De Francesco Ticiana, Bacharach Jason, Smith Oluwatosin, Shah Manjool
John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
Clinica de Olhos De Francesco, Rua Barao de Aracati 499, Fortaleza 60115080, Brazil.
Ther Adv Ophthalmol. 2024 Oct 13;16:25158414241287431. doi: 10.1177/25158414241287431. eCollection 2024 Jan-Dec.
The glaucoma treatment paradigm is starting to change from a more reactive approach that relies on topical medications to a more proactive approach that leverages procedural interventions. This evolution toward interventional glaucoma has been enabled by a growing array of lower-risk minimally invasive procedures such as laser trabeculoplasty, minimally invasive glaucoma surgery, and procedural pharmaceuticals. A common feature of these glaucoma interventions-as with all glaucoma interventions-is the need for early, prompt, and accurate diagnosis. The present review summarizes new and upcoming developments in glaucoma diagnostics. These include technologies and techniques for home-based intraocular pressure measurement, novel visual field platforms, photography- and optical coherence tomography-based visualization, and artificial intelligence applications. They also include emerging technologies such as mitochondrial flavoprotein fluorescence imaging, detection of apoptosing retinal cells, collector channel visualization, and genetic testing. These diagnostic modalities have the potential to circumvent the limitations of traditional diagnostic methods. By increasing the frequency and feasibility of obtaining valuable glaucoma data with more rapid detection of disease and progression, these diagnostics may enable an interventional approach to glaucoma treatment for the betterment of patient care.
青光眼的治疗模式正开始从依赖局部药物的较为被动的方法转变为利用手术干预的更为主动的方法。一系列风险较低的微创手术，如激光小梁成形术、微创青光眼手术和手术用药物，推动了向介入性青光眼治疗的这一演变。与所有青光眼干预措施一样，这些青光眼干预措施的一个共同特点是需要早期、及时和准确的诊断。本综述总结了青光眼诊断方面新出现和即将出现的进展。这些进展包括用于家庭眼压测量的技术和方法、新型视野平台、基于摄影和光学相干断层扫描的可视化技术以及人工智能应用。它们还包括新兴技术，如线粒体黄素蛋白荧光成像、凋亡视网膜细胞检测、集液管可视化和基因检测。这些诊断方法有可能克服传统诊断方法的局限性。通过更快速地检测疾病和病情进展来增加获取有价值的青光眼数据的频率和可行性，这些诊断方法可能会促成一种介入性青光眼治疗方法，以改善患者护理。
