Possible mechanisms of primary angle-closure and malignant glaucoma
Possible mechanisms of primary angle-closure and malignant glaucoma
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DOI：
10.1097/00061198-200304000-00013
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发表时间：
2003-04-01
影响因子：
2
通讯作者：
Congdon, NG
中科院分区：
文献类型：
--
作者：
Quigley, HA;Friedman, DS;Congdon, NG
在过去的5年中，基于人群的患病率调查，大规模的临床评估和诊断方法的技术进步有助于我们对原发性闭角型青光眼（PACG）的了解。在20世纪早期，高触觉压力、疼痛和快速失明的眼睛之间的联系被称为“急性充血性”青光眼。80年前，Curran1记录了虹膜切开术对这些眼睛的有益效果，并提出虹膜切开术损害了房水流入前房。由于这些眼睛代表了绝大多数被认为患有青光眼的人，他怀疑是否有很多青光眼患者没有症状，眼压（IOP）水平较低，即我们现在所认为的开角型青光眼（OAG）。Rosengren2对青光眼前段进行了非常现代的生物识别分析，检测了两组患者。前房较浅的患者IOP较高，有症状，而前房深度正常的患者为无症状青光眼。这是第一次定量分离两种主要形式的原发性青光眼。虽然Barkan推广了用于青光眼诊断的角膜炎镜检查，并做出了区分PACG和OAG的开创性观察，但只有他后来的出版物才接受了通过瞳孔抵抗房水运动的重要性。相反，他强调了
During the last 5 years, population-based prevalence surveys, large-scale clinical evaluations, and technological advances in diagnostic methods have contributed to our understanding of primary angle-closure glaucoma (PACG). During the early 20th century, the association between eyes with high tactile pressure, pain, and rapid blindness was called “acute congestive” glaucoma. Eighty years ago, Curran1 documented the beneficial effect of iridotomy in these eyes and proposed that they had impaired aqueous humor flow into the anterior chamber. Since these eyes represented the vast majority of those recognized to have glaucoma, he doubted that there were very many cases of glaucoma with no symptoms and lower levels of intraocular pressure (IOP), the condition that we now recognize as open-angle glaucoma (OAG).Rosengren2 performed a remarkably modern biometric analysis of the anterior segment in glaucoma eyes, detecting 2 groups of patients. Those with shallower anterior chambers had higher IOP and were symptomatic, while those with chambers of normal depth had asymptomatic glaucoma. This was the first quantitative separation of the 2 major forms of primary glaucoma. While Barkan popularized gonioscopy for glaucoma diagnosis and made seminal observations to distinguish PACG from OAG, 3, 4 only his later publications show acceptance of the importance of resistance to aqueous humor movement through the pupil. 5 Instead, he stressed the