原发性房角关闭行Nd:YAG激光周边虹膜切开术后脉络膜厚度的改变

doi:10.3760/cma.j.issn.1674-845X.2018.07.004.

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1245 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract

Objective: To measure the choroidal thickness of patients with primary angle closure (PAC) before and after Nd:YAG laser peripheral iridotomy (LPI) using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT); and to compare the difference between the choroidal thickness of patients with PAC and normal subjects. Methods: This was a prospective cohort study. Thirty patients (48 eyes) who were diagnosed with PAC were selected as the PAC group in the ophthalmology clinic of Shaoxing People's Hospital from October 2015 to February 2017. Thirty patients (50 eyes) undergoing regular physical examination were selected as normal controls in our hospital during the same period. Intraocular pressure and central anterior chamber depth were measured in the normal control group and PAC group before LPI, and 1 week, 1 month, 3 months and 6 months after LPI. Choroidal thickness was measured with EDI-OCT at the subfovea, as well as at 0.5, 1.5 and 3.0 mm from the fovea superiorly,inferiorly, temporally, and nasally. Repeated measures ANOVA was used to compare data between the two groups at different time points, and to plot the choroidal thickness of the receiver operating characteristic curve to determine the best diagnostic limits. Pearson correlation analysis was used to assess the correlation among choroidal thickness, intraocular pressure and central anterior chamber depth. Independent t test was used to compare between the two groups. Results: The central anterior chamber depth of the PAC group was more shallow than that of the normal control group (t=-14.383, P < 0.001). The difference in central anterior chamber depth was statistically significant before LPI and 1 week, 1 month, 3 months and 6 months after LPI (F=10.313, P=0.001). And the central anterior chamber depth of the PAC group became deeper from preoperation to 3 months postoperation (P < 0.01). The choroidal thickness of the PAC group was greater than that of the normal control group at 13 points before LPI (all P < 0.01). The difference in choroidal thickness was statistically significant before and after LPI (F=240.512, P < 0.001). The choroidal thickness of the PAC group at 1 week, 1 month, 3 months and 6 months after LPI was significantly thinner than that at pre-operation (P < 0.001). The choroidal thickness of all subjects in the two groups was negatively correlated with the depth of the central anterior chamber at SF, T1, T2, T3, S2, S3, I1, I2 and I3 (r=-0.249, -0.239, -0.416, -0.330, -0.184, -0.176, -0.189, -0.184, -0.160, P < 0.001). There was no correlation between choroidal thickness, intraocular pressure or axial length. Conclusions: The choroid in patients with PAC is thicker than in the normal group. The choroid in PAC patients became thinner after LPI surgery. Choroidal thickening may be one of the pathogenic factors of PACG. In addition, choroidal thickness plays a role in the early diagnosis of PAC and the disease observation and assessment of the
therapeutic effect of LPI.

Key words： primary angle closure YAG laser iridotomy choroidal thickness optical coherence tomography

Received: 08 January 2018

Fund:

Project of Zhejiang Province Medical and Health Research (2018238020)

Corresponding Authors: Wei Chen, Department of Ophthalmology, Shaoxing People's Hospital, Shaoxing 312000, China (Email: chennweii@hotmail.com)

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Chen Zhang
	Wei Chen

Cite this article:

Chen Zhang,Wei Chen. Changes in Choroidal Thickness after Nd:YAG Laser Peripheral Iridotomy in Patients with Primary Angle Closure[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2018, 20(7): 406-413.

URL:

https://www.cjoovs.com/EN/10.3760/cma.j.issn.1674-845X.2018.07.004. OR https://www.cjoovs.com/EN/Y2018/V20/I7/406

