Tehrani Shandiz
Casey Eye Institute, Oregon Health & Science University , Portland, OR , USA.
Curr Eye Res. 2015 Feb;40(2):191-200. doi: 10.3109/02713683.2014.968935. Epub 2014 Oct 6.
Glaucoma is the principal cause of irreversible blindness in the world, the second leading cause of blindness in the United States, and it results in optic nerve head axonal degeneration and corresponding visual field deficits. Intraocular pressure (IOP) is the only known modifiable risk factor in glaucoma. Non-modifiable risk factors for glaucoma include age, ethnicity, central corneal thickness, and family history. While our understanding of the role of gender as a risk factor in glaucoma development and progression remains nascent, multiple observations have shown gender differences in the incidence and prevalence of glaucoma. Depending on the type of glaucoma, hormone therapy, oral contraceptive use and menopausal status have also been associated with glaucoma. In addition, pregnancy leads to changes in IOP, while the treatment of glaucoma must be tailored based on the systemic effects of topical therapeutics on the mother and fetus. This review will focus on the epidemiologic, anatomic and endocrinologic differences in male and female glaucoma patients. In addition, this review will discuss treatment modalities that may be more appropriate for one gender than the other, especially with respect to a woman's pregnancy status.
青光眼是全球不可逆性失明的主要原因，在美国是第二大致盲原因，它会导致视神经乳头轴突变性及相应的视野缺损。眼压（IOP）是青光眼唯一已知的可改变风险因素。青光眼的不可改变风险因素包括年龄、种族、中央角膜厚度和家族史。虽然我们对性别作为青光眼发生和进展风险因素的作用的理解仍处于初期阶段，但多项观察表明青光眼的发病率和患病率存在性别差异。根据青光眼的类型，激素治疗、口服避孕药的使用和绝经状态也与青光眼有关。此外，怀孕会导致眼压变化，而青光眼的治疗必须根据局部治疗药物对母亲和胎儿的全身影响进行调整。本综述将重点关注男性和女性青光眼患者在流行病学、解剖学和内分泌学方面的差异。此外，本综述还将讨论可能对某一性别比对另一性别更合适的治疗方式，尤其是在女性怀孕状态方面。
