Potop Vasile, Dragosloveanu Christiana Diana Maria, Ciocâlteu Alina Mihaela, Burcel Miruna Gabriela, Marinescu Maria Cristina, Dăscălescu Dana Margareta Cornelia
Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania.
Life (Basel). 2024 Sep 12;14(9):1154. doi: 10.3390/life14091154.
Glaucoma is a widespread ophthalmological disease, with a high impact and frequent visual morbidity. While the physiopathology of the two types of primary glaucoma (open angle and angle closure) has been studied, there seems to be little relationship between the two. In this study, we gather clinical and preclinical data to support the idea that the two primary glaucomas are "mirrored" in terms of morphological parameters and disease physiopathology. In short, primary angle closure glaucoma (PACG) is associated with hyperopia and low axial length, and primary open angle glaucoma (POAG) is associated with myopia and high axial length. Moreover, in PACG and in primary angle closure or primary angle closure suspect cases, while there is extensive iridotrabecular contact, the intraocular pressure (IOP) is still maintained in the lower half of the normal range throughout the evolution of the disease, which suggests a baseline trabecular hyperfiltration in PACG. In the opposite case, myopic eyes with open angles and a higher risk of developing POAG often have a baseline IOP in the upper half of the normal range, suggesting a baseline trabecular hypofiltration. As we explore clinical, genetic and animal model data regarding these opposing aspects, we hypothesize the existence of a mirroring relationship between PACG and POAG. Defining the relationship between the two potentially blinding diseases, with a high prevalence worldwide, may aid in understanding the mechanisms better and refining diagnosis and treatment. Thus, our theory has been named the Mirror Theory of Primary Glaucomas.
青光眼是一种广泛存在的眼科疾病，具有高影响力且视觉发病率频繁。虽然已经对两种原发性青光眼（开角型和闭角型）的病理生理学进行了研究，但两者之间似乎关系不大。在本研究中，我们收集了临床和临床前数据，以支持这两种原发性青光眼在形态学参数和疾病病理生理学方面是“镜像”关系的观点。简而言之，原发性闭角型青光眼（PACG）与远视和眼轴长度短有关，而原发性开角型青光眼（POAG）与近视和眼轴长度长有关。此外，在PACG以及原发性闭角型或原发性闭角型疑似病例中，虽然存在广泛的虹膜小梁接触，但在疾病的整个发展过程中，眼压（IOP）仍维持在正常范围的下半部分，这表明PACG存在基线小梁高滤过。相反，开角型且发生POAG风险较高的近视眼中，基线眼压通常在正常范围的上半部分，这表明存在基线小梁低滤过。当我们探索有关这些相反方面的临床、遗传和动物模型数据时，我们假设PACG和POAG之间存在镜像关系。定义这两种在全球范围内患病率高且可能致盲的疾病之间的关系，可能有助于更好地理解其机制并完善诊断和治疗。因此，我们的理论被命名为原发性青光眼的镜像理论。
