原发性急性闭角型青光眼发作后RNFL的变化

Changes of retinal nerve fiber layer after an episode of primary acute angle-closure glaucoma

摘要:

目的:观察原发性急性闭角型青光眼(primary acute angle-closure glaucoma,PAACG)发作缓解后视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化规律。方法:PAACG发作患者36例在治疗缓解后2,4,8,12wk测量平均RNFL厚度和上方、颞侧、下方、鼻侧RNFL厚度,分别与对照眼比较并分析发作眼RNFL厚度随时间的变化。结果:RNFL厚度在2wk和4wk时,发作眼和对侧眼比较差异无显著性;发作眼重复测量分析结果表明,伴随访时间的延长发作眼各个象限的RNFL厚度逐渐变薄,其中2wk与4,8,12wk比较均有统计学意义(均P<0.01)。其余各时间之间差别无显著性意义。结论:PAACG单次发作缓解后对RNFL造成损害,这种损害主要发生于下方,在眼压缓解后8wk内仍继续进展。

Abstract:

AIM:To investigate retinal nerve fiber layer (RNFL) thickness changes after primary acute angle-closure glaucoma (PAACG). METHODS:Totally 36 patients were recruited, 26 Female (72.2%) and 10 male (27.8%). All the PAACG attacks were resolved after treatment by anti-glaucoma drug followed by laser peripheral iridotomy or surgery. Patients completed RNFL thickness measurement including mean,superior, temporal,inferior and nasal RNFL thickness at 2,4,8,12weeks after resolved using FD-OCT. Analysis of repeated measures and independent-sample t test analysis was carried out to analyze the difference of RNFL thickness (SPSS 15.0). RESULTS:There was no significant difference in RNFL thickness between the attacked eyes and the controled eyes at 2 weeks and 4 weeks. RNFL thickness of all quandrants in the attacked eyes thinned gradually with follow-up, among which there was significant difference between 2 weeks and 4,8,12weeks and there was no significant differences between other weeks. CONCLUSION:After an episode of PAACG, the RNFL thickness is thinning continually mainly in inferior quadrant during the first 8 weeks after primary acute angle-closure glaucoma.