青少年型开角型青光眼48例临床分析

目的 :探讨青少年型青光眼的临床特点、治疗效果及并发症。方法 :对 1996年 7月至 1999年 7月收治的 48例 ( 92眼 )青少年开角型青光眼的临床表现、治疗情况进行分析。结果 :80眼合并近视 ,44眼合并高度近视 ,手术后视力恢复差。结论 :青少年近视度数加深者或高度近视患者应注意警惕是否伴有青光眼 ,主张及早手术     

青少年开角型青光眼临床分析

目的探讨青少年型青光眼的临床特点,手术疗效及并发症.方法对1993年11月～2004年12月我院所有手术治疗的68例(136眼)青少年开角型青光眼的临床表现,手术治疗情况进行了分析.结果122眼合并近视,占89.71%.术中及术后并发症为前房出血和术后浅前房,术后视力68眼有提高,49眼无变化,19眼下降.术后眼压＜10 mmHg 28眼,10～20mmHg97眼,21～25mmHg11眼.结论青少年近视或近视度数不断加深应注意警惕是否伴有青少年开角型青光眼.     

青光年型青光眼122例临床观察

目的：就122例晚期青光眼患住院手术治疗的情况做了回顾性探讨,针对青少年近视的防治,应警惕青少年型青光眼潜在的危险。方法：晚期青光年型青光眼的治疗以手术为主,术中术后应防止瘢痕形成,提高治疗成功率,结果：术中应用丝裂霉素C,术后使用5－FU,本组病例成功率可达77％,结论：对于早期青少年型青光型青光眼应以保守治疗为首选,晚期患则以手术治疗为主。     

青少年近视合并高眼压的静态阈值视野改变

目的：探讨合并高眼压青少年近视的静态视野改变的特点及其临床意义。方法：应用Octopus101型全自动视野计对45例(87只眼)青少年近视合并高眼压和36例(72只眼)正常眼压青少年近视进行定量视野测定，并分析其视野缺损形式及视野指数与眼压、屈光度的关系。结果：合并高眼压青少年近视的视野损害发生率明显高于正常眼压青少年近视。视野损害多表现为生理盲点扩大，特征性青光眼视野缺损。与正常眼压青少年近视有显著性差异。平均敏感皮MS值、平均缺损MD值、缺损变异LV值均与正常眼压青少年近视有显著性差异，且在正常眼压青少年近视组中，随着近视度数增加，MS值逐渐下降，MD及LV值逐渐升高。结论：高眼压是青少年近视人群中发展为青光眼性视野损害的一个重要因素。眼压应列为青少年近视的眼科常规检查项目。采用全自动视野计检测是早期发现青少年近视青光眼性视野损害的最敏感最有特异性的检查方法。     

青少年型青光眼(附14例临床分析)

由于青光眼早期诊断技术不断提高,对青少年型青光眼的确诊率亦有所提高。多数学者认为30岁以下发病,而不引起眼球扩大的青光眼为青少年型青光眼。临床表现与开角型慢性单纯性青光眼相似。因合并近视眼者较多,对其视力的恶化,常认为近视程度的加深,导致青光眼的漏诊。现将本院近几年中经治的青少年型青光眼14例24眼报告于下:     

改良黏弹剂Schlemm管切开术治疗青少年型青光眼的临床研究

目的:观察改良的黏弹剂Schlemm管切开术治疗青少年型青光眼的疗效及安全性.方法:对被诊断为青少年型青光眼的27例43眼患者施行改良的黏弹剂Schlemm管切开术.记录患者的性别、接受该手术治疗时的年龄、是否有青光眼家族史、术前术后最佳矫正视力、青光眼药物使用情况、眼压及其它手术情况.记录具体手术步骤及术中术后是否发生明显的并发症.结果:改良的黏弹剂Schlemm管切开术治疗青少年型青光眼,术后2a的成功率为74%,术前平均眼压为35.38±7 15mmHg.2a后,患者平均眼压16.50±2.52mmHg,眼压下降值为18.88mmHg(P<0.01).术中及术后均未出现明显并发症.结论:长期随访的数据显示改良的黏弹剂Schlemm管切开术治疗青少年型青光眼有较好的临床效果,结合其术中、术后的并发症较少等优点,该手术有望成为青少年型青光眼的首选治疗术式.     

青少年型青光眼21例临床分析

青少年型青光眼２１例临床分析金华市中心医院眼科吕志刚，蔡灵德青少年型青光眼，亦称发育性青光眼（１），由于其发病隐蔽、进展缓慢，并常伴有近视等而被误诊或漏诊，造成不可逆的视力障碍。现将我院１９８０～１９９２年住院收治的２１例青少年型青光眼临床分析如下：...     

