (P > 0.05). There were no significant differences in STS and IT at four quadrants (superior, nasal, inferior, temporal quadrants) among the three groups (P > 0.05). Conclusion: UBM can accurately observe and measure the difference in related parameters of the anterior segment among normal group, APACG group and PACS group, revealing the difference in anterior segment, which has important clinical significance.