不同类型青光眼彩色多普勒血流显像的比较研究

目的观察113例不同类型青光眼眼动脉(OA)、睫状后短动脉(SPCA)及视网膜中央动脉(CRA)的血流动力学改变.方法对原发性开角型青光眼(POAG)36例(66只眼)、急性闭角型青光眼(ACAG)40例(76只眼)、慢性闭角型青光眼(CCAG)37例(71只眼)及正常人40例(80只眼)进行彩色多普勒血流显像(CDFI)检查,测定血流参数为收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)和阻力指数(RI).结果①与正常组相比较,各组青光眼的OA,SPCA 及CRA 的PSV和EDV有明显下降,尤以EDV的下降显著(P<0.01),而RI明显增高(P<0.01),差异有显著意义.② ACAG组与CCAG组眼部血流参数比较差异无显著意义(P>0.05).③ POAG组三支动脉的EDV较ACAG组及CCAG组减慢,而RI增高,差异有显著意义(P<0.05).④各型青光眼眼部血流参数均呈低流速高阻状态.结论不同类型青光眼均存在局部不同程度的血液循环障碍;CDFI对视神经乳头血流改变有较高的敏感性,对青光眼的早期诊断、用药及预后判断均有重要价值.

Ocular hemodynamics in patients with different types of glaucoma by color Doppler flow imaging

Objective To observe the hemodynamics of ophthalmic artery (OA), short posterior ciliary artery (SPCA) and central retinal artery (CRA) in the patients with different types of glaucoma. Methods The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of OA, SPCA and CRA were measured by color Doppler flow imaging (CDFI) in 36 patients (66 eyes) with primary open angle glaucoma (POAG), 40 (76 eyes) with acute closed-angle glaucoma (ACAG), 37 (71 eyes) with chronic closed-angle glaucoma (CCAG), and 40 healthy subjects (80 eyes). Results Compared with the control group, PSV and EDV were significantly decreased, and RI was remarkably increased ( P < 0.01 ) in 3 arteries in patients group. There were no statistical differences in 3 hemodynamic parameters between ACAG and CCAG groups, but EDV was decreased, and RI increased obviously ( P <0.05) in 3 arteries of POAG subjects in comparison with ACAG and CCAG patients. Hemodynamic parameters in glaucoma patients were characterized as higher resistance and lower velocity. Conclusion There were regional circulatory disorders in different types of glaucoma. CDFI is sensitive to detect hemodynamic change of the optical papilla, which is valuable in the early diagnosis, monitoring medication response and predicting prognosis in the patients with glaucoma.