OCT在原发性急性闭角型青光眼中的应用

目的应用光学相干断层扫描仪（OCT）测量原发性急性闭角型青光眼（APACG）视网膜神经纤维层（RNFL）厚度，观察其变化规律。方法应用OCT测量首次急性发作（＜6?h）的APACG患者(26例)RNFL厚度的改变，测量时间为入院经治疗角膜透明后当天和经治疗眼压下降至正常范围后1周、1个月、3个月、6个月（共5次）。同时测量正常成人（年龄匹配，30例）的RNFL厚度作为对比。结果入院经治疗角膜透明当天和眼压正常后1周平均RNFL厚度分别为（122.14±21.37）、（110.25±17.43）μm，较正常对照组增厚（P<0.01，P<0.05）；眼压正常后1个月平均RNFL厚度为（103.34±15.19）μm,较正常稍增厚（P>0.05）；眼压正常后3个月和正常后6个月平均RNFL厚度分别为（102.56±14.11）、（101.22±15.54）μm,较正常对照组稍下降（P>0.05）。结论眼压急性升高在早期造成RNFL水肿，RNFL厚度增厚，经过治疗眼压降至正常范围后，RNFL厚度逐渐下降。眼压正常后3个月和6个月RNFL厚度趋于稳定。

Application of OCT in acute primary angle-closure glaucoma

To explore the change law of the retinal nerve fiber layer （RNFL） thickness in acute primary angle closure glaucoma （APACG）. Methods26 subjects of APACG with the first acute attack(＜6?hours) and 30 normal controls were included in this study. The RNFL thickness was accessed by optical coherence tomography （OCT）on the 1st day when the cornea became clear and at 1 week,1 month, 3 months，and 6 months after intraocular pressure( IOP) was controlled（5 times ）. RNFL thickness was compared between attacked eyes and normal control eyes. ResultsRNFL thickness on the 1st day of corneal transparency（122.14±21.37）μm was thicker than that of normal controls（P<0.01）.At 1 week after IOP was controlled, RNFL thickness （110.25±17.43）μm was thicker than that of normal controls （P<0.05）. At 1 month after IOP was controlled, RNFL thickness （103.34±15.19）μm was a little thicker than that of normal controls （P>0.05）, there was no significant difference. At 3 months （102.56±14.11）μm and 6 months （101.22±15.54）μm after IOP was controlled, RNFL thickness was a little thinner than that of normal control (P>0.05) , and there were no significant differences. ConclusionIn the early period, acute rising of IOP caused edema of the retina, and RNFL became thicker. After IOP decreased to a normal range, RNFL became thinner. At 3 and 6 months after IOP was controlled, the RNFL thickness tended to be stable.