Pentacam 前房分析仪在原发性闭角型青光眼中的应用
邢晓杰 汤欣 刘五存
300020 天津和平区甘肃路4号，天津市眼科医院，白内障中心
【摘要】目的 分析Pentacam三维前房分析仪测量的原发性闭角型青光眼与正常人群的前房形态参数。方法 对65例急性闭角型青光眼(A-PACG)患者,70例慢性闭角型青光眼(C-PACG)患者,75例正常人(N)进行Pentacam检查,记录前房轴深(ACD)、平均和最小前房夹角(ACA)、前房容积(ACV)等测量数值；3次重复性前房形态检查,评价前房测量的可重复性。结果 与正常人进行比较,原发性闭角型青光眼的前房浅ACD:[A-PACG=(1.84±0.13)mm,C- PACG=(1.93±0.16)mm,N=(2.70±0.22)mm]；房角较窄mean ACA:[A-PACG=(22.91°±5.89°),C- PACG=(26.96°±7.46°),N=(32.19°±15.06°)]；前房结构较拥挤ACV:[A-PACG=(76.40±14.58)mm3,C-PACG=(82.36±16.07)mm3,N=(158.2±28.69)mm3]。各组测量数据中，ACD、ACV测量的可重复较好，ACA测量的可重复性略差。应用多因素方差分析结果显示,正常人眼ACD、ACV与性别、年龄相关,女性较男性前房轴深浅（P<0.05）、前房容积小（P<0.05）。急性闭角型青光眼组中ACD 与 ACV间线性相关（P<0.05，R2=0.40），其余各组均无相关性（P>0.05）；慢性闭角型青光眼各组测量数据间均有显著相关性（P<0.001）；正常组中ACD 与 ACV间显著相关（P<0.001，R2=0.85），ACD 与 ACA间中等相关（P<0.05），ACV 与 ACA间无相关（P>0.05，R2=0.05）结论 Pentacam检查为原发性闭角型青光眼的早期诊断提供一个新的诊断依据，对青光眼患者的随访和正常人群的筛查工作具有重要临床应用价值。
【关键词】原发性闭角型青光眼；前房形态参数；Pentacam前房分析仪； Scheimpflug摄像法
Application of Pentacam in the studies of primary angle closure glaucoma
XING Xiao-jie, TANG Xin, LIU Wu-cun
Tianjin eye hospital, Tianjin 300020, China. Corredponding author: XING Xiao-jie. E-mail：isabel0124@163.com
【abstract】Objective To assess the anterior chamber measurements with Pentacam three dimension anterior eye segment analysis system in the primary angle closure glaucoma (PACG) and nomal population. Methods A total of 210 patients with PACG were studied including 65 patients with acute PACG(A-PACG),70 patients with chronic PACG(C-PACG),75 patients normal control(N). Anterior chamber depth(ACD), mean and minimum anterior chamber angle (ACA), and anterior chamber volume (ACV) were evaluated with Pentacam examination.Anterior chamber measurements were performed three times to assess the reproducibility of Pentacam system. Results Compared to normal subjects, the patients with PACG presented a shallow ACD:[A-PACG=(1.84±0.13)mm,C-PACG=(1.93±0.16)mm,N=(2.70±0.22)mm];
narrow of the mean ACA:[A-PACG=(22.91°±5.89°),C- PACG=(26.96°±7.46°),N=(32.19°±15.06°)];crowed of ACV:[A-PACG=(76.40±14.58)mm3,C-PACG=(82.36±16.07)mm3,N=(158.2±28.69)mm3]. ACD and ACV measurements are reliable and reproducible.ACD and ACV measurements are correlated with gender and age(P<0.05). The repeatability of ACA measurement is relatively poor. Excellent correlation was found between ACD and ACV for C-PACG（P<0.001）.ACD and meanACV correlated only moderately for A-PACG(P<0.05，R2=0.40). There was no correlation between ACV and ACA for all (P>0.05).Conclusion Using the Pentacam, it was possible to examine different parameters of the anterior chamber within a short period and with good reliability.It is helpful to early diagnosis for PACG inclinic.
【key words】primary angle closure glaucoma; anterior chamber measurement; Pentacam system; Scheimpflug images
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