[关键词]
[摘要]
目的：评价神经生长因子(nerve growth factor，NGF)眼用凝胶对急性闭角型青光眼术后视神经保护的疗效及其安全性。
方法：选取2011-12/2013-10在厦门大学附属厦门眼科中心行小梁切除术治疗的急性闭角型青光眼患者并完成全部的治疗和随访患者45例61眼，其中23例32眼(治疗组)急性闭角型青光眼患者行小梁切除术后采用NGF眼用凝胶治疗3mo，22例29眼(对照组)以生理盐水替代NGF。所有患者随访12mo以上，治疗期间定期随访视力、视野、视网膜神经纤维层厚度和视乳头杯盘比改变，并观察凝胶眼部应用的安全性。
结果：两组患者的术后1mo的眼压控制在21mmHg以下，视力比术前明显提高。治疗组患者术后眼压和视力与对照组相比无显著差异(P>0.05)，但术后6，12mo的视野平均光敏度、平均缺损优于对照组； 光学相干断层扫描(OCT)和海德堡视网膜断层扫描检查(HRT-Ⅲ)的结果均显示治疗组患眼在术后6，12mo的视网膜神经纤维层厚度显著大于对照组，而杯/盘比显著小于对照组。治疗组患眼未观察到眼表损伤、角膜内皮减少等眼部并发症。
结论：急性闭角型青光眼术后给予NGF治疗是视神经保护的安全和有效措施。
[Key word]
[Abstract]
AIM: To evaluate the neuroprotective effect of nerve growth factor(NGF)on acute angle-closure glaucoma patients after trabeculetomy.
METHODS: Patients with viral keratitis who underwent trabeculectomy in treatment of acute angle-closure glaucoma in Xiamen Eye Center of Xiamen University from December 2011 to October 2013 were selected and completed the treatment, 61 eyes of 45 cases were followed up. The treatment group of 23 cases(32 eyes)with acute angle-closure glaucoma patients were treated by NGF gel for 3mo after trabeculetomy, while in the control group 22 cases(29 eyes)were treated by normal saline replaced NGF. All patients were followed up for at least 12mo, visual acuity, perimetry, retinal nerve fiber layer(RNFL)thickness and cup/disc ratio of the patients were followed up during the treatment. The safety of topical use of NGF gel was also evaluated.
RESULTS:In all patients, the intraocular pressure(IOP)was successfully controlled under 21mmHg and the visual acuity was markedly increased in the affected eye after trabeculectomy. Compared with control group, the postoperative IOP and visual acuity had no significant differences in treatment group(P>0.05). The average light sensitivity of perimetry and mean defect were better than that in control group postoperative 6 and 12mo; The results of optical coherent tomography(OCT)and Heiderburg Retina Tomography(HRT)-Ⅲ showed that RNFL thickness was significantly greater than that in control group, while cup/disc ratio significantly less than that in control group postoperative 6 and 12mo. Ocular surface damage, corneal endothelium to reduce and other eye complication were no observed in treatment group.
CONCLUSION:Acute angle-closure glaucoma treated by NGF gel after operation is effective and safe.
[中图分类号]
[基金项目]
国家自然科学基金项目(No. 81170841); 厦门市科技计划杰出青年创新人才计划项目(No.3502Z20116011); 厦门市科技计划项目(No.3502Z20134040)
