Contemporary approach to the diagnosis and management of primary angle-closure disease

被引:30
|
作者
Razeghinejad, M. Reza [1 ,2 ]
Myers, Jonathan S. [1 ]
机构
[1] Wills Eye Hosp & Res Inst, Glaucoma Serv, 840 Walnut St,Suite 1140, Philadelphia, PA 19107 USA
[2] Shiraz Univ Medcial Sci, Poostchi Ophthalmol Res Ctr, Shiraz, Iran
关键词
anterior segment imaging; closed-angle glaucoma; gonioscopy; goniosynechialysis; laser iridotomy; laser iridoplasty; lens extraction; primary angle-closure glaucoma; trabeculectomy; OPTICAL COHERENCE TOMOGRAPHY; LASER-PERIPHERAL-IRIDOTOMY; ANTERIOR-CHAMBER ANGLE; PLATEAU IRIS SYNDROME; CLEAR LENS EXTRACTION; RANDOMIZED CONTROLLED-TRIAL; TERM-FOLLOW-UP; INTRAOCULAR-PRESSURE FLUCTUATION; OCULAR HYPERTENSION TREATMENT; ACADEMY-OF-OPHTHALMOLOGY;
D O I
10.1016/j.survophthal.2018.05.001
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
The primary angle-closure disease spectrum varies from a narrow angle to advanced glaucoma. A variety of imaging technologies may assist the clinician in determining the pathophysiology and diagnosis of primary angle closure, but gonioscopy remains a mainstay of clinical evaluation. Laser iridotomy effectively eliminates the pupillary block component of angle closure; however, studies show that, in many patients, the iridocorneal angle remains narrow from underlying anatomic issues, and increasing lens size often leads to further narrowing over time. Recent studies have further characterized the role of the lens in angle-closure disease, and cataract or clear lens extraction is increasingly used earlier in its management. As a first surgical step in angle-closure glaucoma, lens extraction alone often effectively controls the pressure with less risk of complications than concurrent or stand-alone glaucoma surgery, but may not be sufficient in more advanced or severe disease. We provide a comprehensive review on the primary angle-closure disease nomenclature, imaging, and current laser and surgical management. (C) 2018 Elsevier Inc. All rights reserved.
引用
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页码:754 / 768
页数:15
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