[1]	Cheng JW, Cheng SW, Ma XY, et al. The prevalence of primary
[1]	Cheng JW, Cheng SW, Ma XY, et al. The prevalence of primary
	glaucoma in mainland China: A systematic review and metaanalysis.
	J Glaucoma, 2013, 22(4): 301-306. DOI: 10.1097/IJG.
	glaucoma in mainland China: A systematic review and metaanalysis.
	J Glaucoma, 2013, 22(4): 301-306. DOI: 10.1097/IJG.
0b	013e31824083ca.
0b	013e31824083ca.
[2]	Foster PJ, Buhrmann R, Quigley HA, et al. The definition and
[2]	Foster PJ, Buhrmann R, Quigley HA, et al. The definition and
	classification of glaucoma in prevalence surveys. Br J Ophthalmol,
20	02, 86(2): 238-242. DOI: 10.1136/bjo.86.2.238.
	classification of glaucoma in prevalence surveys. Br J Ophthalmol,
20	02, 86(2): 238-242. DOI: 10.1136/bjo.86.2.238.
[3]	Huang W, Wang W, Gao X, et al. Choroidal thickness in the
[3]	Huang W, Wang W, Gao X, et al. Choroidal thickness in the
	subtypes of angle closure: An EDI-OCT study. Invest Ophthalmol
	Vis Sci, 2013, 54(13): 7849-7853. DOI: 10.1167/iovs.13-13158.
	subtypes of angle closure: An EDI-OCT study. Invest Ophthalmol
	Vis Sci, 2013, 54(13): 7849-7853. DOI: 10.1167/iovs.13-13158.
[4]	江媛, 陈伟, 陈增辉, 等. 三维眼前节分析系统与超声生物显
[4]	江媛, 陈伟, 陈增辉, 等. 三维眼前节分析系统与超声生物显
	微镜测量急性原发性闭角型青光眼前房深度的一致性分析.
	中华眼视光学与视觉科学杂志, 2013, 15(10): 616-619. DOI:
	微镜测量急性原发性闭角型青光眼前房深度的一致性分析.
	中华眼视光学与视觉科学杂志, 2013, 15(10): 616-619. DOI:
10	3760/cma.j.issn.1674-845X.2013.10.009
10	3760/cma.j.issn.1674-845X.2013.10.009
[5]	Thomas R, George R, Parikh R, et al. Five year risk of
[5]	Thomas R, George R, Parikh R, et al. Five year risk of
	progression of primary angle closure suspects to primary angle
	progression of primary angle closure suspects to primary angle
	closure: a population based study. Br J Ophthalmol, 2003, 87(4):
	closure: a population based study. Br J Ophthalmol, 2003, 87(4):
45	0-454.
45	0-454.
[6]	Thomas R, Parikh R, Muliyil J, et al. Five-year risk of progression
[6]	Thomas R, Parikh R, Muliyil J, et al. Five-year risk of progression
	of primary angle closure to primary angle closure glaucoma: a
	of primary angle closure to primary angle closure glaucoma: a
	population-based study. Acta Ophthalmol Scand, 2003, 81(5): 480-
	population-based study. Acta Ophthalmol Scand, 2003, 81(5): 480-
	485.
	485.
[7]	Zhou M, Wang W, Ding X, et al. Choroidal thickness in fellow
[7]	Zhou M, Wang W, Ding X, et al. Choroidal thickness in fellow
	eyes of patients with acute primary angle-closure measuredby enhanced depth imaging spectral-domain optical coherence
	eyes of patients with acute primary angle-closure measuredby enhanced depth imaging spectral-domain optical coherence
	tomography. Invest Ophthalmol Vis Sci, 2013, 54(3): 1971-
19	78. DOI: 10.1167/iovs.12-11090.
	tomography. Invest Ophthalmol Vis Sci, 2013, 54(3): 1971-
19	78. DOI: 10.1167/iovs.12-11090.
