原发性开角型青光眼和高眼压患者及正常人群结膜印迹细胞学检查的比较

Comparison of conjunctival impression cytology in primary open angle glaucoma, ocular hypertension and normal subjects

摘要:

目的：比较原发性开角型青光眼和高眼压患者及拥有健康眼球表面的正常人群的泪膜功能和印象细胞学检查的数值。

方法：此前瞻性研究中纳入了原发性开角型青光眼患者11例11眼(平均年龄：62.7±6.1岁)，高眼压患者12例12眼(平均年龄：62.8±6.4岁)及健康人12例12眼(平均年龄：62.9±6.03岁)。这些患者均是最近被诊断出患有原发性开角型青光眼及高眼压，且之前未接受过抗青光眼方面的治疗。均行结膜印迹细胞学检查、泪膜破裂时间和基础泪液分泌试验。每组印迹细胞学检查的样本根据Nelson分级法分为0～3级。应用Kruskal-Wallis检验和Dunn多重比较检验进行统计分析。

结果：原发性开角型青光眼患者，高眼压患者及正常人群平均基础泪液分泌值分别为10.4±1.3，10.9±1.2和11.1±1.1 mm/5min，其差距没有统计学意义(P=0.33)； 三组的泪膜破裂时间分别为11.2±1.1， 11.3±1.1和11.8±1.2s，其差距没有统计学意义(P=0.35)。原发性开角型青光眼患者中6眼(54.5%)为0级， 5眼(45.5%)为1级。高眼压患者中6眼(50%)为0级， 6眼(50%)为1级，健康人中6眼(50%)为0级， 6只眼(50%)为1级(P=0.97)。

结论：氧化应激可能会导致青光眼，眼表疾病，泪腺功能障碍及机体杯状细胞所分泌的黏液减少。原发性开角型青光眼患者，高眼压症患者及健康人群间的印象细胞学检查数值并无显著差异。

Abstract:

AIM: To compare the tear functions and the impression cytology scores of the patients with primary open angle glaucoma(POAG), ocular hypertension(OHT)and normal subjects with healthy ocular surface both functionally and clinically.

METHODS: Eleven eyes of 11 patients with POAG(mean age: 62.7±6.1y), 12 eyes of 12 patients(mean age: 62.8±6.4y)with OHT and 12 eyes of 12 normal subjects(mean age: 62.9±6.03y)were included to this prospective study. The patients with POAG and OHT had been recently diagnosed with these diseases and none of them had taken anti-glaucoma treatment before. In addition to conjunctival impression cytology, tear break-up time(TBUT)and basal Schirmer's tests(BST)were performed. Impression cytology specimens of each group were graded and scored in the range of 0-3 according to Nelson's method. Kruskal-Wallis analysis and Dunn's multiple comparison tests were used for statistical analysis.

RESULTS: The mean BST values were 10.4±1.3, 10.9±1.2 and 11.1±1.1 mm/5min of POAG, OHT and control groups respectively. The differences among the BST values of the POAG, OHT and control group were not statistically significant(P=0.33). The mean TBUT values were 11.2±1.1, 11.3±1.1 and 11.8±1.2s in POAG, OHT and normal subjects respectively. The differences among the BUT values of the POAG, OHT and control group were not statistically significant(P=0.35). Six eyes(54.5%)revealed grade 0 and 5 eyes(45.5%)revealed grade 1 impression cytology scores in POAG group. Six eyes(50%)revealed grade 0 and 6 eyes(50%)revealed grade 1 impression cytology scores in OHT group and 6 eyes(50%)revealed grade 0 and 6 eyes(50%)revealed grade 1 impression cytology scores in normal subjects(P=0.97).

CONCLUSION: Oxidative stress may cause glaucoma, ocular surface diseases, lacrimal gland malfunction and a decrease in mucus secretion ofgoblet cells in all of the body. There were no significant differences between the impression cytology scores of patients with POAG, OHT and normal subjects.