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目的对比窄前房角和宽前房角老年人眼前段结构的形态特征。方法选取59-73岁正常眼压老年人41名(62眼)作为观察对象。根据房角镜检查分为窄房角组(32只眼)和宽房角组(30只眼),分别用A超及超声生物显微镜(UBM)检测前房深度、晶体厚度、眼轴长度、晶体相对位置测量,睫状体厚度、房角开放距离、小梁虹膜角、虹膜厚度、虹膜晶体接触距离,并且对比点1%匹罗卡品滴眼液前后眼前段结构的变化。结果与宽角眼相比,窄角眼前房浅、晶体厚度较大、相对晶体位置前移、睫状体薄、小梁虹膜角窄,房角开放距离小、虹膜厚度小、虹膜晶体接触距离较大;睫状体厚度与晶体厚度呈负相关(r1=-0.53,p<0.01;r2=-0.40,p<0.05),与前房深度成正相关(r1=-0.83,p<0.01;r2=-0.79,p<0.01);窄角眼点匹罗卡品后使小梁虹膜角增加,房角开放距离增加,睫状体厚度增加,虹膜晶体接触距离增加,虹膜厚度变小,前房深度减小。宽角眼点匹罗卡品后小梁虹膜角减小,前房深度减小,房角开放距离减小,虹膜厚度变小,睫状体厚度增加,虹膜晶体接触距离增加。点1%匹罗卡品滴眼液前后,两组的前房深度差值、小梁虹膜角差值、房角开放距离差值均有显著性差异(p<0.01),睫状体厚度差值、平均虹膜厚度差值、以及虹膜晶体接触距离差值均无显著性差异(p>0.05)。结论老年人窄前房角的眼前段结构预示,他们可能是发生闭角青光眼的高危人群。
Objective To compare the morphological characteristics of the anterior segment of the narrow anterior chamber angle and wide anterior chamber angle in the elderly. Methods 41 (62 eyes) aged 59-73 years old with normal intraocular pressure were selected as observation objects. According to gonioscopy, we divided them into three groups: narrow-angle group (32 eyes) and wide-angle group (30 eyes). The depth of anterior chamber, thickness of the anterior chamber, The relative position of the lens, the thickness of the ciliary body, the open angle of the anterior chamber, the iris angle of the trabecular, the thickness of the iris and the contact distance of the iris crystal were measured. Results Compared with the wide-angle eyes, the narrow-angle eyes had a shallow anterior chamber, a large thickness of the lens, a relative position of the lens, a thin ciliary body, a narrow angle of the iris of the trabeculae, a small opening angle of the angle, a small iris thickness, (R1 = -0.53, p <0.01; r2 = -0.40, p <0.05), and had a positive correlation with depth of anterior chamber (r1 = -0.83, p <0.01; r2 = -0.79, p <0.01). After the narrow-angle eye pilocarpine, the angle of trabecular iridocorneal angle increased, the angle of opening increased, the thickness of ciliary body increased, the contact distance of iris crystal increased, the thickness of iris decreased, Depth reduction. After the wide-angle point pilocarpine, the iridocorneal angle decreased, the depth of the anterior chamber decreased, the angle of the open angle decreased, the thickness of the iris decreased, the thickness of the ciliary body increased, and the contact distance of the iris crystal increased. Before and after 1% pilocarpine eye drops, there was a significant difference (p <0.01) in the difference of anterior chamber depth, trabecular iris angle, and angle of open angle between the two groups (p <0.01) Value, average iris thickness difference, and iris crystal contact distance difference was not significantly different (p> 0.05). Conclusions The anterior segment of the narrow anterior chamber in the elderly predicts that they may be at high risk for closing angle glaucoma.