CASIA SS-1000眼前节OCT对初发期和膨胀期皮质性白内障患者晶状体厚度及前房结构测量的比较

摘要

背景 随着病情发展,皮质性白内障患眼的晶状体厚度及前房结构将发生变化,可能对眼部结构及功能产生重要影响,需要一种可直接测量晶状体前后表面及房角结构的检查方法,以量化不同分期白内障的上述指标变化. 目的 采用CASIA SS-1000眼前节光相干断层扫描(AS-OCT)测量并比较初发期和膨胀期白内障患者晶状体厚度及房角相关指标. 方法 采用观察性研究设计.连续纳入2015年10月16-30日于陆军军医大学大坪医院眼科门诊就诊的初发期和膨胀期皮质性白内障患者50例87眼,其中男21例,女29例;初发期白内障患者28例44眼,平均年龄(56.46±12.90)岁,膨胀期白内障患者22例43眼,平均年龄(70.95±8.81)岁.利用CASIA SS-1000 AS-OCT测量患眼晶状体厚度、房角开放距离(AOD)、前房角隐窝面积(ARA)、小梁网虹膜间面积(TISA)、小梁网虹膜角(TIA)及前房深度(ACD),比较2个组患眼相关指标的差异.结果 初发期白内障晶状体平均厚度为(4.438±0.487)mm,膨胀期白内障晶状体厚度平均为(5.094±0.451) mm,膨胀期白内障患眼晶状体明显增厚,平均增加(0.656±0.101) mm,差异有统计学意义(t=-6.513,P=0.000);初发期白内障患眼ACD平均为(2.966±0.326)mm,膨胀期患眼ACD平均为(2.534±0.376) mm,随着白内障发展,ACD平均减少(0.432±0.075)mm,差异有统计学意义(t=5.730,P=0.000).在房角相关测量指标中,膨胀期白内障患眼AOD500、AOD750、ARA500、ARA750、TISA500、TISA750、TIA500和TIA750明显低于初发期白内障患眼,差异均有统计学意义(均P=0.000).结论 膨胀期白内障患者晶状体厚度明显增加,前房变浅,房角明显变窄.CASIA SS-1000 AS-OCT测量房角扫描时间短,清晰度高,具有很好的临床应用前景.%Background With the progression of cortical cataract,the lens thickness and anterior chamber will change and may have significant influences on the structure and function of the eyes.A special measurement is needed to observe the anterior and posterior surface of lens and detailed angle structure,and to quantify these changes.Ohjective This study was to compare the lens thickness and angle structures by CASIA SS-1000 anterior segment optical coherence tomography (AS-OCT) in early and intumescent stage of cataract and quantify the ocular anatomical differences.Methods An observational study was performed.Fifty cortical cataract patients (87 eyes) of the early stage or the intumescent stage in the ophthalmology outpatient clinic of Daping Hospital from October 16 to October 30,2015 were continuously enrolled in this research.The eyes were assigned to the early stage group (28 patients 44 eyes) and the intumescent stage group (22 patients 43 eyes) according to the slit lamp examination results.The average age was (56.46 ± 12.90) years in the early stage group and (70.95 ± 8.81) years in the intumescent stage group.With the use of CASIA SS-1000 AS-OCT measurements,lens thickness,angle opening distance (AOD),angle recess area (ARA),trabecular-iris space area (TISA),trabecular-iris angle (TIA) and anterior chamber depth (ACD) were measured and compared between the two groups.Results Lens thickness was (4.438±0.487) mm in the early stage group and (5.094±0.451)mm in the intumescent stage group,with an average increase of (0.656±0.101) mm,showing a significant difference between the two groups (t =-6.513,P =0.000).ACD in the early stage group was (2.966±0.326)mm and (2.534±0.376)mm in the intumescent stage group,with an average decrease of (0.432±0.075)mm,showing a significant difference between the two groups (t =5.730,P =0.000).AOD500,AOD750,ARA500,ARA750,TISA500,TISA750,TIA500 and TIA750 were all lower in the intumescent stage group than those in the early stage group,with significant differences between the two groups (all at P=0.000).Conclusions The lens was thicker,ACD was shallower and anterior angle was narrower in the intumescent stage than those in the early stage of cortical cataract patients.SS-1000 AS-OCT is efficiency with high definition,and is supposed to have promising prospect of clinical application.