急性闭角型青光眼大发作后视网膜神经纤维层厚度的变化

目的观察急性闭角型青光眼大发作后视网膜神经纤维层厚度的改变。方法应用相关光断层扫描（OCT）测量急性闭角型青光眼大发作患者发病及治疗后的视网膜神经纤维层厚度的改变，在同期测量36只眼正常成人的视网膜神经纤维层厚度作为对比。病例入选标准为急性闭角型青光眼单眼大发作患者，能够配合进行OCT检测。测量时间为人院后当天、经治疗眼压下降至正常范围后1、3、6个月。结果符合人选标准并完成随访的病例共36例。在入院当天视网膜神经纤维层厚度较正常对照组增加（P〈0．05）。眼压正常后1、3、6个月，平均视网膜神经纤维层厚度较正常对照均明显下降（P〈0．05），并随时间推移呈逐渐下降趋势。在眼压下降到正常范围后的1—3个月内视力逐渐上升，而在3～6个月内视力基本稳定。眼压下降到正常后，在整个随访期内均处于正常范围，但是随着时间的推移有逐渐上升的趋势。结论眼压的急性升高在早期可造成视网膜神经纤维层平均厚度增加，以上、下方为主。在经过治疗眼压降至正常范围内后，视网膜神经纤维层厚度逐渐下降、变薄。

Optical coherence tomography measurement of retinal nerve fiber layer after acute primary angle closure glaucoma

Objective To detect retinal nerve fiber layer（RNFL） thickness after acute primary angle closure glaucoma under attack. Methods This is a prospective, observational case study. Thirty-six patients who had a single unilateral APAC attack and 36 single eyes from normal controls were tested by stratus optical coherence tomography （ OCT ） with circular scans around the optic nerve head （ diameter = 3.46 mm ）. Duration of APAC attack was （ 12.4 ± 8.4 ） hours. Comparisons of average RNFL thickness and RNFL thickness in four quadrants, and normal controls were made. Results At the time of admission, the RNFL thickness of superior quadrant and inferior quadrant of patients were increased comparing with the controls. After the intraocular pressure has been controlled, the RNFL thickness gradually decreased, and there are significant differences among 1, 3, and 6 m. Conclusion Superior quadrant and inferior quadrant RNFL thickness was significandy increased at the time of admission. After the intraocular pressure has been controllcd, the RNFL thickness was thinning.