Cohen Laura P, Pasquale Louis R
Departments of Ophthalmology and Massachusetts Eye and Ear, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02114.
Departments of Ophthalmology and Massachusetts Eye and Ear, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02114 Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02114.
Cold Spring Harb Perspect Med. 2014 Jun 2;4(6):a017236. doi: 10.1101/cshperspect.a017236.
Glaucoma is a neurodegenerative disorder in which degenerating retinal ganglion cells (RGC) produce significant visual disability. Clinically, glaucoma refers to an array of conditions associated with variably elevated intraocular pressure (IOP) that contributes to RGC loss via mechanical stress, vascular abnormalities, and other mechanisms, such as immune phenomena. The clinical diagnosis of glaucoma requires assessment of the ocular anterior segment with slit lamp biomicroscopy, which allows the clinician to recognize signs of conditions that can produce elevated IOP. After measurement of IOP, a specialized prismatic lens called a gonioscope is used to determine whether the angle is physically open or closed. The structural manifestation of RGC loss is optic nerve head atrophy and excavation of the neuroretinal rim tissue. Treatment is guided by addressing secondary causes for elevated IOP (such as inflammation, infection, and ischemia) whenever possible. Subsequently, a variety of medical, laser, and surgical options are used to achieve a target IOP.
青光眼是一种神经退行性疾病，其中退化的视网膜神经节细胞（RGC）会导致严重的视力残疾。临床上，青光眼指的是一系列与眼压（IOP）不同程度升高相关的病症，眼压升高会通过机械应力、血管异常以及其他机制（如免疫现象）导致RGC丧失。青光眼的临床诊断需要使用裂隙灯生物显微镜对眼前节进行评估，这使临床医生能够识别可导致眼压升高的病症迹象。测量眼压后，使用一种称为前房角镜的特殊棱镜镜片来确定房角是开放还是关闭。RGC丧失的结构表现是视神经乳头萎缩和神经视网膜边缘组织的凹陷。治疗尽可能以解决眼压升高的继发原因（如炎症、感染和缺血）为指导。随后，使用多种药物、激光和手术方法来实现目标眼压。
