应用超声生物显微镜检测原发性婴幼儿型青光眼的眼前节形态特征.docVIP

???? 应用超声生物显微镜检测原发性婴幼儿型青光眼的眼前节形态特征 ???? ????　【摘要】　目的　了解原发性婴幼儿型青光眼(primary infantile glaucoma, PIG)在活体状态下的眼前节组织结构特点。方法　应用超声生物显微镜(ultrasound biomicroscopy, UBM), 以50 mHz的超高频超声探头，对38例（58只眼）原发性婴幼儿型青光眼的眼前节结构进行测量和动态学检查。结果　PIG患儿无论发病早晚、病情轻重或年龄大小，其最主要的病变特征是巩膜突与房角顶点的相对位置发生变化，3/4患眼的巩膜突位于房角顶点外侧或后外方，1/4患眼的巩膜突与虹膜根部附着处平行。睫状突长度和厚度均大于同龄正常儿童。睫状突向前、向内移位，部分与虹膜相贴。结论　PIG患儿的巩膜突与房角顶点相对位置的改变，提示巩膜突发育不良或虹膜附着点靠前，这是原发性婴幼儿型青光眼发病的病理基础。　　【关键词】　超声生物显微镜　　青光眼 A study of anterior segment structures in primary infantile glaucoma eyes by ultrasound biomicroscopy ZHU Xiaoqing, LI Zhihui, LIN Ding, et al. Department of Ophthalmology, Beijing Tong Ren Hospital, Beijing 100730 　　【Abstract】　Objective　To investigate anterior segment structures in primary infantile glaucoma (PIG) eyes by ultrasound biomicroscopy (UBM) in vivo. Methods　UBM high frequency transducer (50mHz) was used to measure and observe the anterior segment of 38 PIG cases (58 eyes). Results　No matter the severity of the disease or the age at onset, the most significant characteristics of the diseased eyes are relative positional changes between scleral spur and angle apex. In three forth of the eyes, the scleral spur lay in the lateral or posterior-lateral site of the angle apex and in one forth of the eyes the site of the tip of scleral spur was parallel with the iris root insertion. The thickness and length of ciliary processes in the eyes of PIG were greater than that of the normal infantile eyes. The ciliary processes were anteriorly displaced, pulled towards the lens, and part of them got into contact with the iris. Conclusions　The relative positional changes between scleral spur and angle apex in diseased eyes indicate that the poor development of scleral spur and the iris anterior insertion are the basic pathogenesis in PIG.　　【Key words】　Ultrasound biomicroscopy　　Glaucoma 　　原发性婴幼儿型青光眼(primary infantile glaucoma，PIG)［1］是儿童致盲的主要原因之一，是指发生在3岁之前的先天性青光眼，临床表现为眼压升高、角膜增大和水肿、视杯病理性增大。近百年来，对原发性婴幼儿型青光眼发病机制的研究存在着许多争议，诸多学者对其进行了组织病理学研究，但由于方法的限制，对