成人青光眼及其发病机制、诊断和管理的详细研究

P. P. Sarwade, Madhav Kumar Mishra, Harpreet Kaur, C. M. Latha, S. H. Sherief, Kavita Narayan, Rapborlang Khongshei, Parmar Hemantbhai Natubhai, Shikshan Maharshi, Guruvarya R. G. Shinde Mahavidyalaya, Paranda Dist, India Dharashiv M.S
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引用次数: 0

摘要

作为仅次于白内障的全球第二大致盲原因,青光眼的诊断和治疗是普通医生必须了解的重要课题。青光眼通常可根据三个关键因素进行分类:前房角开放或关闭的程度、发病强度(急性或慢性)以及潜在病因(原发性或继发性)。大多数青光眼病例都是原发性的,表明没有任何并发症。然而,继发性青光眼的根本原因可能是一系列视力疾病。容易患上慢性青光眼的人应定期进行眼科检查,以便及早发现病情,防止在确诊前视力逐渐恶化。由于视神经和视网膜神经纤维层受损,青光眼会导致中心和周边视野受损。目前所有的治疗方法,包括药物、激光和手术,都旨在降低眼压(IOP),因为眼压是唯一可以改变的因素,也是影响病情发展的关键因素。药物疗法是常用的一线治疗方法,但其有效性受到不依从性、不良反应和费用的限制。虽然激光和手术方法能够长期有效地降低眼内压(IOP),而且与药物治疗相比成本更低,但治疗过程中的风险也随之增加,治疗不成功的可能性也更高。各种现代微创青光眼手术取代了传统的切口疗法,因为它们提高了安全性,降低了疗效。虽然微创青光眼手术的长期成功与否仍有待大规模随机试验来确定,但这些方法已大大改变了青光眼的手术治疗。
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A Detailed Study of Glaucoma in Adults, Its Pathogenesis, Diagnosis and Management
As the second most prevalent cause of blindness in the world, after cataracts, glaucoma diagnosis and treatment are crucial topics for general physicians to know. Glaucomas can often be categorised based on three key factors: the extent to which the anterior chamber angle is open or closed, the intensity of the onset (acute or chronic), and the underlying cause (primary or secondary). Most cases of glaucoma are primary, indicating the absence of any comorbidities. Nevertheless, secondary glaucomas may arise from a range of visual illnesses as their root cause. Individuals who are susceptible to developing chronic glaucoma should undergo regular eye examinations in order to detect the condition at an early stage and prevent the progressive deterioration of vision that may occur prior to diagnosis. Glaucoma leads to impairments in both central and peripheral vision fields due to damage to the optic nerve and the retinal nerve fibre layer. All current treatments, including drugs, lasers, and procedures, aim to reduce intraocular pressure (IOP) because it is the only factor that can be changed and is crucial in the progression of the condition. Pharmacotherapy is the usual first-line treatment, although its effectiveness is constrained by noncompliance, adverse effects, and cost. While laser and surgical methods offer the ability to effectively lower intraocular pressure (IOP) for extended periods and at a lower cost compared to medicine, they come with increased risks during the process and a higher likelihood of treatment not being successful. Various modern minimally invasive glaucoma operations have replaced conventional incisional therapies because they offer improved safety and reduced efficacy decreases. While the long-term success of minimally invasive glaucoma surgeries still needs to be determined by large-scale randomised trials, these methods have greatly transformed the surgical treatment of glaucoma.
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