Hoffmann Esther M, Prokosch-Willing Verena
Klin Monbl Augenheilkd. 2017 Nov;234(11):1407-1422. doi: 10.1055/s-0043-118611. Epub 2017 Sep 20.
Glaucoma leads to blindness but there are diagnostic and therapeutic developments that aid ophthalmologists in the improved mangement of the disease compared to the past. Known risk factors such as age, myopia, dark pigmented skin, genetics, and elevated intraocular pressure play an important role for the individual patient's prognosis, and many yet unknown or not sufficiently investigated risk factors come along. The structured examination of the optic nerve head is crucial for the clincial diagnosis by the ophthalmologist. At least a photo documentation - better imaging of the optic nerve head and its retinal nerve fibers - should be performed in newly diagnosed suspect glaucoma or ocular hypertension. Visual field testing is just as important and it is recommended to perform 6 visual fields in the first two years after diagnosis. Treatment principles are evolving and minimally invasive surgery techniques are upcoming. However, trabeculectomy with mitomycin C is still superior regarding long-term results compared to microstents and minimal shunt procedures.
青光眼可导致失明,但与过去相比,目前出现了一些诊断和治疗方面的进展,有助于眼科医生更好地管理这种疾病。年龄、近视、深色皮肤、遗传因素以及眼压升高这些已知的风险因素对个体患者的预后起着重要作用,此外还有许多未知或尚未得到充分研究的风险因素。对视神经乳头进行结构化检查对眼科医生的临床诊断至关重要。对于新诊断的疑似青光眼或高眼压症患者,至少应进行照片记录——对视神经乳头及其视网膜神经纤维进行更好的成像。视野检测同样重要,建议在诊断后的头两年内进行6次视野检测。治疗原则在不断发展,微创外科手术技术也即将出现。然而,与微支架和最小分流手术相比,丝裂霉素C小梁切除术的长期效果仍然更优。