| Objective: To detect and analysis quantitatively the difference in the anterior segment biological parameters between the normal subject and patients suffering PACG(including acute PACG and chronic PACG), as well as the distinction among different stages of PACG(the pre-clinical stage of APACG, the remission period of APACG, the early stage of CPACG, the progress period of CPACG) using anterior segment optical coherence tomography(Heidelberg SD-OCT).So as to investigate the relationship between the pathogenesis of PACG and the anterior segment anatomy structure.Methods: The study collected 170 cases(188 eyes) seeing a doctor in The Second Hospital Of Hebei Medical University from December 2013 to December 2014, including 35 cases(35 eyes) with pre-clinical stage of acute primary angle-closure glaucoma(APACG), 35 cases(38 eyes) with remission period of APACG, 35cases(35 eyes) with early stage of chronic primary angle-closure glaucoma(CPACG), 35cases(40 eyes) with progress period of CPACG and 30 cases(40 eyes) coming for regular eye health examination in general clinic.They were divided into 5 groups: pre-clinical stage of APACG group,remission period of APACG group, early stage of CPACG group, progress period of CPACG group and normal group. Heidelberg Spectralis OCT was used to measure the anterior segment biological parameters of each group. SPSS13.0 was used to compare with the anterior chamber width(ACW), angle opening distance(AOD), trabecular iris area(TISA), iris thickness(IL) and crystalline lens rise(CLR) of APACG group and CPACG group to normal group, pre-clinical stage group to remission period group, early stage group to progress period group. Above parameters were used t test and(or) independent samples nonparametric test for statistical analysis. The age of the groups were analyzed by variance analysis, gender ratio were analyzed by chi-square test.Results: The anterior segment parameters of APACG: ACW(11.5±0.5) mm, AOD 0.050 mm,TISA 0.018 mm 2,IT750 0.429 mm,IT2000 0.458 mm,ITmax 0.576 mm,CLR(1.071 ± 0.213)mm. The anterior segment parameters of CPACG: ACW(11.4±0.5)mm, AOD 0.059 mm,TISA 0.020 mm2,IT750(0.389±0.031)mm,IT2000 0.432 mm,ITmax(0.538±0.033mm),CLR(0.944±0.233)mm. The anterior segment parameters of APACG pre-clinical stage group: ACW(11.5±0.4)mm, AOD 0.076 mm,TISA 0.028 mm2,IT750(0.404±0.016)mm,IT2000(0.438±0.025)mm, ITmax 0.523 mm,CLR 0.860 mm. The anterior segment parameters of APACG remission period group: ACW( 11.5 ± 0.6) mm, AOD 0.034 mm,TISA 0.013 mm 2,IT750 0.439 mm,IT2000 0.477 mm,ITmax(0.595±0.014)mm, CLR(1.223±0.152)mm. The anterior segment parameters of CPACG early stage group: ACW(11.4±0.6)mm, AOD 0.070 mm,TISA 0.027 mm2,IT750(0.409±0.025)mm,IT2000(0.470±0.031)mm, ITmax(0.564±0.022)mm, CLR 0.781 mm. The anterior segment parameters of CPACG progress period group: ACW 11.4mm,AOD 0.052 mm,TISA 0.019 mm2,IT750(0.372±0.025)mm,IT2000 0.3975 mm,ITmax( 0.516 ± 0.023) mm, CLR 1.071 ± 0.202 mm. The anterior segment parameters of normal group: ACW(13.2±0.2)mm, AOD 0.630 mm,TISA 0.134 mm2,IT750(0.351±0.020)mm,IT2000 0.391 mm,ITmax(0.500±0.022)mm, CLR 0.203±0.493 mm. The parameters of APACG and CPACG were significantly(P<0.001) bigger than normal group, however, AOD and TISA were significantly(P<0.001) decreased. The AOD and TISA of remission period of APACG were significantly(P<0.05) decreased than progress period(remission period: AOD 0.034 mm, TISA 0.013mm2; progress period: AOD 0.052 mm, TISA 0.019mm2). Both CLR and IT of APACG remission period were significantly(P<0.05) increased compared with CPACG progress period, however, there was no significant difference in ACW(Z=-1.043,P=0.297).The AOD and TISA of remission period of APACG were significantly(P<0.05) decreased, respectively, than pre-clinical stage(remission period: AOD 0.034 mm, TISA 0.013mm2; pre-clinical stage: AOD 0.076 mm, TISA 0.028mm2). The CLR(1.223 ± 0.152)mm of remission period was significantly(Z=-4.769,P<0.001) increased than pre-clinical stage 859.5mm the same as IT(P<0.001). ACW between the two groups was no significant difference(t=-0.264,P=0.794). The AOD and TISA of progress period of CPACG were significantly(P<0.05) decreased than early stage(progress period: AOD 0.052 mm, TISA 0.019mm2; early stage: AOD 0.070 mm, TISA 0.027mm2). Compared with progress period of CPACG, the IT of early stage were significantly(P<0.001) increased, but the CLR(0.781 mm vs. 1.071±0.202mm) were significantly(Z=-3.869,P<0.001) decreased. There was no significant difference in ACW between early stage and progress period(Z=0.144, P=0.886).Conclusions: 1 Compared with normal people, the patients of APACG and CPACG have a more crowding anterior segment structure, more anterior located lens and thicker iris thickness. 2 The patients of remission period of APACG has a more crowding anterior segment configuration, more anterior located lens and thicker iris thickness than progress period of CPACG. 3 The patients of remission period of APACG has a more crowding anterior segment structure, more anterior located lens and thicker iris thickness than clinic stage. We infer that it is likely to induce acute glaucoma when the anterior parameters of clinic stage reach or exceed the scope of remission period.4 The patients of progress period of CPACG has a more crowding anterior segment structure, more anterior located lens than early stage. However, the early stage’s IT thickness was thicker than the former. This may be the high intraocular pressure existed for a long time leads to the iris atrophy. |
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