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目的 探讨高度近视合并原发性开角型青光眼 (primaryopen angleglaucoma ,POAG)的早期诊断依据。方法 (1)将存档的 2 1例 (40只眼 )高度近视合并POAG患者资料 (A组 )与随机抽取的2 1例 (40只眼 )中度近视合并POAG患者的资料 (B组 )及 2 1例 (42只眼 )低度近视合并POAG患者的资料 (C组 )进行对照 ,比较初次就诊时 3组患者间视野缺损、视网膜神经纤维层缺损 (retinalnervefibrelayerdefect,RNFLD)、最高眼压值及最佳矫正视力等指标的差异 ;(2 )观察A组患者的三维眼底照片 ,分析其临床特点。结果 (1)初诊时 ,A组患者中、重度视野缺损和RNFLD的比例明显高于B、C组 ,矫正视力低于B、C组 ;(2 )高度近视患者视乳头、视网膜的特异性变化及视乳头周围病变等 ,直接干扰对青光眼的早期诊断 ;(3)散瞳检查或立体眼底拍片是提高青光眼检出率的重要手段。结论 认识高度近视本身及合并POAG时的临床特点 ,有利于提高临床医师对该病的警觉性及早期诊断水平
Objective To investigate the early diagnosis of high myopia with primaryopen angleglaucoma (POAG). Methods (1) The data of 21 POAG patients with high myopia with POAG (group A) and 21 patients with moderate myopia (POAG) randomly selected from 21 eyes of 40 eyes (group B) and Twenty-one patients (42 eyes) with low myopia and POAG (group C) were compared. The visual field defect, retinal nerve fiber defect (RNFLD), maximum intraocular pressure Best corrected visual acuity and other indicators of the difference; (2) observed A group of patients with three-dimensional fundus photographs, analysis of its clinical features. Results (1) At the first visit, the ratio of severe visual field defect to RNFLD in group A was significantly higher than that in group B and C, and the corrected visual acuity was lower than that in group B and C. (2) The specificity of optic nerve and retina in high myopia And the optic nerve around the lesions, etc., directly interfere with the early diagnosis of glaucoma; (3) Mydriatic examination or three-dimensional fundus photography is an important means to improve the detection rate of glaucoma. Conclusions The understanding of the clinical features of high myopia itself and pooled POAG is helpful to improve clinicians’ alertness and early diagnosis of the disease