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Eye (London, England) Oct 2015Primary Angle Closure Glaucoma (PACG) is one of the most common types of glaucoma affecting over 15 million individuals worldwide. Family history and ethnicity are... (Review)
Review
Primary Angle Closure Glaucoma (PACG) is one of the most common types of glaucoma affecting over 15 million individuals worldwide. Family history and ethnicity are strongly associated with the development of the disease, suggesting that one or more genetic factors contribute to PACG. Although strictly heritable disease-causing mutations have not been identified, a number of recent association studies have pointed out genetic factors that appear to contribute to an individual's risk to develop PACG. In addition, genetic factors have been identified that modify PACG endophenotypes for example, axial length. Herein we review the current literature on this important topic.
Topics: Axons; Eye Proteins; Genetic Linkage; Genetic Predisposition to Disease; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Retinal Ganglion Cells; Risk Factors
PubMed: 26206529
DOI: 10.1038/eye.2015.124 -
Current Opinion in Ophthalmology Mar 2007Acute angle closure glaucoma is a potentially blinding side effect of a number of local and systemic drugs, including adrenergic, both anticholinergic and cholinergic,... (Review)
Review
PURPOSE OF REVIEW
Acute angle closure glaucoma is a potentially blinding side effect of a number of local and systemic drugs, including adrenergic, both anticholinergic and cholinergic, antidepressant and antianxiety, sulfa-based, and anticoagulant agents. The purpose of this article is to bring this condition to the attention of clinicians using these compounds as well as ophthalmologists called to see the patient.
RECENT FINDINGS
Acute angle closure glaucoma due to pupillary block, treatable by peripheral iridotomy, can be caused by adrenergic agents, either locally (phenylephrine drops, nasal ephedrine, or nebulized salbutamol) or systemically (epinephrine for anaphylactic shock), drugs with anticholinergic effects including tropicamide and atropine drops, tri and tetracyclic antidepressants, and cholinergic agents like pilocarpine. A novel anticholinergic form is the use of periocular botulinum toxin diffusing back to the ciliary ganglion inhibiting the pupillary sphincter. Sulfa-based drugs (acetazolamide, hydrochlorothiazide, cotrimoxazole, and topiramate) can cause acute angle closure glaucoma by ciliary body edema with anterior rotation of the iris-lens diaphragm. Iridotomy is not effective.
SUMMARY
Most attacks of acute angle closure glaucoma involving pupillary block occur in individuals that are unaware that they have narrow iridocorneal angles. Practitioners using any of the above drugs should be aware of their potential to cause acute angle closure.
Topics: Acute Disease; Anticoagulants; Central Nervous System Agents; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Prognosis; Risk Factors
PubMed: 17301614
DOI: 10.1097/ICU.0b013e32808738d5 -
Eye (London, England) Oct 2005Glaucoma is the second cause, after cataract, of world blindness. Approximately half is thought to be primary angle-closure glaucoma (ACG). This review asks whether ACG... (Review)
Review
PURPOSE
Glaucoma is the second cause, after cataract, of world blindness. Approximately half is thought to be primary angle-closure glaucoma (ACG). This review asks whether ACG can be prevented on a population basis. METHODS AND POPULATIONS: Review of published information from the Inuit of Greenland, Canada and Alaska, and descriptions of recent studies in Asian populations in Mongolia, China and South-East Asia.
RESULTS
The Greenland Inuit have the shallowest anterior chamber depths (ACDs) so far recorded. The proportion of blindness due to ACG was reduced from 64% to 9% over 37 years by systematic optical measurement of central ACD and the van Herick test in the older Inuit, followed by gonioscopy and prophylactic iridectomy or laser iridotomy when indicated. In Mongolia, ultrasound measurement of central ACD had good sensitivity and specificity as a screening test. A randomized controlled trial of screening and prophylactic laser is being completed. In China and South-East Asia, the mechanism of angle closure appears to be more varied and complex and its detection may require more elaborate imaging.
