原发性闭角型青光眼患者与可疑原发性房角关闭患者虹膜睫状体构型特征的比较分析

目的 比较原发性闭角型青光眼（PACG）患者与可疑原发性房角关闭（PACS）患者的房角生物学特征。设计 回顾性比较性病例系列。研究对象 2019年10月至2021年3月同济医院58例PACG及PACS患者。方法 回顾患者病例资料及超声生物显微镜（UBM）图像，测量其房角生物学参数，进行定量及定性分析。主要指标 中央前房深度（ACD）、500 μm房角开放距离（AOD500）、500 μm小梁虹膜夹角（TIA500）、500 μm小梁睫状突距离（TCPD500）、500 μm小梁睫状体夹角（TCA500）、虹膜根部厚度（IT500）、睫状突长度（CPL）、睫状体厚度（CBT）。结果 与PACS组（n=25）相比，PACG组（n=33）患者最佳矫正视力（BCVA）更低（0.4±0.35、0.2±0.17），基线眼压更高（21.17±6.09、15.57±3.57 mmHg），眼轴更短（22.17±1.22、22.74±0.88 mm），ACD更浅（1.77±0.27、1.94±0.25 mm），AOD500、TIA500、TCPD500、TCA500更小（0.04±0.04、0.10±0.05 mm；3.90±4.58、11.07±4.77°；0.51±0.10、0.58±0.10 mm；60.55±13.26、71.54±12.58°），CPL更长（1.43±0.26、1.28±0.15 mm）。虹膜插入点位于睫状体基底部的比例（54.5%、20.0%）及睫状体前旋的比例（68.0%、39.4%）PACG组较PACS组更大（P均<0.05）。而IT500、CBT、虹膜成角和虹膜凸度在两组间未见差异。结论 PACG眼较PACS眼具有更短的眼轴和更浅的前房，长而前旋的睫状体构型更明显，虹膜插入点位于基底部的比例更高。（眼科，2022，31： 20-26）

Comparison of iris and ciliary biometry parameters between eyes of primary angle closure glaucoma and primary angle closure suspects

Objective To observe the differences of anterior segment biometry parameters between primary angle closure glaucoma(PACG) and primary angle closure glaucoma suspects(PACS). Design Retrospective comparative case series. Participants 58 patients with PACG/PACS who were diagnosed from October, 2019 to Mrach, 2021 at Wuhan Tongji Hospital. Methods Medical records of all patients were reviewed including ultrasound biomicroscopy (UBM). Qualitative and quantitative comparison of biometry parameters between PACG/PACS groups were conducted. Main Outcome Measures  anterior chamber depth (ACD), angle opening distance 500(AOD500), trabecular-iris angle 500(TIA500), trabecular-ciliary process distance 500(TCPD500), trabecular-ciliary process angle(TCA), iris thickness 500 (IT500）, ciliary process length(CPL), ciliary body thickness(CBT). Result Compared with PACS group (n=25), PACG group (n=33) had lower best corrected visual acuity (BCVA) (0.4±0.35, 0.2±0.17), higher baseline intraocular pressure (21.17±6.09, 15.57±3.57 mmHg), shorter ocular axis (22.17±1.22, 22.74±0.88 mm), shallower ACD (1.77±0.27, 1.94±0.25 mm), and AOD500, TIA500, TCPD500 TCA500 is smaller (0.04±0.04, 0.10±0.05 mm; 3.90±4.58, 11.07±4.77 °; 0.51 ± 0.10, 0.58±0.10 mm; 60.55±13.26, 71.54±12.58 °, respectively) and CPL is longer (1.43±0.26, 1.28±0.15 mm). The proportion of iris insertion point at the base of ciliary body (54.5%, 20.0%) and ciliary body pronation (68.0%, 39.4%) in PACG group was greater than that in PACS group (all P<0.05). There was no statistically significant difference in IT500, CBT and proportion of iris angulation and iris convexity between PACG group and PACS group. Conclusion Smaller AL, shallower anterior chamber depth, more significant the anterior rotation and size of the ciliary body, and larger proportion of the basal iris insertion in PACG group than in PACS group were observed, whether these features be risk factors of PACG progression, remains to be determined by long term follow-up observation. (Ophthalmol CHN, 2022, 31: 20-26)