[8]	Wang W, Zhou M, Huang W, et al. Does acute primary
[8]	Wang W, Zhou M, Huang W, et al. Does acute primary
	angle-closure cause an increased choroidal thickness? Invest
	Ophthalmol Vis Sci, 2013, 54(5): 3538-3545. DOI: 10.1167/
	angle-closure cause an increased choroidal thickness? Invest
	Ophthalmol Vis Sci, 2013, 54(5): 3538-3545. DOI: 10.1167/
	iovs.13-11728.
	iovs.13-11728.
[9]	Wang N, Wang B, Zhai G, et al. A method of measuring anterior
[9]	Wang N, Wang B, Zhai G, et al. A method of measuring anterior
9	chamber volume using the anterior segment optical coherence
9	chamber volume using the anterior segment optical coherence
	tomographer and specialized software. Am J Ophthalmol, 2007,
14	3(5): 879-881. DOI: 10.1016/j.ajo.2006.11.051.
	tomographer and specialized software. Am J Ophthalmol, 2007,
14	3(5): 879-881. DOI: 10.1016/j.ajo.2006.11.051.
[10]	张兆康, 高健生, 梁玉, 等. 健康气功八段锦对原发性青光眼
[10]	张兆康, 高健生, 梁玉, 等. 健康气功八段锦对原发性青光眼
	患者心理状态及生存质量的影响. 中国中医眼科杂志, 2016,
26	(4): 234-238. DOI: 10.13444/j.cnki.zgzyykzz.2016.04.007.
	患者心理状态及生存质量的影响. 中国中医眼科杂志, 2016,
26	(4): 234-238. DOI: 10.13444/j.cnki.zgzyykzz.2016.04.007.
[11]	Ku JY, Nongpiur ME, Park J, et al. Qualitative evaluation of the
[11]	Ku JY, Nongpiur ME, Park J, et al. Qualitative evaluation of the
	iris and ciliary body by ultrasound biomicroscopy in subjects
	with angle closure. J Glaucoma, 2014, 23(9): 583-588. DOI:
	iris and ciliary body by ultrasound biomicroscopy in subjects
	with angle closure. J Glaucoma, 2014, 23(9): 583-588. DOI:
10	1097/IJG.0b013e318285fede.
10	1097/IJG.0b013e318285fede.
[12]	Arora KS, Jefferys JL, Maul EA, et al. The choroid is thicker
[12]	Arora KS, Jefferys JL, Maul EA, et al. The choroid is thicker
	in angle closure than in open angle and control eyes. Invest
	Ophthalmol Vis Sci, 2012, 53(12): 7813-7818. DOI: 10.1167/
	in angle closure than in open angle and control eyes. Invest
	Ophthalmol Vis Sci, 2012, 53(12): 7813-7818. DOI: 10.1167/
	iovs.12-10483.
	iovs.12-10483.
[13]	Quigley HA, Friedman DS, Congdon NG. Possible mechanisms
[13]	Quigley HA, Friedman DS, Congdon NG. Possible mechanisms
	of primary angle-closure and malignant glaucoma. J Glaucoma,
20	03, 12(2): 167-180. DOI: 10.1097/00061198-200304000-
	of primary angle-closure and malignant glaucoma. J Glaucoma,
20	03, 12(2): 167-180. DOI: 10.1097/00061198-200304000-
00	013.
00	013.
[14]	赵海滨, 刘二华, 谭钢, 等. 应用频域相干光断层深度增强成
[14]	赵海滨, 刘二华, 谭钢, 等. 应用频域相干光断层深度增强成
	像技术测量正常人眼黄斑区脉络膜厚度的研究. 中国现代医
	学杂志, 2013, 23(29): 100-103. DOI: 10.3969/j.issn.1005-8982.
	像技术测量正常人眼黄斑区脉络膜厚度的研究. 中国现代医
	学杂志, 2013, 23(29): 100-103. DOI: 10.3969/j.issn.1005-8982.
20	13.29.022.
20	13.29.022.
[15]	Spaide RF, Koizumi H, Pozzoni MC, et al. Enhanced depth
	imaging spectral-domain optical coherence tomography. Am J
[15]	Spaide RF, Koizumi H, Pozzoni MC, et al. Enhanced depth
