Glaucoma Service and Dana Center for Preventive Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Lancet. 2011 Apr 16;377(9774):1367-77. doi: 10.1016/S0140-6736(10)61423-7. Epub 2011 Mar 30.
Most medical practitioners have regular contact with adults who have one of the two forms of glaucoma: open-angle glaucoma or angle-closure glaucoma. Data from population-based surveys indicate that one in 40 adults older than 40 years has glaucoma with loss of visual function, which equates to 60 million people worldwide being affected and 8·4 million being bilaterally blind. Even in developed countries, half of glaucoma cases are undiagnosed. Glaucoma is mostly asymptomatic until late in the disease when visual problems arise. Vision loss from glaucoma cannot be recovered, and improved case-detection methods for glaucoma are needed. Glaucoma is commonly treated with daily eye-drop drugs, but adherence to treatment is often unsatisfactory. As a usually asymptomatic and chronic disease, glaucoma has similar treatment challenges to chronic systemic diseases. Similarities to the pathogenesis of common CNS diseases mean that common neuroprotective strategies might exist. Successful gene therapy, which has been used for other eye diseases might be possible for the treatment of glaucoma in the future.
开角型青光眼或闭角型青光眼。基于人群的调查数据表明，40 岁以上的成年人中每 40 人就有 1 人患有青光眼并伴有视力丧失，这相当于全世界有 6000 万人受到影响，840 万人双眼失明。即使在发达国家，一半的青光眼病例也未被诊断出来。青光眼在疾病晚期出现视力问题之前通常没有症状。青光眼引起的视力丧失无法恢复，因此需要更好的青光眼病例检测方法。青光眼通常用每日滴眼药物治疗，但治疗的依从性往往不尽人意。作为一种通常无症状的慢性疾病，青光眼与慢性全身性疾病具有相似的治疗挑战。与常见中枢神经系统疾病发病机制的相似性意味着可能存在共同的神经保护策略。成功的基因治疗已用于治疗其他眼部疾病，未来可能也适用于治疗青光眼。
