高眼压症中央角膜厚度与眼压关系的临床观察

目的 评价高眼压症患者中央角膜厚度(CCT)与眼压(IOP)的关系,并探讨CCT在判断高眼压症患者是否给予降眼压药物干预治疗中的临床意义.方法 对54例(108只眼)高眼压症患者进行非接触眼压计检测和超声角膜厚度测量,并对校正眼压＜21 mmHg的患者31例62只眼(占57.4%)不予降眼压治疗,追踪观察其眼压、视野、视乳头以及视网膜神经纤维层的情况.结果 IOP随CCT增加而增高,并呈正相关(CCT每增加100μm,IOP将随之增加2.1mmHg).对校正眼压＜21mmHg的患者不予降眼压治疗,随访24～36个月,平均30个月,其中1例2只眼出现视野改变,发生率为1.85%.结论 中央角膜厚度测量可以作为高眼压症与青光眼进行鉴别诊断,以及判断高眼压症能否发展为青光眼的重要依据,常规测量高眼压症患者的CCT并校正其眼压,对高眼压症患者的合理处置非常重要,对校正眼压＜21mmHg的患者可以不需降压药物干预治疗,仅需密切随访.     

角膜厚度与高眼压症及青光眼的眼压

目的 探讨高眼压症、正常眼压性青光眼、原发性开角型青光眼患者及正常人的角膜厚度差异,分析角膜厚度与眼压间的关系,以及角膜厚度的测定对各型青光眼的诊断意见。方法 用超声波角膜测厚仪检测７３例（７３只眼）高眼压症、７９例（７９只眼）正常人的中央角膜厚度,并将其测定结果进行比较。回顾性分析每只青光眼治疗前的最高眼压（Ｇｏｌｄｍａｎｎ）,包括２４ｈ眼压曲线,用Ｅｈｌｅｒ法通过中央角膜厚度对眼压进行校正。结     

近视伴高眼压症的眼压与中央角膜厚度的关系

目的 :探讨近视眼患者中高眼压症的眼压与中央角膜厚度的关系及其临床意义。方法 :用超声角膜测厚仪及非接触眼压计对 14例 2 8眼近视伴高眼压症患者的中央角膜厚度和眼压进行测定 ,并采用SPSS 10 .0作统计分析。结果 :14例 2 8眼的眼压范围为 2 0～ 2 9mmHg,平均 (2 3.88± 2 .2 6 )mmHg ;中央角膜厚度为 5 33～ 6 70 μm ,平均 (5 86 .5 0± 31.91) μm ;屈光度为 - 0 .75～ - 3.5 0D ,平均 - (1.5 0± 0 .6 9)D。应用SPSS(10 .0 )软件进行相关分析 :眼压与厚度经回归分析 ,直线方程式为 :Y(中央角膜厚度 ) =4 4 5 .15 1+5 .92 0X(眼压 ) ;眼压与屈光度的相关系数r =0 .35 5 ,P >0 .0 5。结论 :眼压与中央角膜厚度成正相关 ,与屈光度无相关性。近视眼中高眼压症的眼压升高与中央角膜厚度增加有关 ,提示近视眼伴高眼压症患者的真实眼压可能是正常的 ,只是由于中央角膜厚度的增加而使眼压的测量值升高。检测中央角膜厚度有助于更正确地估计实际的眼压值。     

中央角膜偏厚的高眼压症患者临床观察

目的预测中央角膜厚度在高眼压症转归中的作用。方法将门诊用非接触眼压计检测的高眼压症患者做超声角膜厚度测量,中央角膜厚度大于及等于575μm的患者60例(120只眼)纳入本研究,不予降眼压治疗,追踪观察眼压、视乳头、视野变化。结果随访36～76个月,平均48个月。其中1例1只眼出现视野改变,发生率为0.83%(1/120)。结论角膜厚度是判断高眼压症是否发展为青光眼的最有力的预测因素.常规中央角膜厚度测量对高眼压症患者的合理处理是非常重要的。中央角膜偏厚且眼压低于28mmHg的高眼压症患者不需要抗青光眼治疗,仅需定期观察。     