	Ophthalmol, 2008, 146(4): 496-500. DOI: 10.1016/j.ajo.2008.
	imaging spectral-domain optical coherence tomography. Am J
05	032.
	Ophthalmol, 2008, 146(4): 496-500. DOI: 10.1016/j.ajo.2008.
[16]	Ikuno Y, Kawaguchi K, Nouchi T, et al. Choroidal thickness
05	032.
[16]	Ikuno Y, Kawaguchi K, Nouchi T, et al. Choroidal thickness
	in healthy Japanese subjects. Invest Ophthalmol Vis Sci, 2010,
51	(4): 2173-2176. DOI: 10.1167/iovs.09-4383.
[17]	李略, 杨治坤, 董方田. 应用增强深部成像的相干光断层扫描
	in healthy Japanese subjects. Invest Ophthalmol Vis Sci, 2010,
51	(4): 2173-2176. DOI: 10.1167/iovs.09-4383.
	测量正常人脉络膜厚度. 中华眼科杂志, 2012, 48(9): 819-823.
	DOI: 10.3760/cma.j.issn.0412-4081.2012.09.012.
[17]	李略, 杨治坤, 董方田. 应用增强深部成像的相干光断层扫描
[18]	Ding X, Li J, Zeng J, et al. Choroidal thickness in healthy
	测量正常人脉络膜厚度. 中华眼科杂志, 2012, 48(9): 819-823.
	DOI: 10.3760/cma.j.issn.0412-4081.2012.09.012.
	Chinese subjects. Invest Ophthalmol Vis Sci, 2011, 52(13):
95	55-9560. DOI: 10.1167/iovs.11-8076.
[18]	Ding X, Li J, Zeng J, et al. Choroidal thickness in healthy
[19]	禹海, 夏国英, 高明宏. 频域干涉光断层扫描观察正常人眼
	Chinese subjects. Invest Ophthalmol Vis Sci, 2011, 52(13):
95	55-9560. DOI: 10.1167/iovs.11-8076.
	脉络膜厚度的研究. 中国实用眼科杂志, 2012, 30(1): 69-72.
	DOI: 10.3760/cma.j.issn.1006-4443.2012.01.016.
[19]	禹海, 夏国英, 高明宏. 频域干涉光断层扫描观察正常人眼
[20]	朱岩, 汪军, 孟忻, 等. 糖尿病视网膜病变黄斑部脉络膜厚
	度临床分析. 中华眼底病杂志, 2014, 30(2): 132-135. DOI:
	脉络膜厚度的研究. 中国实用眼科杂志, 2012, 30(1): 69-72.
	DOI: 10.3760/cma.j.issn.1006-4443.2012.01.016.
10	3760/cma.j.issn.1005-1015.2014.02.004.
[20]	朱岩, 汪军, 孟忻, 等. 糖尿病视网膜病变黄斑部脉络膜厚
	度临床分析. 中华眼底病杂志, 2014, 30(2): 132-135. DOI:
[21]	欧阳博文, 孙明甡, 王萌萌, 等. 三岁龄恒河猴眼球生物学参
10	3760/cma.j.issn.1005-1015.2014.02.004.
	数研究. 中华眼视光学与视觉科学杂志, 2017, 19(4): 204-210.
	DOI: 10.3760/cma.j.issn.1674-845X.2017.04.003.
[21]	欧阳博文, 孙明甡, 王萌萌, 等. 三岁龄恒河猴眼球生物学参
[22]	Margolis R, Spaide RF. A pilot study of enhanced depth imaging
	数研究. 中华眼视光学与视觉科学杂志, 2017, 19(4): 204-210.
	DOI: 10.3760/cma.j.issn.1674-845X.2017.04.003.
	optical coherence tomography of the choroid in normal eyes.
	Am J Ophthalmol, 2009, 147(5): 811-815. DOI: 10.1016/j.ajo.
[22]	Margolis R, Spaide RF. A pilot study of enhanced depth imaging
20	08.12.008.
	optical coherence tomography of the choroid in normal eyes.
	Am J Ophthalmol, 2009, 147(5): 811-815. DOI: 10.1016/j.ajo.
[23]	Li Z, Wang W, Zhou M, et al. Enhanced depth imaging-optical
20	08.12.008.
	coherence tomography of the choroid in moderate and severe
[23]	Li Z, Wang W, Zhou M, et al. Enhanced depth imaging-optical
	primary angle-closure glaucoma. Acta Ophthalmol, 2015, 93(5):
	e349-355. DOI: 10.1111/aos.12616.
	coherence tomography of the choroid in moderate and severe
[24]	Quigley HA, Broman AT. The number of people with glaucoma
	primary angle-closure glaucoma. Acta Ophthalmol, 2015, 93(5):
	e349-355. DOI: 10.1111/aos.12616.
