Angle Closure Glaucoma in High Myopic Eyes-Report of Two Cases

隅角閉鎖型青光眼於高度近視眼－二病例報告

何宗諭(Tsung-Yu Ho) ； 鄺冬梅(Tung-Mei Kuang) ； 周清光(Joe Ching-Kuang Chou) ； 劉瑞玲(Catherine Jui-Ling Liu)

《中華民國眼科醫學會雜誌》 47卷2期 (2008/06) Pp. 188-192

https://doi.org/10.30048/ACTASOS.200806.0014

摘要

目的：病人同時有隅角閉鎖型青光眼及高度近視的情形並不常見，我們報告二位合併隅角閉鎖型青光眼及高度近視病人之臨床表徵及提出在這些非典型病人身上造成隅角閉鎖的可能機轉。
方法：我們收集二位近視超過六百度合併隅角閉鎖的病人並報告他們的年齡、性別、裂隙燈及隅角鏡檢查、眼生物測定學檢查、臨床診斷和治療結果。
結果：二位病人包括一位女性及一位男性。平均年齡是69.5歲，平均眼軸長為25.26公釐，平均前房深度為么47公釐，平均晶體厚度為4.90公釐，二位病人經診斷皆為原發性瞳孔閉鎖造成之隅角閉鎖。
結論：隅角閉鎖可以發生在高度近視的眼睛，瞳孔閉鎖是這類病人最常見的原因。小心地隅角鏡檢查伴隨眼生物測定學檢查才能作正確的診斷並給予個別化最適當的處置。

並列摘要

Purpose: High myopic patients with angle-closure glaucoma are uncommon. We reported two cases with angle closure and high myopia and evaluated their clinical characteristics. Possible mechanisms for angle closure were proposed in these atypical patients.
Method: Two patients with myopic spherical equivalent of more than six diopters and angle closure were reviewed. Data recorded included age at time of initial consultation, gender, slit-lamp examination, gonioscopy, biometric parameters, clinical diagnosis, and therapy.
Result: There are one female and one male. The mean age at the time of consultation was 69.5 years and the mean axial length was 25.26 mm. Mean anterior chamber depth was 2.47 mm. Mean lens thickness was 4.90 mm. Both of the patients were diagnosed with primary pupillary block.
Conclusion: Angle closure in eyes with high myopia is uncommon but possible. Lens swelling related pupillary block is the possible cause in these patients. Careful gonioscopy accompanied by biometric examination can lead to the correct diagnosis and individualized management in these eyes.

並列關鍵字

angle closure glaucoma ； gonioscopy ； high myopia ； pupillary block