近视合并原发性闭角型青光眼的眼前节参数特征

目的：分析近视合并原发性闭角型青光眼（PACG）的眼前节参数特征及近视与PACG的关系。方法：多中心横断面研究。连续纳入2019年1月至2021年8月厦门大学附属眼科中心、四川大学华西医院眼科、深圳市眼科医院、大连市第三人民医院眼科、郑州市第二人民医院眼科等5个眼科中心明确诊断的近视合并PACG患者210例（263眼）。根据等效球镜度（SE）将受检眼分为低度近视组（SE -3.00~-1.00 D）、中度近视组（SE-6.00~-3.00 D）、高度近视组（SE≤-6.00 D）。根据眼轴长度（AL）将受检眼分为AL≤24 mm组和AL>24 mm组。所有患眼均接受常规眼科检查，采用主观验光仪进行屈光度检查，采用IOLMaster 700测定中央前房深度（ACD）、晶状体厚度（LT）、AL，根据公式计算SE、玻璃体腔长度（VL）、相对晶状体位置（RLP）。不同近视程度组间眼前节参数比较采用单因素方差分析，不同AL组间眼前节参数比较采用独立样本t检验。结果：低度近视组176眼，中度近视组60眼，高度近视组27眼，3组受检眼AL总体比较差异有统计学意义（F=27.95，P<0.001），其中高度近 视组AL长于低度近视组和中度近视组，差异均有统计学意义（均P<0.001）；3组间LT总体比较差异有统计学意义（F=5.81，P=0.003），其中高度近视组LT短于低度近视组和中度近视组（P=0.002、0.001）；3组间RLP总体比较差异有统计学意义（F=13.69，P<0.001），其中高度近视组RLP比低度近视组和中度近视组更靠前（P<0.001）。AL>24 mm组受检眼ACD比AL≤24 mm组深（t=-2.60，P=0.010），但AL>24 mm组受检眼RLP比AL≤24 mm组更靠前（t=6.74，P<0.001）。结论：高度近视合并PACG的AL较长，LT较短，但RLP更靠前。相对拥挤的前房结构可能是此类近视患者发生房角关闭的原因之一。

Study of the Characteristics of Ocular Biometric Parameters in Patients with Myopia Combined PrimaryAngle-Closure Glaucoma

Objective: To analyze the characteristics of ocular biometric parameters and the relationship between myopia with primary angle-closure glaucoma (PACG). Methods: A multicenter cross-sectional study was performed. Atotal of 210 cases (263 eyes) of myopia complicated with PACG in Xiamen Eye Center, Xiamen University, West China Hospital of Sichuan University, Shenzhen Eye Hospital, the Third People's Hospital of Dalian, and Zhengzhou Second People's Hospital from January 2019 to August 2021 were collected. Patients were divided into three groups based on spherical equivalent (SE): low myopia group (SE-3.00--1.00 D), moderate myopia group (SE-6.00--3.00 D), high myopia group (SE≤-6.00 D). Patients were also divided into two groups based on axial length (AL):AL>24 mm group, andAL≤24 mm group. All subjects underwent examinations including measurements of central anterior chamber depth (ACD), lens thickness (LT), and AL using the IOLMaster 700. SE and vitreous cavity length (VL) and relative lens position (RLP) was calculated. The characteristics of ocular biometric parameters and their relationship with myopia were analyzed. The ocular segment parameters between various myopia degree groups were analyzed by one-way ANOVA. The ocular segment parameters between various AL groups were analyzed by independent sample t-test. Results: One hundred and seventy-six eyes were low myopia, 60 eyes were moderate myopia, and 27 eyes were high myopia. There was a significant difference in AL between the three groups (F=27.95, P<0.001). The AL was substantially longer in the high myopia group than in the low myopia and moderate myopia groups, with statistically significant differences (all P<0.001). A significant difference was found in LT among the three groups (F=5.81, P=0.003). The LT was shorter in the high myopia group than in the low myopia and moderate myopia groups (P=0.002, 0.001). There was a significant difference in RLP across the three groups (F=13.69, P<0.001). The RLP in the high myopia group was significantly advanced compared to the low myopia and moderate myopia groups (all P<0.001). The ACD was deeper in the AL>24 mm group than in the AL≤24 mm group (t=-2.60, P=0.010). However, the RLP was signifcantly advanced in the AL>24 mm group than in theAL≤24 mm group, showing a statistically signifcant (t=6.74, P<0.001). Conclusions: High myopia combined with PACG led to longer AL and shorter LT, but anterior RLP. One of the reasons for angle closure in such myopic patients may be the relatively crowded anterior chamber.