Episcleral hemangioma distribution patterns could be an indicator of trabeculotomy prognosis in young SWS patients
Episcleral hemangioma distribution patterns could be an indicator of trabeculotomy prognosis in young SWS patients
复制标题
巩膜外血管瘤分布模式可能是年轻 SWS 患者小梁切开术预后的指标
DOI：
10.1111/aos.14363
复制
发表时间：
2020-01-30
影响因子：
3.4
通讯作者：
Guo, Wenyi
中科院分区：
文献类型：
--
作者：
Wu, Yue;Peng, Cheng;Guo, Wenyi
目的探讨年轻Sturge-Weber综合征（SWS）患者巩膜上血管瘤分布类型与小梁切开术预后的关系。方法选取2016年2月至2017年6月在我院眼科行小梁切开术的4岁以下Sturge-Weber综合征诱发的青光眼患者。根据患者的巩膜外血管瘤类型，可将其分为简单巩膜外血管异常网络（SEVAN）组和多发巩膜外血管异常网络（MEVAN）组。在随访期间记录眼内压（IOP），直至末次访视。结果46例（50眼）SWS患者。平均手术年龄为12.6 ± 15.1个月（范围1-47个月）。SEVAN组26只眼，MEVAN组24只眼。两组术前人口学资料比较差异无统计学意义（p > 0.05）。两组在12个月（p = 0.013）和24个月（p = 0.002）时的IOP存在显著差异。在24个月随访时，SEVAN和MEVAN组小梁切开术成功的累积比例分别为89.7%和36.0%。术前角膜直径（每0.5 mm）较大的MEVAN患者更有可能经历小梁切开术失败（风险比[HR]，7.997 [95% CI，1.640-38.996]，p = 0.010; 1.853 [95% CI，1.128-3.042]，p = 0.015）。结论SEVAN和MEVAN血管瘤的分布模式不同。小梁切开术在年轻SWS患者MEVAN中的预后比SEVAN差。除前房角异常外，血管因素可能是SWS早发性青光眼的病因。
Purpose To explore the relationships between episcleral hemangioma distribution patterns and trabeculotomy prognosis in young Sturge-Weber syndrome (SWS) patients. Methods Sturge-Weber syndrome-induced glaucoma patients less than 4 years of age who underwent trabeculotomy in our Ophthalmology Department from February 2016 to June 2017 were included. Every patient could be divided into simple episcleral vascular abnormal network (SEVAN) or multiple episcleral vascular abnormal network (MEVAN) groups according to their episcleral hemangioma patterns. The intraocular pressure (IOP) was recorded during follow-up until the last visit. Results Fifty eyes (forty-six patients) of SWS were included. Mean age of surgery was 12.6 +/- 15.1 months (range 1-47 months). Twenty-six eyes were in the SEVAN group, while 24 eyes were in the MEVAN group. There were no significant differences between the two groups in demographic data before surgery (p > 0.05). IOPs at 12 months (p = 0.013) and 24 months (p = 0.002) were significantly different between the two groups. At the 24-month follow-up, the cumulative proportions of trabeculotomy success in the SEVAN and MEVAN groups were 89.7% and 36.0%, respectively. Patients with MEVAN and larger preoperative corneal diameter (per 0.5 mm) were more likely to experience failed trabeculotomy (hazards ratio [HR], 7.997 [95% CI, 1.640-38.996], p = 0.010; 1.853 [95% CI, 1.128-3.042], p = 0.015). Conclusion Hemangiomas exhibited different distribution patterns between SEVAN and MEVAN. Trabeculotomy had a poorer prognosis in young SWS patients with MEVAN than in those with SEVAN. In addition to anterior chamber angle anomalies, vascular factors may contribute to the aetiology of SWS early-onset glaucoma.