开角型青光眼患者结膜微血管结构的临床研究

摘要

目的 应用功能裂隙灯活体显微镜(FSLB)探究开角型青光眼患者结膜微循环的血流动力学情况.方法 采用FSLB对18例开角型青光眼患者的结膜微血管血流动力学进行测量并将其分为两组,右眼为A组,左眼为B组.球结膜经数字相机进行较高清晰度的视野成像后,形成非侵入性球结膜微循环血流灌注图(nMPMs ),同时以60帧/s高成像速率和×210高放大率对血流动力学成像.应用定制软件,进一步对结膜nMPMs进行分形分析,进行血管密度及血流动力学测定.结果 与A组比较,B组结膜的微血管各方位密度、长度、直径、微动脉及微静脉血流速度均无改变,差异无统计学意义(P＞0.05); A、B两组上、下侧微动脉和微静脉的血流速度 ＜ 鼻、颞侧微动及静脉血流速度,差异有统计学意义(P＜0.05);A、B两组内结膜的各方位微血管密度、长度、直径比较,差异有统计学意义(P＜0.05).结膜微血管密度、长度、直径由大到小排列为:颞侧/鼻侧 ＞ 下方 ＞ 上方.结论 功能性裂隙灯生物显微镜能用于检测开角型青光眼患者球结膜微循环血流动力学改变情况.%Objective To investigate the application of functional slit lamp biomicroscopy (FSLB) in mapping hemodynamics conjunctiva microcirculation of open-angle glaucoma. Methods The hemodynamics of conjunctival micro-vessels in 18 patients with open angle glaucoma were recorded by FSLB and were divided into 2 groups: right eye group (group A) and left eye group (group B). The spherical conjunctiva was imaged by a high-resolution digital camera. The nMPMs were recorded at a high imaging rate of 60 frames per second and a high magnification of × 210 with images obtained. Vascular density and hemodynamics of conjunctival nMPMs were identified using customized software. Results No significant differences in the density, length, diameter, fretting and venous flow velocity of conjunctival micro-vessels were observed between group A and group B (P ＞ 0.05). The velocity of micro-artery and veinsin the upper and lower sides of 2 groups were significantly higher than those in nasal and temporal side (P ＜ 0.05). Statistically significant differences in microvascular density, length and diameter were observed in both groups (P ＜ 0.05). The rank of micro-vessel density is as listed from highest to lowest: temporal / nasal, lower, above. Conclusions FSLB can effectively detect hemodynamics changes in conjunctival microcirculation in open angle glaucoma patients.