角膜中央厚度对高眼压症和开角型青光眼眼内压测量值的影响

目的研究角膜中央厚度对高眼压症和原发性开角型青光眼病人的眼内压测量值的影响.方法对44例(88眼)临床诊断为高眼压症的患者,31例(61眼)原发性开角型青光眼患者及52例(104眼)与高眼压症患者屈光状态相近的正常人的角膜中央厚度及眼内压进行检测,用统计学方法比较3组的角膜中央厚度的差异及高眼压症患者的眼内压值与角膜中央厚度的相关关系.结果①高眼压症组的角膜中央厚度的平均值585.6±35.7μm明显高于原发性开角型青光眼(54.1±38.7μm)(P＜0.01)及正常对照组(535.5±29.4μm)(P＜0.01),而原发性开角型青光眼的角膜中央厚度与正常对照组相比无显著性差异(P＜0.05).②将高眼压症患者的角膜中央厚度与眼内压测量值进行简单线性相关分析,可见角膜中央厚度与眼内压测量值呈明显正相关,相关系数为0.636(P＜0.01).角膜中央厚度每增加50μm可使眼内压测量值升高约2mmHg.结论①高眼压症患者的角膜中央厚度明显大于原发性开角型青光眼和正常眼,高眼压症患者的角膜中央厚度与眼内压呈明显的正相关,提示高眼压症患者是由于角膜中央厚度高于正常范围而造成眼内压测量值的升高.②角膜中央厚度值可作为高眼压症及原发性开角型青光眼的诊断与鉴别诊断的重要依据.提示临床工作中,可将角膜中央厚度检测作为排除青光眼的常规检查手段.③当角膜中央厚度在520±50μm的范围内,眼压读数相对准确,如果角膜中央厚度超过570μm,眼压读数相应增高,这可能是高眼压症患者眼压测量值高于正常范围的重要原因之一.     

高眼压症与角膜厚度

目的评价角膜厚度在高眼压症眼压测量中的作用影响.方法选取34例(68眼)高眼压症患者(眼压≥21mmHg,≤35mmHg,正常视野,正常视神经乳头,无角膜水肿等病变)均为复旦大学医学院眼耳鼻喉科医院眼科门诊患者.年龄6～65岁(19.70±13.52),平均20岁,男性18例,女性20例.由专人应用Goldmann压平眼压计测量眼压,由专人应用Sonoscan     

角膜中央厚度与眼压读数

目的　探讨角膜中央厚度与眼压读数的关系。方法　对44例88眼屈光角膜手术前的患者,分别用压平眼压计和超声角膜测厚仪进行角膜中央厚度和眼压的测量,并对二者之间的关系进行统计分析。结果　Ⅰ组角膜中央厚度≥580μm,眼压为21.50～27.00mmHg(23.70mmHg±1.36mmHg)(1kPa=7.5mmHg),屈光度-2.00～-12.00D。Ⅱ组角膜中央厚度＜520μm,眼压为11.00～20.00mmHg(15.66mmHg±1.71mmHg),屈光度-1.25～-11.25D。Ⅰ组眼压高于Ⅱ组（P＜0.001）。结论　角膜厚度与眼压有明显的相关性,即角膜厚度增加眼压相应增高,当眼压读数高于正常时,应考虑到是角膜中央厚度的改变。     

角膜中央厚度与高眼压症

目的：探讨部分高眼压症患者所表现出的非病理性高眼压（ＯＨＴ）是否为角膜中央厚度（ＣＣＴ）增加所导致的测量误差。方法：共收集了１１名ＯＨＴ患者（２１只眼）及１１名正常对照。用超声角膜测厚仪测量中央角膜厚度,用角膜曲率测量仪测角膜曲率。结果：ＯＨＴ患者ＣＣＴ为５９４．８±１７．５μｍ,明显高于正常对照（５２９．１±２７．３μｍ）,两组角膜曲率差异无显著性。结论：至少一部分ＯＨＴ患者所表现出的非病理性高眼压来源于增厚的角膜中央厚度造成的测量误差。测量ＣＣＴ对于正确评估压平眼压,判断患者是否存在视野损害的危险及确定治疗与否的临界眼压具有重要临床意义。     

Combining corneal hysteresis with central corneal thickness and intraocular pressure for glaucoma risk assessment

Purpose

To determine whether adjusting corneal hysteresis (CH) values for central corneal thickness (CCT) and intraocular pressure (IOP) improves its capability to differentiate primary open-angle glaucoma (POAG) from ocular hypertension (OH).

Methods

This prospective, observational, cross-sectional study included 169 eyes of 169 subjects with a diagnosis of POAG (n=81) or OH (n=88). We utilized the Ocular Response Analyzer (ORA), Pascal Dynamic Contour Tonometer (DCT), Goldmann applanation tonometer (GAT), and ORA ultrasound pachymeter to obtain CH, IOP, and CCT values. Correlational, regression, and t-test analyses were conducted before and after the sample was divided into low, intermediate, and thick CCT subgroups.

