原发性开角型青光眼和低压型青光眼的眼水动力学参数的临床研究

E. Stepanova, O. I. Lebedev
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摘要

目的。在典型的原发性开角型青光眼(POAG)和低压型青光眼(LTG)病例中,量化不同阶段眼内液沿不同途径的流出量,并比较所获得的结果。方法。本研究纳入不同阶段POAG患者30例(57只眼),年龄58 ~ 80岁(平均年龄67±8.0岁)。对照组患者33例(62眼),年龄51 ~ 80岁,平均年龄69±10.4岁。所有受试者均无既往激光或手术治疗史。对照组为同年龄组临床健康个体15例(30只眼)。第一天,使用TNC- 100-S型声压仪进行电子声压图,记录4分钟的曲线。第二天,根据N.V. Kosykh教授的方法,使用包膜周围真空压缩环同时阻断引流流出通道进行张力造影术。结果。随着阶段的推进,POAG的总流出易度系数(EOC)有明显的降低趋势。它在疾病的II和III期分别减少35%和30%。伴有POAG的巩膜途径的EOC在疾病的II期和III期降低,分别达到33.3%和25%。POAG的巩膜流出率在II期和III期分别增加3.3%和6.5%。在I期和II期LTG中,该指标稳定并保持在相当高的水平,在III期与II期相比下降了33.3%。LTG的巩膜流出率在II期增加21%,在III期增加11%。结论。液体沿巩膜通道流出的速率在LTG中高于POAG。与POAG相比,LTG的巩膜流出量占总流出量的比例更大。在这方面,可以得出结论,在LTG的平均标准范围内保持IOP可能与更明显的巩膜流出通道功能有关。
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A clinical study of hydrodynamic parameters of the eye in primary open-angle glaucoma and low-tension glaucoma
   PURPOSE. To quantify the outflow of intraocular fluid along various pathways depending on the stage of the disease in typical primary open-angle glaucoma (POAG) and low-tension glaucoma (LTG) cases, and compare the obtained results.   METHODS.  This study involved 30 patients (57 eyes) with POAG at various stages, aged 58 to 80 years old (mean age 67 ± 8.0 years). The comparison group included 33 patients (62 eyes) with LTG at various stages aged 51 to 80 years old (mean age 69 ± 10.4 years). All subjects had no history of previous laser or surgical interventions on the studied eye. The controls were 15 clinically healthy individuals (30 eyes) of the same age group. On the first day, electronic tonography was performed using tonograph TNC- 100-S with a 4-minute recording of the curve. On the next day, tonography was per-formed with simultaneous blockade of the  drainage outflow pathway using a perilimbal vacuum — compression ring according to the method by Prof. N.V. Kosykh.   RESULTS. The overall ease of outflow coefficient (EOC) in POAG has a pronounced tendency to decrease with stage advancement. Its decrease in the II and III stages of the disease is 35 % and 30 %, respectively. The EOC for the uveoscleral pathway with POAG decreases in the II and III stages of the disease and amounts to 33.3 % and 25 %, respectively. The ratio of uveoscleral outflow in POAG increases by 3.3 % and 6.5 % in the II and III stages, respectively. With stage I and II LTG, this indicator is stable and remains at a fairly high level, and in the III stage it decreases by 33.3 % compared to stage II. The ratio of uveoscleral out-flow in LTG increases by 21 % in the II stage and by 11 % in the III stage of the disease.   CONCLUSION. The rate of fluid outflow along the uveoscleral pathway is higher in LTG than in POAG. The ratio of uveoscleral outflow to overall outflow is greater in LTG in comparison with POAG. In this respect, it can be concluded that preservation of IOP within the limits of the average norm in LTG may be associated with a more pronounced function of the uveoscleral outflow pathway.
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