行政院國家科學委員會補助專題研究計畫成果報告:原發性隅角閉鎖性青光眼集團篩檢標準早期診斷的研究（３／３）

原發性隅角閉鎖性青光眼之流行病學研究，自吾等與美國霍斯金大學Dana 眼預防失明中心於1996 年合作研究以來，甚被重視，陸陸續續有重要的流行病學的報告，並對其篩檢標準舉辦各項研討會。 由於原發性隅角閉鎖性青光眼有兩項特徵，即： ( l ）三分之二病人為慢性，臨床上大都不具特別之病訴。 ( 2 ）該症之眼球，比一般正常眼球小。 因此，該症之流行病篩檢及診斷標準，吾等經更多年的研究與經驗，乃提出近年來廣為發展之眼影像分析法，以客觀之數字來分別本症與健康人眼之不同畫J 分，做為本症早期診斷依據依據；其主要方法如下： 1 ．以一般眼用超音波（A -scan ）測量眼軸長度、水晶體厚度，以及前房深度區別。2 ．應用影像分析隅角狹窄度以及形態變化：此項研究包括ScheimPfiug 影像分析與ultrasound biomicroscopy ( UBM ）法。 3 ．視神經乳頭陷凹與其纖維之研究：應用視神經分析儀可早期檢查出其視神經之變化。 上述研究結果曾在美國霍斯金大學眼預防失明中心所舉辦之全球閉鎖性青光眼專家約20 名進行討論與檢討，並於91 年11 月10-11日亞洲閉鎖性青光眼研究會提出報告。而有關視神經乳頭與纖維之研究，則已投稿審查中。至於應用此影像分析法早期診斷閉鎖性青光眼，則詳於英文稿，準備投稿中。In the past decade, the epidemiological study has point out the importance of primary angle-closure glaucoma (PACG), because the number of PACG patients and its blindness can not be neglected. The image study of PACG has a long history since 19 century of more than one hundred years. The most important purpose of such study is to early detection and diagnosis of PACG, prior to the severe damage caused by this disorder. PACG has typical eye of smaller than average, therefore, accurate image analysis can be an important tool, especially by recent biotechnological application. Haag-Strait II patchymeter, by Lowe, as well as our study indicated important of anterior chamber depth measurement. A-scan sonography added the crucial oculometry for axial length, and lens thickness. Ultrasound biomicroscope and Scheimpflug video image provide the characteristic chamber angle change and measurement for PACG. In addition they also provide the chamber angle width and the pharmacological relation. Optic disc image study may also be interesting for the characteristic disc change of PACG, useful for the practitioner. In the field of medical, laser, and surgical therapy, image analysis is another important tool. We may predict the image analysis in glaucoma, especially in PACG is the essential issue in the years to come