Glaucoma Research Facility and Clinical Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Curr Opin Ophthalmol. 2011 Mar;22(2):87-95. doi: 10.1097/ICU.0b013e328343729f.
Primary angle closure disease, PACD, has had a plethora of classifications and terminologies. The International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification was a simple classification, extremely useful in surveys, but could not be clinically applied because of the varied presentation of PACD.
Reviewing the literature, it was seen that the landmarks in progression of PACD were an anatomical predisposition; iridocorneal apposition/adhesions; chronic rise in intraocular pressure (IOP), despite an iridotomy; and glaucomatous optic neuropathy. Therefore, a staging system for PACD is proposed. PACD suspect--occludable angle; PACD I--occludable angle with evidence of closure, but a normal IOP after iridotomy; PACD II--peripheral anterior synechiae in an occludable angle with a chronically raised IOP after iridotomy, with or without a suspicious optic nerve head; and PACD III--peripheral anterior synechiae in an occludable angle, with a raised IOP after iridotomy, and glaucomatous optic neuropathy.
This proposed classification has amalgamated all the clinically described subtypes of PACD--subacute, acute, chronic, symptomatic, and asymptomatic--into a staging, based on extent of damage to the outflow channels and optic nerve head, providing a basis for standardized therapy and possibly a quantifiable long-term prognosis.
原发性闭角型青光眼（PACG）有许多分类和术语。国际眼科地理和流行病学学会（ISGEO）分类是一种简单的分类，在调查中非常有用，但由于 PACG 的多种表现形式，无法在临床上应用。
通过回顾文献，人们发现 PACG 进展的标志是解剖学倾向；房角黏连/粘连；尽管进行了虹膜切开术，但眼内压（IOP）仍持续升高；以及青光眼视神经病变。因此，提出了 PACG 的分期系统。PACG 可疑——可闭角；PACG I——可闭角，有闭角的证据，但虹膜切开术后 IOP 正常；PACG II——闭角中有周边前粘连，虹膜切开术后 IOP 持续升高，伴有或不伴有可疑视神经头；PACG III——闭角中有周边前粘连，虹膜切开术后 IOP 升高，伴有青光眼视神经病变。
该分类方法将所有临床上描述的 PACG 亚型——亚急性、急性、慢性、有症状和无症状——合并为一个基于流出通道和视神经头损伤程度的分期，为标准化治疗提供了基础，并可能提供可量化的长期预后。