近视眼视盘形态学变化与开角型青光眼的相关性研究进展

近年来研究发现, 近视尤其是高度近视的眼部形态改变与开角型青光眼的关系密切, 这些形态改变不仅是近视患者易患青光眼的危险因素, 同时也对此类患者病程进展有着一定影响。开角型青光眼是进行性、不可逆性的致盲性眼病, 因此近视患者早期发现、确诊、病情进展时及时干预显得十分重要。现笔者回顾近年文献, 在形态学变化上就近视与开角型青光眼的相关性做一综述。     

近视眼视盘形态学变化与开角型青光眼的相关性研究进展

近年来研究发现,近视尤其是高度近视的眼部形态改变与开角型青光眼的关系密切,这些形态改变 不仅是近视患者易患青光眼的危险因素,同时也对此类患者病程进展有着一定影响。开角型青光眼 是进行性、不可逆性的致盲性眼病,因此近视患者早期发现、确诊、病情进展时及时干预显得十分 重要。现笔者回顾近年文献,在形态学变化上就近视与开角型青光眼的相关性做一综述。     

选择性激光小梁成形术189眼治疗观察

目的观察选择性激光小梁成形术(SLT)作为原发性开角型青光眼、视网膜静脉阻塞伴开角型青光眼、进展性近视伴开角型青光眼、正常眼压性青光眼、前部缺血性视神经病变改善眼压首选治疗的安全性和有效性。方法分别对原发性开角型青光眼患者48例79只眼,视网膜静脉阻塞伴开角型青光眼患者26例36只眼,正常眼压性青光眼患者12例24只眼,前部缺血性视神经病变(AION)患者28例32只眼,进展性近视伴开角型青光眼患者14例18只眼,总计128例189只眼进行SLT治疗。结果以患者术后眼压较术前眼压下降≥3mmHg为有效,分别计算出患者术后2小时、1月、3月、6月、12月的有效率,总有效率分别为93.65%、97.48%、95.65%、94.57%、91.49%。结论SLT有显著的降眼压效果、安全、损伤小、实用、简便、科学。     

青少年型青光眼122例臨床觏察

目的就122例晚期青光眼患者住院手術治瘵的情况做了回颇性探討.針對青少年性近視的防治,應警惕青少年型青光眼潜在的危險.方法晚期青少年型青光眼的治瘵以手術爲主,術中術後應防止瘢痕形成,提高治瘵成功率.結果術中應用絲裂霉素C,術後使用5-FU,本組病例成功率可達77%.結論對于早期青少年型青光眼應以保守治瘵爲首選,晚期患者則以手術治瘵爲主.     

高度近视与原发性开角型青光眼关系的研究进展

近年来,在青光眼及近视发病机制研究中发现,高度近视与原发性开角型青光眼的发病有明显相关性.高度近视眼底病理改变是开角型青光眼的高危因素,且高度近视眼底改变与早期开角型青光眼眼底改变容易混淆,造成青光眼早期诊断困难.如何从高度近视患者中早期发现青光眼,并进行早期干预治疗成为难点.本文回顾分析近年文献,对高度近视与原发性开角型青光眼的关系做一综述.     

青少年近视与右利手关系的临床观察

目的:评估右利手与青少年近视的关系。方法:收集我院门诊376例青少年近视患者,对患者行右利手、非右利手评估,散瞳和显然验光(行角膜地形图、裂隙灯、眼压检查、直接检眼镜检查眼底,排除圆锥角膜、青光眼等其他眼部疾病)后,依近视度数进行分类。结果:右利手组:高、中度近视眼组近视度数右眼高于左眼,差异有统计学意义(P<0.05),轻度近视眼组两眼间差异无显著性意义,散光度数只有轻度近视眼组差异有显著性意义;非右利手组:除了轻度近视眼组柱镜度数两眼间差异有显著性意义(P<0.05),其他组两眼间差异无显著性意义。结论:近视的形成与右利手的形成有着密切的联系,应提倡孩子自小用左手进行一些日常生活活动,从而预防近视,减少两眼的屈光参差度数,预防屈光参差性弱视的发生。     

Should mitral valve prolapse be considered as one of the risk factors for open angle glaucoma? A preliminary observation

AIM:To assess the incidence of mitral valve prolapse in patients with newly diagnosed primary open angle glaucoma.METHODS:The study included 12 patients without any other comorbidities or taking any general or local medications.Each patient underwent a full ophthalmological examination with visual field assessment and optical computed tomography of the macula and optic nerve head.Carotid Doppler ultrasound was performed to exclude impaired blood flow in this region and transthoracic echocardiography with assessment of the function and morphology of the heart valves.RESULTS:In the study group,mitral valve prolapse was found in seven patients(58.3%),while mitral valve regurgitation in 11 patients(91.7%).One case of normal pressure glaucoma and four cases of juvenile glaucoma were diagnosed.There were also other risk factors for glaucoma:myopia(58.3%),migraine headaches(41.7%),a positive family history of glaucoma(16.7%).CONCLUSION:Mitral valve prolapse could be indicated as a new risk factor for glaucoma.It seems reasonable to conduct screening tests for glaucoma in patients with mitral valve prolapse in the course of echocardiography.     

