Circumferential iris transillumination defects in exfoliation syndrome.
Circumferential iris transillumination defects in exfoliation syndrome.
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DOI：
10.1097/ijg.0b013e318255da16
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发表时间：
2013-09
影响因子：
2
通讯作者：
Anderson MG
中科院分区：
文献类型：
--
作者：
Fingert JH;Burden JH;Wang K;Kwon YH;Alward WL;Anderson MG
我们使用红外检测系统在一些患有剥脱综合征的患者中发现了同心圆透照缺陷的模式。在剥脱综合征小鼠模型中也观察到了这种虹膜异常模式。当前研究的目的是确定同心虹膜透照缺陷是否是剥脱综合征特有的，并且可能对识别早期疾病病例有一定的诊断作用。来自爱荷华大学青光眼诊所的总共 68 名志愿者参与了这项研究，他们的眼睛正常 (n=21) 或诊断为剥脱综合征 (n=12)、色素分散综合征 (n=8) 或原发性开角型青光眼 (n=27)。这些受试者的虹膜分别由四位眼科医生使用红外摄像技术进行了检查，他们的诊断被掩盖。四名检查员将视频上存在的同心圆形透照缺陷分级为无（0 级）、可能（1 级）、明确（2 级）或显着（3 级）。在使用 Cochran-Mentel-Haenszel 检验评估去除不同评估者的影响后，我们寻找透射照明同心带的存在与剥脱综合征诊断之间的关联。我们对色素分散综合征和原发性开角型青光眼进行了相同的分析。平均 38% 的正常受试者、35% 的 POAG 患者、53% 的色素分散综合征患者和 77% 的剥脱综合征患者检测到任何同心圆形虹膜透照缺陷（1-3 级）的存在。当比较每个患者组和正常对照之间的同心圆形虹膜透照（1-3级合并）的频率时，在剥脱综合征患者和对照之间检测到显着差异（p值= 0.000019）。 POAG 与对照之间（p=0.64）或色素分散综合征与对照之间（p=0.20）没有检测到显着差异。此外，仅在剥脱综合征中观察到明显的同心圆形虹膜透照（3级）。使用红外系统检测同心圆形虹膜透照缺陷是简单、廉价、快速且在剥脱综合征中相对具体的方法。未来需要更大规模的研究来证实这项小型试点研究的结果。此外，这种检查技术有可能帮助医生早期诊断剥脱综合征，并更好地规划未来的手术，以尽量减少并发症的风险。
We identified a pattern of concentric circular transillumination defects in a few patients with exfoliation syndrome using an infrared detection system. This pattern of iris abnormality has also been observed in a mouse model of exfoliation syndrome. The objective of the current study is to determine if concentric iris transillumination defects are specific to exfoliation syndrome and may have some diagnostic utility for identifying early cases of disease. A total of 68 volunteers from the University of Iowa Glaucoma Clinic with normal eyes (n=21) or diagnoses of either exfoliation syndrome (n=12), pigment dispersion syndrome (n=8), or primary open angle glaucoma (n=27) were enrolled in the study. The irides of these subjects were each examined by four ophthalmologists masked to their diagnosis, using infrared videography. The presence of concentric, circular transillumination defects on the videos was graded as none (grade 0), possible (grade 1), definite (grade 2), or prominent (grade 3) by four examiners. We searched for an association between the presence of concentric bands of trans-illumination and the diagnosis of exfoliation syndrome after removing the effect of different raters was evaluated using the Cochran-Mentel-Haenszel test. We performed the same analysis for pigment dispersion syndrome and for primary open angle glaucoma. The presence of any concentric, circular iris trans-illumination defects (grades 1–3) was detected in a mean of 38% normal subjects, 35% POAG patients, 53% pigment dispersion syndrome patients, and 77% of exfoliation syndrome patients. When the frequency of concentric, circular iris transillumination (grades 1–3 pooled) was compared between each of the patient groups and normal controls, a significant difference was detected between exfoliation syndrome patients and controls (p-value = 0.000019). No significant difference was detected between POAG and controls (p=0.64) or between pigment dispersion syndrome and controls (p=0.20). Furthermore, prominent concentric, circular iris trans-illumination (grade 3) was only observed in exfoliation syndrome. Detection of concentric, circular iris transillumination defects with an infrared system is easy, inexpensive, rapid, and relatively specific in exfoliation syndrome. Future larger studies will be needed to confirm the findings of this small pilot study. Furthermore, this examination technique has the potential to help physicians to make earlier diagnoses of exfoliation syndrome and to better plan for future surgeries to minimize risk of complication.