目的:使用扫频源光学相干断层扫描(SS-OCT)对原发性闭角型疾病(PACD)患者Schlemm管(SC)的变化进行体内评估。
方法:招募未接受手术的PACD患者。本文扫描的SS-OCT象限包括3点和9点的鼻部和颞部,分别。测量SC的直径和横截面积。进行线性混合效应模型以分析参数对SC变化的影响。感兴趣的假设与角度状态有关(虹膜接触,ITC/打开角度,OPN),通过对SC直径和SC面积的估计边际均值(EMM)进行成对比较来进一步探讨。在国贸中心区域,还通过混合模型研究了小梁-虹膜接触长度(TICL)百分比与SC参数之间的关系。
结果:共纳入35例患者的49只眼进行测量和分析。在ITC区域可观察到的SCs百分比仅为58.5%(24/41),OPN区为86.0%(49/57)(χ2=9.44,p=0.002)。ITC与SC大小减小显著相关。在ITC和OPN区域,SC的直径和横截面面积的EMM分别为203.34μm和261.41μm(p=0.006)和3174.43μm2和5347.63μm2(p=0.022),分别。性,年龄,球面等效折射,眼内压,轴向长度,角度闭合的范围,急性发作史和LPI治疗与SC参数无显著相关性.在国贸中心区域,较大的TICL百分比与SC直径和面积的减小显著相关(分别为p=0.003和0.019).
结论:PACD患者的SC形态可能受角度状态(ITC/OPN)的影响,ITC与SC大小减小显著相关。OCT扫描所描述的SC的这些变化可能有助于阐明PACD的进展机制。
OBJECTIVE: To perform an in vivo evaluation of the changes in Schlemm\'s canal (SC) among patients with primary angle-closure disease (PACD) using swept-source optical coherence tomography (SS-OCT).
METHODS: Patients diagnosed with PACD who had not undergone surgery were recruited. The SS-OCT quadrants scanned herein included the nasal and temporal sections at 3 and 9 o\'clock, respectively. The diameter and cross-sectional area of the SC were measured. A linear mixed-effects model was performed to analyze the effects of parameters on the SC changes. The hypothesis of interest was related to the angle status (iridotrabecular contact, ITC/open angle, OPN), which was further explored with pairwise comparisons of the estimated marginal means (EMMs) of the SC diameter and SC area. In the ITC regions, the relationship between the trabecular-iris contact length (TICL) percentage and SC parameters was also studied by a mixed model.
RESULTS: A total of 49 eyes of 35 patients were included for measurements and analysis. The percentage of observable SCs in the ITC regions was only 58.5% (24/41), whereas it was 86.0% (49/57) in the OPN regions (χ2 = 9.44, p = 0.002). ITC was significantly associated with a decreasing SC size. The EMMs for the diameter and cross-sectional area of SC at the ITC and OPN regions were 203.34 μm versus 261.41 μm (p = 0.006) and 3174.43 μm2 versus 5347.63 μm2 (p = 0.022), respectively. Sex, age, spherical equivalent refraction, intraocular pressure, axial length, extent of angle closure, history of acute attack and treatment with LPI were not significantly associated with SC parameters. In the ITC regions, a larger TICL percentage was significantly associated with a decrease in SC diameter and area (p = 0.003 and 0.019, respectively).
CONCLUSIONS: The morphologies of SC could be affected by the angle status (ITC/OPN) in patients with PACD, and ITC was significantly associated with a decreasing SC size. These changes in SC as described by OCT scans might help to elucidate the progression mechanisms of PACD.