OUTFLOW OBSTRUCTION IN PIGMENTARY AND PRIMARY OPEN ANGLE GLAUCOMA
OUTFLOW OBSTRUCTION IN PIGMENTARY AND PRIMARY OPEN ANGLE GLAUCOMA
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DOI：
10.1001/archopht.1992.01080240109042
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发表时间：
1992-12-01
影响因子：
--
通讯作者：
MURPHY, CG
中科院分区：
文献类型：
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作者：
ALVARADO, JA;MURPHY, CG
为了定位青光眼流出阻塞的部位，我们通过形态测量方法评估了小梁网组织。对来自 27 名原发性开角型青光眼 (n=13)、色素性青光眼 (n=4) 和色素分散综合征 (n=2) 患者以及非青光眼正常受试者 (n=8) 的 33 个标本进行了比较。在这些样本中，测量了水通道的范围以及这些通道在死胡同终止处所占据的面积。在 32 个非青光眼正常样本中（提到的 8 个中的 6 个加上另外 26 个），我们发现死胡同 94% 的表面积由小梁细胞排列。这些测量用于计算死胡同对水流出的阻力。本报告提出了三个新概念：（1）死胡同提供了正常流出阻力的主要部分，（2）色素性青光眼和原发性开角青光眼中的死胡同区域显着减少，是这些情况下阻力增加的主要部分，（3）巨噬细胞是负责小梁网清除色素和碎片的主要细胞类型。提出了色素性青光眼和原发性开角型青光眼中青光眼发生的常见病理生理学顺序。
To localize the site of outflow obstruction in glaucoma, we evaluated the trabecular meshwork tissues by morphometric methods. Thirty-three specimens from 27 patients with primary open angle glaucoma (n=13), pigmentary glaucoma (n=4), and pigment dispersion syndrome (n=2), and from nonglaucomatous normal subjects (n=8) were compared. In these specimens, the extent of aqueous channels and the area occupied by these channels where they terminate in cul-de-sacs were measured. In 32 nonglaucomatous normal specimens (six of the eight mentioned plus an additional 26), we discovered that 94% of the surface area of the cul-de-sacs is lined by trabecular cells. These measurements were used to calculate the resistance to aqueous outflow offered by cul-de-sacs. Three new concepts are advanced in this report: (1) the cul-de-sacs provide a major portion of the normal out-flow resistance, (2) the cul-de-sac area is markedly reduced in pigmentary glaucoma and primary open angle glaucoma, accounting for a major portion of the increase in resistance in these conditions, and (3) macrophages are the major cell type responsible for trabecular meshwork clearance of pigment and debris. A common pathophysiologic sequence of events is proposed for the development of glaucoma in pigmentary glaucoma and primary open angle glaucoma.