国际眼科纵览

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青光眼患者的角膜生物力学研究

王蕊  汤欣  杨瑾  尹则琳  田晓峰   

  1. 300020 天津医科大学眼科临床学院 天津市眼科医院 眼科学与视觉科学天津市重点实验室 天津市眼科研究所
  • 收稿日期:2018-03-22 出版日期:2018-04-22 发布日期:2018-05-04
  • 通讯作者: 汤欣,Email:tangprofessor@aliyun.com

Corneal biomechanics in glaucoma patients

WANG Rui, TANG Xin, YANG Jin, YIN Ze-lin, TIAN Xiao-feng.   

  1. Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 300020, China
  • Received:2018-03-22 Online:2018-04-22 Published:2018-05-04
  • Contact: TANG Xin, Email: tangprofessor@aliyun.com

摘要:

临床上部分眼压控制理想的青光眼患者视野缺损仍持续进展,而部分患者通过治疗即使眼压不能显著降低仍可延缓病情进展。因此患者对眼压的个体敏感性差异决定了青光眼病情的发展。角膜、巩膜的胶原纤维互相连接且成分相似,角膜Descemet前层延伸形成小梁网胶原蛋白的核心,因此角膜生物力学特性是眼球整体生物力学特性的首要表现。当眼压升高时角膜等弹性组织承受形变的能力较弱,导致筛板受压,进一步发生视野损害。个体角膜生物力学属性的差异或许可解释视神经对眼压变化敏感性的不同。本文就角膜生物力学与青光眼诊断、进展、治疗的相互关系进行综述,以期为临床工作提供指导。(国际眼科纵览, 2018,  42:  83-88)

Abstract:

In the clinical, the visual field defect of patients with ideal intraocular pressure is continued to progress, but in some patients the progress of the disease can be delayed even if the intraocular pressure cannot be significantly reduced. Therefore, the differences of individual sensitivity of the patient to the intraocular pressure determine the development of glaucoma. The collagen fibers of cornea and sclera which have similar compositions are connected to each other, and the corneal's Descemet top layer extends to form the core of the trabecular meshwork collagen. Therefore, corneal biomechanic is the first factor of the whole eyeball’s biomechanical properties. With the high pressure, the elastic tissues such as the cornea are less able to withstand deformation, leading to the compression of lamina cribrosa and the damage of visual field. The differences of the individual corneal biomechanic may explain the differences in the sensitivity of the optic nerve to intraocular pressure. This paper reviews the relationship between corneal biomechanic and glaucoma diagnosis, progression and treatment, in order to providing guidance for clinic. (Int Rev Ophthalmol, 2018, 42: 83-88)