应用超声生物显微镜检测原发性婴幼儿型青光眼的眼前节形态特征

目的了解原发性婴幼儿型青光眼（ｐｒｉｍａｒｙｉｎｆａｎｔｉｌｅｇｌａｕｃｏｍａ，ＰＩＧ）在活体状态下的眼前节组织结构特点。方法应用超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｙ，ＵＢＭ），以５０ｍＨｚ的超高频超声探头，对３８例（５８只眼）原发性婴幼儿型青光眼的眼前节结构进行测量和动态学检查。结果ＰＩＧ患儿无论发病早晚、病情轻重或年龄大小，其最主要的病变特征是巩膜突与房角顶点的相对位置发生变化，３／４患眼的巩膜突位于房角顶点外侧或后外方，１／４患眼的巩膜突与虹膜根部附着处平行。睫状突长度和厚度均大于同龄正常儿童。睫状突向前、向内移位，部分与虹膜相贴。结论ＰＩＧ患儿的巩膜突与房角顶点相对位置的改变，提示巩膜突发育不良或虹膜附着点靠前，这是原发性婴幼儿型青光眼发病的病理基础。

A study of anterior segment structures in primary infantile glaucoma eyes by ultrasound biomicroscopyZHU Xiaoqing, LI Zhihui, LIN Ding, et al.

Objective To investigate anterior segment structures in primary infantile glaucoma (PIG) eyes by ultrasound biomicroscopy (UBM) in vivo. Methods UBM high frequency transducer (50mHz) was used to measure and observe the anterior segment of 38 PIG cases (58 eyes). Results No matter the severity of the disease or the age at onset, the most significant characteristics of the diseased eyes are relative positional changes between scleral spur and angle apex. In three forth of the eyes, the scleral spur lay in the lateral or posteriorlateral site of the angle apex and in one forth of the eyes the site of the tip of scleral spur was parallel with the iris root insertion. The thickness and length of ciliary processes in the eyes of PIG were greater than that of the normal infantile eyes. The ciliary processes were anteriorly displaced, pulled towards the lens, and part of them got into contact with the iris. Conclusions The relative positional changes between scleral spur and angle apex in diseased eyes indicate that the poor development of scleral spur and the iris anterior insertion are the basic pathogenesis in PIG.