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原发性房角闭合疑似患者激光周边虹膜切除术后一年残余房角闭合 Residual Angle Closure One Year After Laser Peripheral Iridotomy in Primary Angle Closure Suspects

Baskaran, M., Yang, E., Trikha, S., et al.

期刊名称:American journal of ophthalmology

卷期:2017年第183卷

摘要

摘要:目的:旨在通过前房角镜检评估原发性房角闭合疑似患者(PACS)激光周边虹膜切开术(LPI)后残余房角闭合发生率以及基线临床和前段光学相干断层扫描(AS-OCT)预测因子。设计:随机对照试验资料的分析。方法:使用定制软件对181例≥50PACS患者LPI1年前后的AS-OCT图像进行分析。评估的其他参数是眼内压(IOP)和轴向长度(Axl)。残余房角闭合定义为LPI后房角镜检查中至少2个象限不能看到后小梁网。多因素回归分析确定LPI术后1年残余房角闭合的基线预测因素。结果:参与者平均年龄为62.4岁(标准差9.9)。大部分是女性(137人,占75.7%)和中国人(174人,占96.1%)。 LPI术后1年,148例(81.8%)受试者有房角镜显示的房角闭合。单因素分析显示,基线Axl,前房面积,前房容积,距离巩膜750μm处的房角开口距离和角度凹陷面积均较小,而残余房角闭合患者基线晶状体穹窿和虹膜曲率较大(均P <0.05))。多变量分析显示,基线虹膜容积(B = -0.08P = 0.035)和基线IOPB = 0.23P = 0.032)是残余房角闭合的预测因素。结论:LPI1年,PACS> 80%患者有房角镜显示的残余房角闭合。基线虹膜体积增大,基线眼压升高是残余房角镜显示的房角闭合的独立危险因素。

PURPOSE:To determine the incidence and baseline clinical and anterior segment optical coherence tomography (AS-OCT) predictors associated with residual angle closure as assessed by gonioscopy 1 year after laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS).DESIGN:Subanalysis of randomized controlled trial data.METHODS:AS-OCT images from 181 PACS subjects 50 years of age were analyzed using customized software before and 1 year after LPI. Other parameters assessed were intraocular pressure (IOP) and axial length (Axl). Residual angle closure was defined as the inability to see the posterior trabecular meshwork for at least 2 quadrants on gonioscopy after LPI. Multivariate regression analysis determined the baseline predictors of residual angle closure 1 year after LPI.RESULTS:The mean age of participants was 62.4 (standard deviation 9.9) years. The majority were female (137, 75.7%) and Chinese (174, 96.1%). At 1 year post LPI, 148 (81.8%) subjects had gonioscopic residual angle closure. Univariate analysis showed that baseline Axl, anterior chamber area, anterior chamber volume, angle opening distance at 750μm from the scleral spur, and angle recess area were smaller while baseline lens vault and iris curvature were larger in residual angle closure subjects (all P < .05). Multivariate analysis revealed that baseline iris volume (B=-0.08, P= .035) and baseline IOP (B= 0.23, P= .032) were predictors for residual angle closure.CONCLUSIONS:One year after LPI, >80% of PACS had gonioscopic residual angle closure. Greater baseline iris volume and higher IOP at baseline are independent risk factors for residual gonioscopic angle closure.


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