目的:研究假性剥脱综合征(PXF)或假性剥脱性青光眼患者晶状体上沉积模式的临床相关性。
方法:本回顾性观察性研究筛选了2011-2013年在某三级医院青光眼门诊就诊的346例PXF患者。像存款模式这样的细节,裂隙灯照片中的晶状体表面位置和瞳孔异常及其与临床和人口统计学变量的相关性,进行了分析。
结果:共纳入42例双侧PXF患者的84只眼的研究。在基线IOP为24+3.8mmHg的30只眼中观察到青光眼。比较存款的类型,即古典(n=39眼),放射状色素(RP)形式(n=39眼)和经典和放射状色素(CR)形式(n=6眼)的沉积物,瞳孔皱褶萎缩在所有形式中都很常见,而在RP型中很少有扩张不良(n=5,而在经典形式中n=25,p<0.001)。与RP类型相比,经典和CR形式的平均偏差(MD)更差,后者出现得更早,43±3.2年,CR为48±4.1年,经典形式为56±5.7年,p<0.001。RP组的基线眼压(18±2.3mmHg)明显低于其他两种形式(CR20±3.2mmHg,经典28±2.3mmHg),p<0.001,只有2只眼服用抗青光眼药物。
结论:剥脱沉积物的模式可能表明疾病演变过程的阶段和严重程度,RP代表了较早/较不严重的假性剥脱综合征。
OBJECTIVE: To study the clinical correlates of pattern of deposits over the lens in patients with pseudoexfoliation syndrome (PXF) or pseudoexfoliation glaucoma.
METHODS: This retrospective observational study screened 346 patients with PXF seen in glaucoma clinic of a tertiary hospital from 2011-2013. Details like pattern of deposits, location on the lens surface and pupillary abnormalities in slit lamp photographs and their correlation with clinical and demographic variables, were analysed.
RESULTS: A total of 84 eyes of 42 patients with bilateral PXF were included for the study. Glaucoma was seen in 30 eyes with baseline IOP of 24+3.8 mm Hg. Comparing the type of deposits, namely classical (n = 39 eyes), radial pigmentary (RP) form (n = 39 eyes) and combined classical and radial pigmentary (CR) forms (n = 6 eyes) of deposits, pupillary ruff atrophy was common in all forms while poor dilatation was rare in the RP type (n = 5 vs n = 25 in classical forms, p < 0.001). Mean deviation (MD) was worse in the classical and CR form as compared to RP type with the latter presenting much earlier, 43 ± 3.2 years vs 48 ± 4.1 years in CR and 56 ± 5.7 years in classical form, p < 0.001. The baseline IOP in the RP group (18 ± 2.3 mm Hg) was significantly lower than the other two forms (CR 20 ± 3.2 mm Hg, classical 28 ± 2.3 mm Hg), p < 0.001, with only 2 eyes on anti-glaucoma drugs at presentation.
CONCLUSIONS: Pattern of exfoliation deposits may indicate the stage and severity of the disease process in evolution with the RP representing an earlier/less severe form of pseudoexfoliation syndrome.