论文部分内容阅读
目的分析原发性闭角型青光眼(primaryangle-closureglaucoma,PACG)视盘出血的特征。方法回顾性分析有视盘出血病史的PACG患者的临床资料,所有患者均行Goldmann眼压计检查、前房角镜检查、眼底检查、自动视野检查。随访观察视盘出血的位置、次数、持续时间;与另一未发生视盘出血眼行眼压及杯盘比的比较;并记录患者杯盘比及视野的变化。随访时间为7～261个月,平均(109.2±63.0)个月。结果PACG患者共770例,其中44例(5.7%)有视盘出血史,包括单侧眼视盘出血30例(68%)和双侧先后或同时出血14例(32%)。44例58眼中共出血111次,23眼(40%)有重复出血。111次出血中,85次(77%)发生于视盘颞下区,19次(17%)发生于颞上区。在23眼视盘重复出血中,11眼(48%)发生于视盘同一区域。出血平均持续时间为(12.8±8.1)周。同时,出血眼与未出血的对侧眼相比,眼压及杯盘比差异无统计学意义。对于单侧视盘出血的患者,杯盘比在出血眼及未出血的对侧眼均有显著变化,但视野缺损仅在出血眼更为严重。结论在至少9a的随访中,我们发现PACG患者发生视盘出血的几率为5.7%.尽管其发生率相对较低,但它的发生常与青光眼视神经病变及视野缺损的恶化相关。
Objective To analyze the characteristics of optic disc hemorrhage in primary angle-closure glaucoma (PACG). Methods The clinical data of patients with PACG who had a history of optic disc hemorrhage were analyzed retrospectively. All patients underwent goldmann tonometer, gonioscopy, fundus examination and automatic visual field examination. Follow-up observation of the location, frequency and duration of optic disc hemorrhage; Compared with the other intraocular pressure and cup-to-disk ratio without ocular hemorrhage; and recorded changes of cup-to-disk ratio and visual field. Follow-up time ranged from 7 to 261 months, with an average of (109.2 ± 63.0) months. Results A total of 770 PACG patients were included, of which 44 (5.7%) had a history of optic disc hemorrhage, including 30 cases (68%) of unilateral ocular hemorrhage and 14 cases (32%) of bilateral or simultaneous bleeds. Of the 44 patients (58 eyes), the total number of hemorrhage was 111, and 23 eyes (40%) had repeated bleeding. Among 111 hemorrhages, 85 (77%) occurred in the optic disc area and 19 (17%) occurred in the superior temporal area. Of the 23 disc rebleeds, 11 (48%) occurred in the same area of the disc. The average duration of bleeding was (12.8 ± 8.1) weeks. Meanwhile, there was no significant difference in intraocular pressure and cup-to-cup ratio between the bleeding eye and the non-bleeding contralateral eye. For patients with unilateral disc hemorrhage, the cup was significantly more variable than the hemorrhagic and non-hemorrhagic contralateral eyes, but the visual field defect was more severe only in the bleeding eye. CONCLUSIONS: At least 9 years of follow-up, we found a 5.7% incidence of optic disc hemorrhage in PACG patients, and its incidence is often associated with deterioration of optic neuropathy and visual field defects in glaucoma despite its relatively low incidence.