摘要
青光眼是世界第二大主要的致盲眼病,其中原发性开角型青光眼(POAG)发病率高,发病机制较为复杂,临床诊疗较为困难。其主要特征为视神经损害和视野缺损,严重影响患者的生活质量。原发性开角型青光眼的发病与遗传因素密切相关,其中MYOC、OPTN、WDR36及CAV1/CAV2基因是原发性开角型青光眼的相关基因。原发性开角型青光眼发病的危险因素主要包括眼压、高度近视、种族、年龄及家族史等,发病机制可能是房水流出阻滞、小梁网改变、巩膜内管改变、Schlemm管塌陷、血流动力学异常、相关基因的异常以及房水的影响。目前临床上治疗大多通过药物、激光及手术治疗,其中局部药物治疗是原发性开角型青光眼的首选。原发性开角型青光眼的发病机制的研究尚无统一定义,相应的诊断及治疗的新方法也层出不穷,临床上应根据疾病特点,结合患者实际情况合理的运用手术及药物相结合,不断提高POAG的临床治疗的效果。
Objective:Glaucoma is the second major cause of blindness in the world,and primary open angle glaucoma has a high incidence,complicated pathogenesis and difficult clinical diagnosis and treatment.Its main features are optic nerve damage and visual field defect,which seriously affect the quality of patients'life.The pathogenesis of primary open angle glaucoma is closely related to genetic factors,and MYOC,OPTN,WDR36 and CAV1/CAV2 genes are related to primary open angle glaucoma.The risk factors for primary open angle glaucoma mainly include intraocular pressure,high myopia,race,age and family history,and the pathogenesis may be aqueous humor outflow obstruction,trabecular meshwork changes,intrascleral canal changes,Schlemm's canal collapse,hemodynamic abnormalities,related gene abnormalities as well as the effects of aqueous humor.At present,most of the clinical treatment is through drugs,laser and surgery,and local drug therapy is the first choice for primary open angle glaucoma.The study on the pathogenesis of primary open angle glaucoma has not been uniformly defined,and the corresponding new methods for diagnosis and treatment have been emerging one after another.In clinical practice,the features of the disease should be combined with the patients'actual situation to reasonably use operation and medicines and constantly improve the clinical treatment effect of POAG.
作者
张鑫
李妮
曾继红
ZHANG Xin;LI Ni;ZENG Ji-hong(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu,Sichuan Province,610041,China)
出处
《海南医学院学报》
CAS
2019年第9期712-716,共5页
Journal of Hainan Medical University
基金
国家重大科学仪器设备开发专项资金资助(2012YQ12008005)~~
