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The New England Journal of Medicine Mar 2018
Topics: Acute Disease; Eye; Female; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iris; Middle Aged
PubMed: 29514027
DOI: 10.1056/NEJMicm1712742 -
Ugeskrift For Laeger Sep 2021Glaucoma is the most common cause of irreversible blindness globally with a significant contribution from angle-closure glaucoma. Over the past 20 years, the terminology... (Review)
Review
Glaucoma is the most common cause of irreversible blindness globally with a significant contribution from angle-closure glaucoma. Over the past 20 years, the terminology has been standardised with the term glaucoma being used exclusively for patients with signs of glaucomatous damage to the optic nerve. Prospective randomised clinical trials have changed treatment algorithms as summarised in this review. Prophylactic iridotomy is now only offered to selected at-risk patients, while removal of the lens with phacoemulsification is more often used as the primary treatment of patients with angle closure.
Topics: Cataract Extraction; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Phacoemulsification; Prospective Studies
PubMed: 34498583
DOI: No ID Found -
Revista Da Associacao Medica Brasileira... Jul 2014
Review
Topics: Glaucoma, Angle-Closure; Humans; Iridectomy; Laser Therapy
PubMed: 25211409
DOI: 10.1590/1806-9282.60.04.004 -
Romanian Journal of Ophthalmology 2021Ultrasound biomicroscopy (UBM) is an important tool in the diagnosis, evaluation and follow up of glaucoma patients. Even if we are dealing with a primary angle closure... (Review)
Review
Ultrasound biomicroscopy (UBM) is an important tool in the diagnosis, evaluation and follow up of glaucoma patients. Even if we are dealing with a primary angle closure glaucoma (PACG) or a primary open angle glaucoma (POAG) patient, the mechanism of angle closure can be revealed by performing an UBM. The device can help differentiate between the two types of glaucoma even in patients with opaque corneas when gonioscopy cannot be performed. Knowing the type of glaucoma is vital, especially regarding an individualized treatment, since each patient is unique and needs to be treated accordingly, in order to prevent glaucomatous optic neuropathy and visual field loss. : AC = anterior chamber, ICE = iridocorneal endothelial syndrome, IOP = intraocular pressure, NTG = normal tension glaucoma, PACG = primary angle closure glaucoma, PC = posterior chamber, PEX = pseudoexfoliation syndrome, POAG = primary open angle glaucoma, UBM = ultrasound biomicroscopy.
Topics: Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Microscopy, Acoustic; Tonometry, Ocular; Visual Fields
PubMed: 34179574
DOI: 10.22336/rjo.2021.24 -
Developments in Ophthalmology 2017Advances in anterior segment imaging modalities have contributed new insights towards a better understanding of the various mechanisms of angle-closure glaucoma (ACG).... (Review)
Review
Advances in anterior segment imaging modalities have contributed new insights towards a better understanding of the various mechanisms of angle-closure glaucoma (ACG). This development is key to good decision making when confronted with angle-closure patients needing appropriate therapy. Surgical management of ACG remains an integral part of glaucoma patient care. The distinctive anatomy of angle-closure eyes and the few objective lines of evidence to support the effectiveness of the different surgical treatment options present a challenge to glaucoma surgeons.
Topics: Anterior Eye Segment; Filtering Surgery; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Treatment Outcome
PubMed: 28442694
DOI: 10.1159/000458493 -
Clinical & Experimental Ophthalmology Apr 2018
Topics: Acute Disease; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Tonometry, Ocular
PubMed: 29665201
DOI: 10.1111/ceo.13189 -
Experimental Eye Research Dec 2019Glaucoma, the leading cause of irreversible blindness worldwide, can be divided into two major types: primary open angle glaucoma (POAG) and primary angle closure... (Review)
Review
Glaucoma, the leading cause of irreversible blindness worldwide, can be divided into two major types: primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG). PACG could lead to severe vision loss and has a high prevalence among Asian populations. The worldwide population affected by PACG is estimated to exceed 20 million by 2020. Recent studies have shown that there are at least eight genetic loci significantly associated with risk of PACG, possibly contributing to the phenotype by interacting with environmental factors. This review presents the progress that has been achieved in the genetics of PACG and its future perspectives. This article should be considered as a memorial article to honor Dr. R. Rand Allingham's remarkable contribution to genetic association studies in glaucoma. We are deeply saddened by the loss of Dr. Allingham, not only a huge loss for ophthalmology, but also loss of a dear friend. Looking back to his extraordinary career, Dr. Allingham devoted his whole life and passion into establishing the genetic basis of different forms of glaucoma such as open angle, angle closure, and exfoliation glaucoma. He had a special interest in analyses of populations from African ancestry, which greatly boosted the understanding of glaucoma genetics.
