| Objectives: The purpose of this study was to evaluate the relationshipbetween the primay iris and ciliary body cysts and the primary glaucoma,exploring the contribution of the location, size and number of the cysts to theprimary glaucoma.Methods: The clinical data and UBM image of patients with primaryglaucoma and normal subjects without trauma and intraocular surgeries thosehad UBM examination in our hospital from January2012to December2012,were retrospectively analyzed. All subjects were divided into three groupsbased on finally diagnosis: primary closed-angle glaucoma group, primaryopen-angle glaucoma group and control group. The diagnosis of subjects withprimary glaucoma should accord the diagnostic code that recommended by theChinese Glaucoma Study Group. All eyes in this study should have no injuryand intraocular surgery history, no eye disease besides simple cataract, allsubjects should had no serious systemic disease and cooperate with theinspection.Madain MD300W-mode ultrasound biomicroscopy (UBM) has beenused for examination in our study(frequency was50MHz, scanning depth was5.5～11mm, display range was8.25/16.5mm×5.5/11mm, resolution≤40um, gain was82dB), ensure that settings of the apparatus were at equalpace in each examination. Sagittal and coronal scan have been made insuperior(Sup), supranasal(NS), nasal(Nose), inferonasal(NI), inferior(Inf),inferotemporal(TI), temporal(Temp) and supratemporal(TS) sectors, the probeshould be kept always perpendicular to the surface of the eye. Theexaminations of all subjects were completed by the same skilled sonographer.Collected clear images in the computer for analysis. Recording the side of eye, number, location, contents and reverberation of the wall of cysts and detectingthe maximum horizontal and vertical diameter in the sagittal plane. Dividingall subjects into three groups based on the results of UBM image: A.angle-closure glaucoma group: a) with iris and ciliary body cysts, b) withoutiris and ciliary body cysts; B. open-angle glaucoma group: a) with iris andciliary body cysts, b) without iris and ciliary body cysts; C. normal controls: a)with iris and ciliary body cysts, b) without iris and ciliary body cysts.The results are presented as mean±standard deviation (measurementdata) and percentage (numeration data). SPSS16.0systerm was used forstatistical comparison age, sex of patients, number, location and size of irisand ciliary body cysts between groups. Independent sample t-test, rank sumtest, chi-square test, analysis of variance and Fisher exact propability wereused for statistical analysis. Probability values of less than0.05wereconsidered statistically significant.Results: Cysts were observed in44(8.94%) of492eyes from301subjects.74cysts have been found,28eyes (63.64%) were solitary;16eyes (36.36%) were multiple. There was a characteristic distribution pattern,with cysts found predominantly in the temporal (32.43%), inferotemporal(21.62%), and inferior (20.27%) sectors. Detection rate of cyst in group A was6.61%(23/348), including20(86.96%) eyes with solitary cyst and3(13.04%)eyes with multiple cysts, aerage diameter rang from0.23mm to1.11mm(0.50±0.17mm, mean±SD), cysts were located at the iridociliary sulcus(11,32.35%) and ciliary crown(23,67.65%). Detection rate of cyst in group B was15.00%(6/40), including3(50%) eyes with solitary cyst and3(50%) eyes withmultiple cysts, aerage diameter rang from0.24mm to0.80mm (0.48±0.14mm,mean±SD), all cysts were located at the ciliary crown(6,100%). Detection rateof cyst in group C was14.42%(15/104), including4(26.67%) eyes withsolitary cyst and11(73.33%) eyes with multiple cysts, aerage diameter rangfrom0.25mm to1.13mm (0.51±0.18mm, mean±SD), cysts were located atthe iridociliary sulcus(2,7.14%) and ciliary crown(26,92.86%).Conclusion: Primary iris and ciliary body cysts are common in the population(especially the solitary cyst), and most do not cause any symptoms.Incidence was highest in individuals in their30s. There was significant genderdifference in incidence (male is more than female). The cysts were mostlocated at the iridociliary sulcus and ciliary crown. There was a characteristicdistribution pattern, with cysts found predominantly in the temporal,inferotemporal and inferior sectors. Cysts in patients with primaryangle-closure glaucoma is more in the ciliary sulcus, while in patients withprimary open-angle glaucoma and control group is more in the ciliary crown.There was no significant difference in incidence mean size and locationbetween group B and group C. Cysts in the ciliary sulcus may be apredisposing factor of angle-closure glaucoma, while cyst with intact wall thatnot compress the anterior chamber angle mechanically may not be thepredisposing factor of open-angle glaucoma. |
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