Is myopia a risk factor for glaucoma?

Controversy exists in the literature concerning the role of axial myopia as a risk factor for primary open-angle glaucoma. Epidemiologic evidence suggests that moderate and especially high myopia with a refractive error exceeding -6D is a risk factor for the development and the progression of glaucomatous optic neuropathy, with a twofold to threefold increased risk of glaucoma compared with that of nonmyopic subjects. This risk has been proven to be independent of other glaucoma risk factors and intraocular pressure (IOP). Myopic eyes have slightly although probably not clinically relevant, higher IOPs than emmetropic or hyperopic eyes. Selection bias could account for some of the reported association between glaucoma and myopia given that myopic subjects are likely to consult their ophthalmologist more frequently and glaucoma is underdiagnosed in myopic patients due to the great variability of their optic disc morphology, especially in high myopia, and the difficulty to interpret their visual field. The weakness of the fibroglial matrix of the nerve fibers at the optic disc together with the structural alterations in the lamina cribrosa and choroid, could contribute to the high susceptibility of the optic disc to IOP fluctuations and to increasing the risk of glaucomatous neuropathy, especially in high myopic eyes. Special attention will be given to patients with mild myopia who present with both elevated IOP levels and a positive family history. On the other hand, high myopic subjects should be screened for glaucoma at closer intervals. Moreover, after appropriate adjustments for deviations in central corneal thickness have been made, IOP greater than 17 mmHg must already be regarded as critical and initiation of medical treatment considered.     

The relationship of structure in vivo of low tension glaucoma and myopia

The structure in vivo and incidence of myopia on thirty patients with low tension glaucoma were studied in this paper. Results showed that the incidence of high myopia of patients with low tension glaucoma was higher than normal. All of the mean values of the thickness of lens, the length of vitreous and axis, and the area of optic disc were larger than normal too. These indicate that patients with low tension glaucoma may often be associated with high myopia, and their structure of eye in vivo differs from normal. These may be related to pathogenesis of disease with low tension glaucoma. The relationship of myopia and structure of optic disc with glaucoma were briefly summarized.     

Diurnal intraocular pressure in juvenile open-angle glaucoma

Outpatient diurnal intraocular pressures were obtained on 10 patients with juvenile open-angle glaucoma at approximately 6 hour intervals. There were 8 males and 2 females with an age range of 19 to 38 years. All glaucomatous medications were stopped 24 hours before recording the tensions. The peak intraocular pressure was recorded at the 6 PM interval in 6 of the 10 patients. Three patients recorded their highest pressures at the 12 AM (midnight) interval. Extraordinarily wide angles were observed in all cases and myopia was a common refractive error. Although the family history was not known in 3 patients, there was a positive family history of glaucoma in 7 of the 10 patients, which suggests an autosomal dominant mode of inheritance.     

高度近视合并原发性开角型青光眼的临床诊断研究进展

临床和试验研究均发现,高度近视患者并发原发性开角型青光眼的概率高于非高度近视患者,特别是当高度近视与原发性开角型青光眼并存时,病情变得尤其复杂。对于个体而言,近视和青光眼之间的关系在很多情况下仍然很不明确,高度近视是造成青光眼的风险因素之一,多数情况下从青光眼的眼底变化中也很难分辨出是近视导致还是功能异常,因此高度近视合并原发性开角型青光眼的早期诊断非常困难但意义重大。本文从流行病学特征、视盘结构、视野改变、眼压测量等方面对高度近视与原发性开角型青光眼的关系及诊断进行综述。     

Progressive axial myopia in a juvenile patient with traumatic glaucoma

PURPOSE: To report a case of progressive axial myopia associated with traumatic glaucoma in a juvenile patient with no systemic disease. DESIGN: Interventional case report. METHODS: In a 15-year-old male, serial ocular examinations, including manifest refraction, tonometry, and axial eye length measurement, were performed over a 6-year period, beginning with blunt trauma, right eye, followed by a series of surgical procedures for traumatic cataract and glaucoma. RESULTS: A 4-diopter myopic shift (from -1.25 to -5.25) with a 1.5 mm increase in the axial eye length occurred, whereas the intraocular pressure increased from 21 to 46 mm Hg, during a 2-year period. The refraction, axial eye length, and intraocular pressure remained stable during the same period in the fellow, normal eye. CONCLUSION: Progressive axial myopia associated with traumatic glaucoma is possible in a juvenile patient in his late teens.