Topics: Genetic Predisposition to Disease; Glaucoma, Angle-Closure; Global Health; Humans; Intraocular Pressure; Prevalence; Visual Fields
PubMed: 31634478
DOI: 10.1016/j.exer.2019.107835 -
Klinische Monatsblatter Fur... Nov 2021Secondary angle closure glaucoma is a very heterogeneous subtype of glaucoma with a variety of possible causes leading to a blockade of the regular aqueous humour flow...
Secondary angle closure glaucoma is a very heterogeneous subtype of glaucoma with a variety of possible causes leading to a blockade of the regular aqueous humour flow or outflow. A distinction is made between secondary pupillary block, angle closure with "pulling" or angle closure with "pushing" mechanisms. For each of these three subgroups, there are different causes, which in turn require individual therapy. Treatment of the underlying cause should always take priority whenever possible. Reduction of the intraocular pressure is often a symptomatic therapy with surgical, pressure lowering procedures showing a limited success rate in many forms of secondary angle closure glaucoma. This article intends to provide an overview of the different causes of secondary angle closure, diagnostic approaches and targeted therapies of exemplary causes of each subgroup.From the group of secondary pupillary block, mechanical causes, iris bombé, and intraoperative air or oil input are addressed, from the group of "pulling" causes, angle neovascularization, post-inflammatory angle changes, and iridocorneal endothelial syndrome and for the group of "pushing" mechanisms, gas endotamponade, retroiridal neoplasms and aqueous misdirection syndrome.While secondary angle closure is one of the most challenging glaucoma subgroups for treatment it is crucial to know the different subgroups and their development to choose the right treatment.
Topics: Glaucoma; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Iris; Iris Diseases; Tonometry, Ocular
PubMed: 34380157
DOI: 10.1055/a-1545-9983 -
Current Opinion in Ophthalmology Mar 2020The genetic basis of primary angle closure (PAC) glaucoma is slowly being elucidated. In recent years, genome-wide association studies have identified eight new... (Review)
Review
PURPOSE OF REVIEW
The genetic basis of primary angle closure (PAC) glaucoma is slowly being elucidated. In recent years, genome-wide association studies have identified eight new susceptibility loci for PAC. Our purpose in this review is to summarize our current knowledge of genetics in angle closure, to take a closer look at the eight novel loci and what we have learned about their function, and consider what they might teach us about angle closure disease.
RECENT FINDINGS
Multiple novel loci associated with PAC glaucoma have been identified in large genome-wide association studies. Moreover, primary open angle glaucoma and PAC glaucoma are found to have partly overlapping genetic features.
SUMMARY
The genetic basis of PAC glaucoma is being deciphered. Even though there is still much more to be uncovered, this process has already provided new insights in the pathogenesis of this blinding disease. A better understanding of the pathogenic mechanisms through genomics may be valuable for the development of novel therapies.
Topics: Genome-Wide Association Study; Genomics; Glaucoma, Angle-Closure; Humans
PubMed: 31895154
DOI: 10.1097/ICU.0000000000000645 -
Journal of Glaucoma Jul 2018Exfoliation syndrome is characterized by numerous ocular manifestations, the most important of these being glaucoma and cataract. Its ocular manifestations affect all of... (Review)
Review
Exfoliation syndrome is characterized by numerous ocular manifestations, the most important of these being glaucoma and cataract. Its ocular manifestations affect all of the structures of the anterior segment as well as conjunctiva and orbital structures. Exfoliation material is seen most prominently as characteristic white deposits on the anterior surface of the lens and the pupillary border of the iris. Both open-angle and angle-closure glaucoma are intimately associated with exfoliation syndrome. Other findings include zonular disruption, iris sphincter fibrosis, keratopathy, ocular surface disease, and retinal vein occlusion.
Topics: Cataract; Exfoliation Syndrome; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure
PubMed: 29781834
DOI: 10.1097/IJG.0000000000000986