Pupil dynamics in Chinese subjects with angle closure
Pupil dynamics in Chinese subjects with angle closure
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DOI：
10.1007/s00417-012-1934-7
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发表时间：
2012-09-01
影响因子：
2.7
通讯作者：
Aung, Tin
中科院分区：
文献类型：
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作者：
Zheng, Ce;Cheung, Carol Y.;Aung, Tin
使用前段光学相干断层扫描（AS-OCT）评估瞳孔收缩（SPC）的速度，以响应从暗到光的标准化变化，在眼睛闭合的角度，与开放的角度相比。这是一项前瞻性、比较性、观察性研究。原发性闭角型青光眼（PACG）和/或原发性闭角型青光眼（PAC）的研究对象与一组正常人一起被招募作为对照。通过AS-OCT实时视频记录捕获虹膜和前节响应光照变化的视频，并逐帧分析，从瞳孔扩张到瞳孔缩小。采用定制软件测量虹膜收缩速度、前房深度（ACD）、前房宽度（ACW）、虹膜厚度、瞳孔直径（PD）。SPC定义为瞳孔直径随光照变化的速率。本研究共招募了163名中国受试者。163个符合条件的视频中有137个（82.5%）可用于分析，包括87个闭合角度的受试者（之前都接受过激光周围虹膜切开术）和50个开放角度的受试者。调整年龄和ACW后，闭眼时SPC较低（1.22 mm/sec vs 1.56 mm/sec, p < 0.001），且SPC与眼轴长度、ACD、前房角状态、暗下PD、暗下虹膜厚度呈正相关（均r < 0.05, p < 0.05）。在多变量分析中，在调整了年龄、ACW、ACD、虹膜厚度和垂直杯盘比后，SPC与前房角状态（封闭角与开放角）（beta = 0.276, p = 0.016）和黑暗PD （beta = 0.129, p = 0.009）独立相关。与睁眼受试者相比，闭眼受试者在暗光变化下瞳孔收缩速度较慢，即使在调整了闭眼相关的生物特征因素后也是如此。结果提示虹膜-瞳孔动力学的差异可能在闭角的发病机制中起作用。
To evaluate the speed of pupil constriction (SPC) in response to a standardized change in illumination from dark to light using anterior segment optical coherence tomography (AS-OCT) in eyes with closed angles, compared to those with open angles.This was a prospective, comparative, observational study. Study subjects with primary angle-closure glaucoma (PACG) and/or primary angle-closure (PAC) were recruited along with a group of normal as controls. Videos of iris and anterior segment changes in response to illumination were captured with real-time video recording from AS-OCT and analysed frame by frame, beginning from a dilated to a constricted pupil. Customized software was used to measure speed of iris constriction, anterior chamber depth (ACD), anterior chamber width (ACW), iris thickness, and pupil diameter (PD). SPC was defined as the rate of pupil diameter change in response to illumination.One hundred and sixty three Chinese subjects were recruited in this study. A total of 137 of 163 eligible videos (82.5%) were available for analysis, comprising 87 subjects with closed angles (all had undergone laser peripheral iridotomies before) and 50 with open angles. SPC was less in eyes with closed angles (1.22 mm/sec vs 1.56 mm/sec, p < 0.001), after adjusting for age and ACW, and was positively correlated with axial length, ACD, anterior chamber angle status, PD in the dark, and iris thickness in the dark, (all r > 0.2, all p < 0.05). In multivariate analysis, SPC was independently associated with anterior chamber angle status (closed angle vs open angle) (beta = 0.276, p = 0.016) and PD in dark (beta = 0.129, p = 0.009), after adjusting for age, ACW, ACD, iris thickness and vertical cup-to-disc ratio.Compared to those with open angles, eyes with closed angles in Chinese subjects have slower speed of pupil constriction in response to dark-light change, even after adjusting for biometric factors associated with angle closure. The results suggest that differences in irido-pupillary dynamics may play a role in the pathogenesis of angle closure.