Results

In the full sample, CH and CCT were moderately correlated (r=0.44, P<0.001). Although both were related to diagnosis in univariate regression analysis, only CH was independently related to glaucoma diagnosis in multivariate analysis. After the sample was divided into CCT tertiles, CH was significantly lower in POAG vs OH eyes within all three CCT subgroups, and CH was the only multivariate variable that differentiated POAG from OH in each CCT subgroup. Moreover, the relationship between CH and diagnosis was more robust within the CCT subgroups compared with the full sample, suggesting that integrating CCT into CH interpretation is beneficial. Adjusting CH for IOP did not aid diagnostic precision in this study.

Conclusion

Our findings suggest that combining CH and CCT for glaucoma risk assessment improves diagnostic capability compared to using either factor alone. Conversely, adjusting CH for IOP provided no clear clinical benefit in this study.     

不同类型青光眼患者前部巩膜厚度与中央角膜厚度和眼轴长度的相关性分析

背景 巩膜厚度与青光眼关系密切,不同类型青光眼的临床特点不同,其巩膜厚度可能存在一定差异,但目前的相关研究结果有一定争议. 目的 研究各种类型的青光眼患者前部巩膜厚度(AST)、中央角膜厚度(CCT)和眼轴长度间的关系.方法 采用回顾性描述性研究设计.纳入2009年3月至2010年11月就诊于北京大学第一医院眼科门诊的连续患者160例,其中原发性开角型青光眼(POAG) 34例34眼、正常眼压性青光眼(NTG) 37例37眼、原发性闭角型青光眼(PACG) 35例35眼及高眼压症(OHT) 17例17眼,对照组为早期白内障患者37例37眼.分别采用超声角膜测厚仪、眼部A型超声测量仪测量各组患者的CCT、AST及眼轴长度,采用超声生物显微镜(UBM)测量系统测量颞侧巩膜突后2 mm处的巩膜厚度.采用协方差分析法和SNK-q检验对各组的测量参数进行比较,用Pearson积矩相关分析和线性回归法对上述各组患者AST、CCT及眼轴长度间的关系进行分析. 结果 PACG组、POAG组、NTG组及OHT组的CCT值分别为(535.54±5.20)、(550.47±5.28)、(521.61±5.07)和(575.75±7.76) μm,对照组为(535.06±5.06) μm,5个组间的总体差异有统计学意义(F=9.560,P=0.000),其中OHT组的CCT值较其他各组均增加,差异均有统计学意义(均P=0.000),POAG组的CCT值较PACG、NTG及对照组均增加(P=0.046、0.000、0.040),NTG组及PACG组与对照组间CCT值的差异均无统计学意义(P=0.950、0.060).PACG组、POAG组、NTG组及OHT组AST值分别为(0.593±0.050)、(0.600±0.050)、(0.592士0.060)、(0.610±0.060) mm,对照组为(0.604±0.060) mm,5个组间AST的差异无统计学意义(F=0.700,P=0.590).PACG组的眼轴长度短于其他各组,差异均有统计学意义(均P=0.000).POAG组和NTG组患者的CCT与AST呈正相关(POAG:r=0.445,P=0.008;NTG:r=0.400,P=0.014). 结论 不同类型青光眼患者的CCT不同,AST无明显不同;POAG患者及NTG患者的CCT与AST变化间可能存在一定的正相关.     

中央角膜厚度对非接触式眼压计测量值的影响

目的 探讨中央角膜厚度（central corleal thickness,CCT）对非接触式眼压计测量值的影响及CCT与某些眼部参数的关系.方法 应用超声测厚仪测量正常人（26例）、高眼压症（28例）、慢性闭角型青光眼（13例）和原发性开角型青光眼（24例）患者的CCT,同时测量以上入选者的眼内压（intraocular pressure,IOP）、眼轴长度、角膜曲率及屈光度,观察CCT与各参数之间的关系.结果 正常组的眼内压与CCT存在正相关关系（Pearson r=0.499,P=0.009）,CCT与眼轴长度（Pearson r=0.157,P=0.137）、屈光度（球镜）（Pearson r=-0.114,P=0.282）及角膜曲率（水平径 Pearson r=-0.167,P=0.114 垂直径 Pearson r=-0.034,P=0.746）不相关.结论 CCT与眼轴长度、屈光度（球镜）及角膜曲率不相关,在正常对照组与眼内压呈正相关.     

