PDF(Pubmed)
Abstract：
Primary angle closure disease (PACD) is a major cause of blindness worldwide. It has a high prevalence in East Asia, especially in China, which leads to a higher incidence of blindness than open-angle glaucoma. The aim of this study was to directly observe the circumlental space (CLS) in laser peripheral iridotomized eyes with PACD and to determine whether this structure plays a role in the pathogenesis of PACD. Fifty eyes of 50 patients with PACD, who had received laser peripheral iridotomy performed with neodymium:yttrium-aluminum-garnet were recruited from glaucoma clinics from March 2021 to May 2022, including 17 primary angle closure suspect (PACS), 16 primary angle closure (PAC) and 17 primary angle closure glaucoma (PACG). They were classified into two groups based on whether the ciliary process and the crystalline lens equator were in contact using slit-lamp photograph: the attached group and the unattached group. The demographic, clinical characteristics and anterior segment parameters measured from ultrasound biomicroscopy were compared between the attached group and the unattached group. Thirty-three eyes were assigned to the attached group and 17 eyes belonged to the unattached group. In the unattached group, the mean CLS was 0.10 ± 0.07 mm. No significant differences were identified between the different diagnosis groups in age, sex, best-corrected visual acuity, intraocular pressure, white-to-white, axial length, central corneal thickness, anterior chamber depth, flat keratometry, steep keratometry or iridotomy diameter (p > 0.05). The unattached group had shorter trabecular-ciliary process distance (p = 0.021) and larger ciliary process area (p = 0.001) compared with the attached group. Small CLS and its potential effect (partial ciliary block) might be considered as one of the mechanisms of PACD.
摘要：
原发性闭角型疾病（PACD）是全球范围内导致失明的主要原因。它在东亚的患病率很高，尤其是在中国,导致失明的发生率高于开角型青光眼。这项研究的目的是直接观察PACD激光周围虹膜切除术眼的环隙（CLS），并确定该结构是否在PACD的发病机理中起作用。50例PACD患者的50只眼，从2021年3月至2022年5月，从青光眼诊所招募了接受钕：钇铝石榴石激光周边虹膜切开术的患者，包括17名原发性闭角可疑患者（PACS），16例原发性闭角型青光眼(PAC)和17例原发性闭角型青光眼(PACG)。根据使用裂隙灯照片的睫状突和晶状体赤道是否接触，将它们分为两组：附着组和未附着组。人口统计，比较了附着组与未附着组的临床特征和超声生物显微镜测量的眼前节参数。33只眼被分配到附着组，17只眼属于独立组。在独立小组中，平均CLS为0.10±0.07mm。在不同的年龄诊断组之间没有发现显着差异，性别,最佳矫正视力，眼内压,白色到白色，轴向长度,中央角膜厚度,前房深度,平面角膜曲率测量,角膜曲率测量法或虹膜切开术直径(p>0.05)。与附着组相比，未附着组的小梁-睫状突距离较短（p=0.021），睫状突面积较大（p=0.001）。小CLS及其潜在效应（部分纤毛阻滞）可能被认为是PACD的机制之一。