	worldwide in 2010 and 2020. Br J Ophthalmol, 2006, 90(3):
26	2-267. DOI: 10.1136/bjo.2005.081224.
[24]	Quigley HA, Broman AT. The number of people with glaucoma
[25]	陈威, 郭竞敏, 赵寅, 等. 原发性开角型青光眼患者有氧运动
	worldwide in 2010 and 2020. Br J Ophthalmol, 2006, 90(3):
26	2-267. DOI: 10.1136/bjo.2005.081224.
	前后脉络膜厚度变化分析. 国际眼科杂志, 2017, 17(4): 604-
[25]	陈威, 郭竞敏, 赵寅, 等. 原发性开角型青光眼患者有氧运动
60	9. DOI: 10.3980/j.issn.1672-5123.2017.4.04.
[26]	韩立坡, 韩瑶, 许厚银, 等. 原发性闭角型青光眼激光虹膜周
	前后脉络膜厚度变化分析. 国际眼科杂志, 2017, 17(4): 604-
60	9. DOI: 10.3980/j.issn.1672-5123.2017.4.04.
[26]	韩立坡, 韩瑶, 许厚银, 等. 原发性闭角型青光眼激光虹膜周
	边切开术前后昼夜眼压波动及眼部血流动力学研究. 河北
	医科大学学报, 2010, 31(11): 1335-1338. DOI: 10.3969/j.issn.
10	07-3205.2010.11.021.
	边切开术前后昼夜眼压波动及眼部血流动力学研究. 河北
	医科大学学报, 2010, 31(11): 1335-1338. DOI: 10.3969/j.issn.
[27]	林仲, 李思珍, 牟大鹏, 等. 原发性闭角型青光眼激光周边虹
10	07-3205.2010.11.021.
	膜切开术后前房角形态变化的一年观察. 眼科, 2011, 20(1):
[27]	林仲, 李思珍, 牟大鹏, 等. 原发性闭角型青光眼激光周边虹
	膜切开术后前房角形态变化的一年观察. 眼科, 2011, 20(1):
38	-43.
38	-43.
[28]	Dada T, Mohan S, Sihota R, et al. Comparison of ultrasound
[28]	Dada T, Mohan S, Sihota R, et al. Comparison of ultrasound
	biomicroscopic parameters after laser iridotomy in eyes with
	biomicroscopic parameters after laser iridotomy in eyes with
	primary angle closure and primary angle closure glaucoma. Eye
	(Lond), 2007, 21(7): 956-961. DOI: 10.1038/sj.eye.6702360.
	primary angle closure and primary angle closure glaucoma. Eye
	(Lond), 2007, 21(7): 956-961. DOI: 10.1038/sj.eye.6702360.
[29]	Yoshikawa M, Akagi T, Nakanishi H, et al. Longitudinal change
[29]	Yoshikawa M, Akagi T, Nakanishi H, et al. Longitudinal change
	in choroidal thickness after trabeculectomy in primary openangle
	glaucoma patients. Jpn J Ophthalmol, 2017, 61(1): 105-
11	2. DOI: 10.1007/s10384-016-0482-9.
	in choroidal thickness after trabeculectomy in primary openangle
[30]	Kara N, Baz O, Altan C, et al. Changes in choroidal thickness,
	glaucoma patients. Jpn J Ophthalmol, 2017, 61(1): 105-
11	2. DOI: 10.1007/s10384-016-0482-9.
[30]	Kara N, Baz O, Altan C, et al. Changes in choroidal thickness,
	axial length, and ocular perfusion pressure accompanying
	axial length, and ocular perfusion pressure accompanying
	successful glaucoma filtration surgery. Eye (Lond), 2013, 27(8):
94	0-945. DOI: 10.1038/eye.2013.116.
	successful glaucoma filtration surgery. Eye (Lond), 2013, 27(8):
94	0-945. DOI: 10.1038/eye.2013.116.
[31]	Usui S, Ikuno Y, Uematsu S, et al. Changes in axial length and
[31]	Usui S, Ikuno Y, Uematsu S, et al. Changes in axial length and
	choroidal thickness after intraocular pressure reduction resulting
	from trabeculectomy. Clin Ophthalmol, 2013, 7: 1155-1161. DOI:
	choroidal thickness after intraocular pressure reduction resulting
10	2147/OPTH.S44884.
	from trabeculectomy. Clin Ophthalmol, 2013, 7: 1155-1161. DOI:
10	2147/OPTH.S44884.