眼鈍挫傷引起隅角退縮與前房出血的關係

Clinical Evaluation of Angle Recession in Traumatic Injury

陳怡均(Yei-Ching Chen) ； 文良彥(Liang-Yen Wen)

《中華民國眼科醫學會會刊》 22卷 (1983/05) Pp. 110-113

https://doi.org/10.30048/ACTASOS.198305.0018

摘要

由門診與住院的病人有眼球受鈍挫傷後引起前房出血者75例，眼球受鈍挫傷而無眼球破裂檢查前房積血與隅角退縮情形，依隅角退縮的範圍與程度分，一度者有16.7%，二度者有48.5%，三度有34.8%，退縮範圍小於90度者佔24.2%，小於180度大於90度者佔34.8%，小於270度大於180度者佔21.2%，大於270度的有18.2%，積血的程度與退縮的程度或範圍，並沒有特定的關係。

並列摘要

Blunt injury to eye causing hyphema in the anterior chamber and torn anterior chamber angle are not uncommon. Collins (1892) first described the pathological finding in two enucleated eyes after nonperforating injuries. Wolff and Zimmerman (1962) restored interest in this subject. In the present series of study, attention is directed to the changes in the anterior chamber angle after nonperforating blunt injury in which presenting hyphema in the anterior chamber had occurred.
The present communication reports the gonioscopic findings in 75 patients with traumatic hyphema, all of them, the changes in the chamber angle were examined through Koeppe's Lens, handheld microscope and goniophotoscopy.
The grading of angle recession was divided into three types according to Howard's (1965) classification as shallow (Grade Ⅰ), moderate (Grade Ⅱ), and deep (Grade Ⅲ).
In all 75 hyphema patients the detailed study included inseration of a Koeppe's lens and observation through a handheld microscope. The entire 360 degrees of angle were examined throughout and compared with the healthy fellow eye. Of 75 patients, 66 (88%) showed angle recession. The youngest patients was 5-year-old. Male patients were mush more in number than female (47:3), because most of our patients were in the active duty of the Armed Forces.
The degree of angle recession showed 11 (16.7%) GⅠ, 32 (48.7%) GⅡ, 23 (34.8%) GⅢ. As to the recession area 16 (24.2%) showed less than 90, 24 (34.8%) showed 90-180, 14 (21.2%) showed between 180-270 and 12(18.2) showed more than 270 recession area.
The typical findings of the angle recession were the split of grayish ciliary body thus presenting the grayish ciliary band adjacent to the both sides of the cleft. Other finding included the widening of grayish ciliary band which might be due to the disruption of uveal meshwork or ciliary muscle, the prominent scleral spur and the cleft of the angle which might be to cyclodialysis and separation of the iris root from ciliary body. Ciliary processes sometimes were visible in addition to these findings, peripheral anterior synechia, blood clots, increased pigmentation, hemosiderosis and whitish gray linear trabecula damage were observed, peripheral anterior synechia was often found in the area adjacent to the edge of the recession.

並列關鍵字

Angle recession ； Hyphema ； Trabecular meshwork ； scleral spur