CONCLUSIONS
The mechanism of angle closure and potential for prevention by screening are likely to have to be determined specifically for each population at risk.
Topics: Adult; Aged; Anterior Chamber; Asian People; Biometry; Glaucoma, Angle-Closure; Humans; Inuit; Mass Screening; Middle Aged
PubMed: 16304593
DOI: 10.1038/sj.eye.6701970 -
Vestnik Oftalmologii 2022To review the literature devoted to the problem of primary anterior chamber angle closure (PAC) and the development of this pathology from glaucoma suspect to primary... (Review)
Review
[Primary anterior chamber angle closure: progression from suspect to glaucoma. Part 1. Frequency and rate of transition from suspected primary angle closure to true angle closure and primary angle closure glaucoma].
To review the literature devoted to the problem of primary anterior chamber angle closure (PAC) and the development of this pathology from glaucoma suspect to primary angle closure glaucoma. The paper includes a trend analysis of the studies concerning primary angle closure suspects (PACS). The concept of this review is conditioned by the conflicting strategies for treating patients with initial PAC without glaucomatous optic neuropathy. Solving the problem of angle closure plays a key role in preventing the development of PAC glaucoma, which is the world's leading cause of irreversible blindness. This part of the review provides information on the frequency and rate of disease progression in PACS. The analyzed literature data is contradictory and indicates the need for further search that would consider a standardized approach to defining the concept of PAC disease, demographic factors and unified examination methods for generalizing and systematizing data in order to draw out unified treatment recommendations.
Topics: Anterior Chamber; Blindness; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Ocular Hypertension
PubMed: 36004598
DOI: 10.17116/oftalma2022138041101 -
Klinische Monatsblatter Fur... Jan 2022
Topics: Acute Disease; Cocaine-Related Disorders; Glaucoma, Angle-Closure; Humans; Intraocular Pressure
PubMed: 33853181
DOI: 10.1055/a-1388-7330 -
Chinese Medical Journal Nov 2002To review the major progress in primary angle closure glaucoma (PACG). (Review)
Review
OBJECTIVE
To review the major progress in primary angle closure glaucoma (PACG).
METHODS
Contents of this article were selected from the original papers or reviews related to primary angle closure glaucoma published in Chinese and foreign journals. A total of 76 articles were selected from several hundred original articles or reviews. The content of selected articles is in accordance with our purpose and the authors are authorized scientists in the study of glaucoma.
RESULTS
Primary angle closure glaucoma is the most common type of glaucoma in the Sino-Mongoloid population. PACG in Chinese can be classified into three types depending on the mechanism of angle closure: 1. Multimechanism: 54.8% of Chinese PACG is caused by co-existing factors. The pattern of angle closure appears to mainly be creeping closure. After iridectomy, almost 40% of the cases still manifest a positive response to the darkroom provocative test and progressive synechial closure or recurrent angle closure may occur. Several mechanisms are involved in this form of PACG such as pupillary blocking component, iris crowding component and anterior positioned ciliary body. These factors can coexist in the follow patterns: pupillary blocking and iris crowding coexist; pupillary blocking and anterior positioned ciliary body coexist or three of them co-exist. 2. Pupillary block: (38.1% of Chinese PACG) is caused by iris bombe due to pupillary block with acute or subacute attack. It responds well to iridectomy or laser iridotomy. 3. Non-pupillary blocking: (7.8% of Chinese PACG). They usually have a deeper anterior chamber, and tend to be younger (below 40 years of age). Angle closure in this form of PACG is caused by: iris crowding mechanism or/and anteriorly positioned ciliary body against iris root to angle. It is critical to distinguish multi-mechanism PACG from other types. The initial treatment for this type of PACG is also iridectomy, but after the pupillary block component is eliminated by iridectomy, the residual non-pupillary blocking components should be highlighted by a diagnostic treatment procedure or by a ultrasound biomicroscopy (UBM) provocative test. Finally, the role of UBM in the observation and evaluation of the mechanism of angle closure is discussed and future research directions on PACG in Asians are proposed.
