Wang Yiwei, Guo Yanzhi, Zhang Yang, Huang Shouyue, Zhong Yisheng
Author Affiliations Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Shanghai, 200025, People's Republic of China.
Author affiliations Department of Ophthalmology, Wuxi Branch of Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Wuxi, People's Republic of China.
Eye Brain. 2024 Sep 17;16:39-54. doi: 10.2147/EB.S472920. eCollection 2024.
Glaucoma is the leading cause of irreversible blindness worldwide. It is an ocular disease characterized by an increase in intraocular pressure or, in some cases, normal intraocular pressure, which leads to optic nerve damage and progressive constriction of the visual field (VF). Primary Open-Angle Glaucoma (POAG) and Primary Angle-Closure Glaucoma (PACG) represent the predominant forms of glaucoma. Numerous hypotheses have been posited to elucidate the pathogenic mechanisms underlying these conditions. There is an emerging understanding of the distinct pathological processes that differentiate the various types of glaucoma. While some similarities in the mechanisms between PACG and POAG have been suggested, evidence indicates that there are also significant differences between the two. This review synthesizes the similarities and differences in the etiology of optic neuropathy caused by POAG and PACG, considering their respective pathophysiological mechanisms, the morphology of the optic disc and surrounding tissues, genetic characteristics, optical coherence tomography angiography, optical coherence tomography, and structural and functional features from VF examinations. These characteristics may contribute to a deeper comprehension of the underlying pathogenesis of glaucoma and enhance the management of different types of this ocular condition.
青光眼是全球不可逆性失明的主要原因。它是一种眼部疾病,其特征为眼压升高,或在某些情况下眼压正常,但会导致视神经损伤和视野(VF)逐渐缩小。原发性开角型青光眼(POAG)和原发性闭角型青光眼(PACG)是青光眼的主要类型。人们提出了许多假设来阐明这些病症的致病机制。对于区分不同类型青光眼的独特病理过程,人们的认识正在不断加深。虽然有人提出PACG和POAG在机制上存在一些相似之处,但有证据表明两者之间也存在显著差异。本综述综合了POAG和PACG所致视神经病变病因的异同,考虑了它们各自的病理生理机制、视盘及周围组织的形态、遗传特征、光学相干断层扫描血管造影、光学相干断层扫描以及视野检查的结构和功能特征。这些特征可能有助于更深入地理解青光眼的潜在发病机制,并加强对这种眼部疾病不同类型的管理。