Blue-on-yellow perimetry and corneal thickness in patients with ocular hypertension

AIM: To evaluate the frequency of blue-on-yellow perimetry (B/YP) deficits in ocular hypertension (OHT) patients and to correlate these findings with central corneal thickness (CCT), and to investigate the influence of age, refraction and gender on the B/YP results in OHT patients. METHODS: The B/YP and CCT were checked respectively in 72 OHT patients with normal white-on-white perimetry(W/WP) and normal optic nerve head. The B/YP was tested by Octopus 101 automated perimetry using G2 strategy, while the CCT was checked with DGH-550 ultrasound pachymeter. All patients were chosen randomly one eye for statistical analysis, a binary regression model was used to determine the independent contribution of variables included in the model, and the differences of the intraocular pressure (IOP), CCT, age, refraction and gender between the normal B/YP group and abnormal B/YP group were compared. RESULTS: Forty-nine out of 72 patients with OHT showed normal B/YP results, whereas 23 of 72 patients(31.9%) demonstrated abnormal B/YP results. CCT showed a correlation with the B/YP results (B=-0.038, SE=0.019, P=0.044), whereas none of the IOP, age, refraction and gender was found to be correlated with the B/YP results. The mean CCT in OHT patients with abnormal B/YP group was lower than that with normal B/YP group(t =2.066, P=0.043).There was a significant positive correlation between IOP and CCT (R2=0.513, P= 0.000). CONCLUSION: The mean CCT in OHT patients with abnormal B/YP results was lower than that with normal B/YP results. There was a significant positive correlation between IOP and CCT in OHT patients. The age, refraction and gender didn't influence the B/YP results in OHT patients.     

Long-term change in central corneal thickness from a glaucoma perspective

Aim:

To investigate the longitudinal change in central corneal thickness (CCT) over 3 years in patients with glaucoma.

Materials and Methods:

The Chennai Glaucoma Follow-up Study, an offshoot of the Chennai Glaucoma Study, was designed to evaluate the progression of glaucoma. A cohort of participants in the Chennai Glaucoma Study that were suffering from glaucoma or were at a higher risk for glaucoma underwent comprehensive ophthalmic evaluation at the base hospital at 6-month intervals during the years 2004 to 2007. The CCT (average of 10 readings) was measured between 11 am and 1 pm on any given day using an ultrasonic pachymeter. Patients with a history of ocular surgery, corneal disease and usage of topical carbonic anhydrase inhibitor were excluded. No patient was a contact lens wearer.

Results:

One hundred and ninety-six patients (84 male, 112 female) met the inclusion criteria. We analyzed data from the right eye. The mean age of the patients was 59.97 ± 9.06 years. Fifty-nine (30.1%) of the patients were diabetic. The mean change in CCT (CCT at first patient visit – CCT at last patient visit) was 3.46 ± 7.63 μm. The mean change in CCT was 0.75 μm per year (R² = 0.00). Age, gender, intraocular pressure at the first patient visit and diabetic status had no significant influence on the magnitude of change in CCT.

Conclusion:

A carefully obtained CCT reading by a trained examiner need not be repeated for at least 3 years as long as the ocular and systemic factors known to affect the measurement of CCT are constant.     

高眼压症患者的蓝/黄视野与角膜厚度关系的研究

目的探讨高眼压症(OHT)患者蓝/黄视野检查(BYP)的情况及其与中央角膜厚度(CCT)的关系。方法对31例常规白/白视野检查(WWP)和视乳头检查正常的OHT患者进行BYP检查和CCT测量。采用OCTOPUS101全自动视野计G2程序进行BYP检查,应用DGH550型角膜厚度测量仪进行CCT测量。所有患者随机选择一眼作为研究对象,比较分析BYP视野异常组和正常组的眼压和CCT的差异,分析眼压和CCT间的关系。结果31例OHT患者中,BYP显示视野正常21例,异常10例。视野异常组和正常组的眼压分别为(24.30±1.89)mmHg和(25.48±2.48)mmHg,二组间差异无显著性统计学意义(t=1.32,P=0.1963)。BYP视野异常组的CCT为(557.80±16.41)μm,正常组为(576.00±20.98)μm,二组间差异有显著性意义(t=2.41,P=0.0226)。眼压与CCT之间具有明显的相关性(P<0.05)。结论BYP视野异常组的CCT较正常组的薄。如果将BYP和CCT的检测结果结合起来分析,将对OHT患者发展为青光眼视神经损害作出更有价值的预测。