CONCLUSION
Chinese eyes have been recognized to be prone to the development of creeping angle closure. There is some direct evidence that creeping angle closure is caused by multiple mechanisms. Further study on this topic is needed.
Topics: Asian People; China; Glaucoma, Angle-Closure; Humans
PubMed: 12609093
DOI: No ID Found -
BMC Ophthalmology Nov 2023To report the ocular characteristics and management of three cases of retinitis pigmentosa (RP) concurrent primary angle closure glaucoma (PACG).
BACKGROUND
To report the ocular characteristics and management of three cases of retinitis pigmentosa (RP) concurrent primary angle closure glaucoma (PACG).
CASE PRESENTATION
Three middle-aged patients presenting with diminished vision, high intraocular pressure (IOP), and typical fundus manifestations of RP were clinically evaluated. The individualized treatment was based on the ocular conditions of each case. A novel genetic alteration in ZNF408 was identified in one patient. Two patients with short-axial eyes received unilateral combined trabeculectomy, cataract surgery, and Irido-zonulo-hyaloid-vitrectomy. One of them had a subluxated lens, managed with a capsular tension ring implantation. Their contralateral eyes, respectively, underwent laser peripheral iridotomy (LPI) and transscleral cyclophotocoagulation. The third patient underwent bilaterally combined laser peripheral iridoplasty, LPI, and medication. Ultimately, all patients achieved the target IOP during a two-year follow-up.
CONCLUSION
Young patients with RP may have a risk of developing angle closure glaucoma, and conversely, patients with angle closure glaucoma at younger age should be aware of the presence of RP. Therefore, routine gonioscopy and IOP monitoring are required for RP patients, and detailed fundus examinations are warranted for young PACG patients.
Topics: Middle Aged; Humans; Glaucoma, Angle-Closure; Iridectomy; Iris; Treatment Outcome; Laser Therapy; Retinitis Pigmentosa; Intraocular Pressure; DNA-Binding Proteins; Transcription Factors
PubMed: 37968604
DOI: 10.1186/s12886-023-03190-y -
Discovery Medicine Jan 2013Glaucoma is a group of heterogeneous optic neuropathy and is the second leading cause of irreversible blindness worldwide. The two most common clinical types of glaucoma... (Review)
Review
Glaucoma is a group of heterogeneous optic neuropathy and is the second leading cause of irreversible blindness worldwide. The two most common clinical types of glaucoma include primary open-angle (POAG) and primary angle-closure glaucoma (PACG). PACG is characterized by the closure of angles between iris and trabecular meshwork (iridocorneal angles) mainly because of anatomic abnormalities. The condition is more prevalent in Chinese, Asian Indians, and Eskimos. Because of an unusually high incidence of PACG among siblings of affected patients, it was suggested that genetic factors were involved in its pathology and the action of a large number of grouped or independently inherited genes along with environmental factors result in anatomical abnormalities of PACG. In PACG, the genetic basis is not well understood. Genome-wide association studies have identified several candidate genes in relation to PACG in several different populations. However, they are not reproduced from population to population or the results are controversial. This may indicate that the involvement of genetic abnormality in the pathogenesis of PACG is complex. The availability of spontaneously occurring large animal models such as dogs may provide an opportunity to identify genes responsible for the pathophysiology of PACG in the future. This article summarizes the current status of genetic investigations on PACG which is the most common cause of blindness worldwide.
Topics: Animals; Genetic Predisposition to Disease; Genome-Wide Association Study; Glaucoma, Angle-Closure; Humans
PubMed: 23375010
DOI: No ID Found -
Clinical & Experimental Ophthalmology 2011
Topics: Genetic Association Studies; Glaucoma, Angle-Closure; Humans; Risk Factors
PubMed: 22452677
DOI: 10.1111/j.1442-9071.2011.02663.x -
Asian Journal of Surgery Mar 2024
Review
Topics: Humans; Glaucoma, Angle-Closure; COVID-19; Acute Disease
PubMed: 38057224
DOI: 10.1016/j.asjsur.2023.11.166