原发性慢性闭角型青光眼血流动力学改变与视功能损害关系的临床研究

目的 :探讨眼底血流动力学改变与慢性闭角型青光眼视功能损害的关系。方法 :利用彩色多普勒超声技术 ( CDI)对慢性闭角型青光眼 ( CPCAG)患者的不同病程阶段的眼动脉 ( OA)、视网膜中央动脉 ( CRA)、睫状后短动脉 ( PCAs)的血流参数进行检测 ,对 CPCAG患者视野指数平均缺损值 ( MD)与 OA、CRA、PCAs阻力指数 ( PI)的相关性分别进行研究。结果 :1 CPCAG患者无论是OA还是 CRA、PCAs,其收缩期峰值血流速度 ( PSV)、舒张末期血流速度 ( EDV)、平均血流速度( Vmean)均较正常人减少 ,阻力指数 ( RI)较正常人高 ( P<0 .0 1 )。 2 CPCAG患者的视野 MD值与OA、CRA和 PCA的 RI之间呈显著负相关 ( P<0 .0 1 )。 3CPCAG组随着视野损害的不断进展 ,其眼底血流速度逐渐下降 ,在尚未出现眼底及视野改变的 CPCAG患者中 ,CRA的 EDV降低 ,与正常对照组相比存在显著差异 ( P<0 .0 5)。结论 :1 CPCAG患者存在着视盘和视网膜的血液供应障碍。 2 CPCAG患者的视野损害与眼底血管末梢阻力的增加有关。 3CDI对 CPCAG的早期诊断及病程监测具有重要价值。

Clinical study of the relationship between altered hemodynamic associated with primary chronic angle closure glaucoma and visual function impairment

Objective:To study the correlationship between altered hemodynamics of fundus and visual function impairment of CPCAG.Methods:Hemodynamic parameters such as measures of blood velocity and vascular resistance of ophthalmic artery (OA),central retinal artery (CRA),posterior cilicary short artery (PCAs) of 30 normal eyes and 88 eyes with primary chronic angle closure glaucoma (CPCAG) in different pathological period were detected.The correlationship between mean deviation (MD) of visual field index of patients with CPCAG and resistivity index (RI) of OA,CRA,PCA were studied respectively.Results:①Peak systolic velocity (PSV),end diastolic velocity (EDV),mean velocity (Vmean) of OA,CRA,PCA of patients with CPCAG all reduced,compared with those of normal persons.RI was higher than that of normal persons with statistically significant differentce (P<0 01).② MD of visual field of patients with CPCAG was negatively correlated with RI of OA,CRA,PCA significantly (P<0 01).③ Fundus blood velocity decreased gradually along with the visual field defect process in patients with CPCAG.The EDV of CRA reduced,compred with normal group,with significant difference (P<005),when fundus and visual field of patients with CPCAG had no change.Conclusion:①The patients with CPCAG has shortfall of blood supply to disc and retina.②Visual field impairment in patients with CPCAG is related to increased ending vascular resistance,so vascular factor plays a certain role in visual nerve impairment of glaucoma.③CDI is of great importance in diagnosing CPCAG in early stage,and fundus artery velocity is correlated with CPCAG progressing process,it should be applied as a regular test for glaucoma. 〔