Study Of The Choroidal Thickness In Patients With Chronic Primary Angle-closure Glaucoma

BackgroundGlaucoma is a multifactorial optic nerve disease.Affected by genetic factors,the immediate relatives of glaucoma patients are at high risk.The rise of intraocular pressure is the direct cause of glaucoma,which can lead to progressive optic nerve injury(mainly optic nerve papilla with sunken atrophy)and visual field defect.When glaucoma is not actively treated and allowed to develop,it will not only cause pain to the patients,affect their vision,and eventually lead to blindness and darkness.The abnormal anatomical structure is the characteristics of angle closure glaucoma patients,but the change of choroidal thickness in chronic angle closure glaucoma is still unclear..PurposeThe thickness of retina and choroid in macular area of patients with chronic angle closure glaucoma was measured by optical coherence tomography(OCT),and the difference of thickness of retina and choroid between patients with chronic angle closure glaucoma and normal people was observed.MethodsFrom December 2018 to December 2019,chronic primary angle closure glaucoma(PACG)patients(hospitalized in our hospital)and normal control group were selected.The experimental study was divided into three groups:chronic PACG surgery eyes(33 cases 36 eyes),chronic PACG patients laser treatment group(24 cases 24 eyes),normal control group(32 cases 45 eyes),frequency domain optical coherence tomography cirrus HD OCT,enhanced depth imaging(EDI)was performed on the macular area to obtain the horizontal and vertical cross-sectional images through the macular fovea,and the thickness of retina and choroidal membrane at nine sites(nose,temporal,upper and lower)of the macular fovea and 1mm and 3mm from the macular fovea were measured manually.All measurements were performed by an experienced physician independently,three times respectively,and the average value was taken as the final reference data.Results1.In the measurement of choroidal thickness between three groups,there was no statistically significant(P > 0.05),sites include: under the macula(SFCT),1mm above the macula(S1CT),1mm from the nose of macula(N1CT),1mmbelow the macula(I1CT),1mm from temporal side of macula(T1CT),3mm above(S3CT)and 3mm below the macula(I3CT).2.In the measurement of choroidal thickness between three groups,there was statistically significant at 3mm of the nose of macula(P < 0.05).The thickness of choroid in the operation group of chronic PACG was thicker at 3mm of the nose of macula than that in the laser group of chronic PACG(P < 0.05).3.In the measurement of choroidal thickness between three groups,there was statistically significant at 3mm of the temporal of macula(P < 0.05).The thickness of choroid in the operation group of chronic PACG was thicker at 3mm of the temporal of macula than that in the laser group of chronic PACG(P <0.05).The thickness of choroid in the control group was thicker at 3mm of the temporal of macula than that in the laser group of chronic PACG(P < 0.05).4.In the measurement of retinal thickness between three groups,there was statistically significant in nine directions(P > 0.05).5.The thickness of retina in the operation group of chronic PACG was thinner than that in the control group in nine directions,the difference was statistically significant(P < 0.05)..6.There was no significant difference in the thickness of retina in the macular area.The other eight directions of chronic angle closure glaucoma patients in the operation group were thinner than those in the laser treatment group,the difference was statistically significant(P < 0.05).7.There was no significant difference in the thickness of retina between the laser treatment group and the control group(P > 0.05).Conclusion1.There was no significant difference in macular choroidal thickness of macular region between the operation group of chronic PACG and the control group.2.The thickness of choroid in the operation group of chronic PACG was thicker than that in the laser treatment group of chronic PACG at 3mm of the nose and temporal of macula,the difference was statistically significant.3.The thickness of macular retina in the operation group of chronic PACG was thinner than that in the control group,the difference was statistically significant.4.The thickness of macular retina in the operation group of chronic PACG was thinner than that in the laser group of chronic PACG.5.There was no significant difference in macular retinal thickness between the laser group of chronic PACG and the control group.