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重视降眼压药物的研究和临床应用 总被引:5,自引:0,他引:5
青光眼的治疗包括手术、激光和药物治疗,药物治疗主要是降眼压药。近年来,国内外已开始重视研究保护视神经功能的药物。一、研究降眼压药物的临床意义目前,虽然对青光眼的发病机制尚未明了,但在药物治疗方面,首先考虑消除眼压增高这一危险因素,对于各类原发和继发性... 相似文献
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侯艳宏 《中华实验眼科杂志》2017,(4):368-371
新生血管性青光眼(NVG)是一类以虹膜及房角新生血管形成为特征的继发性青光眼,其致盲率高,治疗棘手,目前主要的治疗策略包括视网膜缺血的治疗、药物控制眼压和手术降低眼压3个方面.虽然NVG有许多手术治疗方法,但多存在并发症,远期效果尚不能令人满意.Ahmed青光眼引流阀植入术(AGVI)因其术后浅前房、低眼压等并发症少,术后眼压控制稳定,是NVG的首选治疗方式之一,影响手术疗效的主要因素为纤维增生、新生血管再次形成等,AGVI联合抗纤维治疗及抗血管内皮生长因子(VEGF)治疗可能为NVG的治疗提供了新的途径.近年来研究表明,AGVI联合抗VEGF药物的应用能够提高手术成功率.AGVI术中联合应用抗纤维药物,如丝裂霉素C、缓释型抗纤维药物等可以改善手术预后.本文针对AGVI治疗NVG及联合抗纤维化、抗VEGF治疗的研究进展进行综述. 相似文献
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John G. Flanagan 《Ophthalmic & physiological optics》1998,18(2):126-132
Glaucoma describes a group of ocular conditions which involve progressive optic nerve damage associated with loss of visual function and, frequently, with elevated intraocular pressure. Recent estimates of worldwide prevalence predict that 67 million people will suffer from glaucoma by the year 2000. Although the clinical features of glaucoma are reasonably well described, the pathogenesis of optic nerve damage remains unclear. Intraocular pressure (IOP) is accepted as an important risk factor; however, it is clear that other factors play a role in the pathogenesis of the disease, and such factors may interact with IOP to greatly enhance its harmful effects. Many of the new therapeutic approaches to the stabilisation and potential cure of glaucoma attempt to address these non-IOP factors. The aim of the following paper is to consider the implications of new estimates of disease prevalence, discuss theories related to optic nerve damage and outline new and future approaches to the medical management of the disease. 相似文献
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P.Siva Reddy 《眼科学报》1992,8(1):21-24
Primary open angle glaucoma is the second most important cause of permanent blindness in the Asia Pacific region. Thus it is very important to identify epidemiological and other risk factore which are associated with open angle glaucoma. The risk for glaucoma optic nerve damage increases with the age and with the level of the intraocular pressure. In this paper, I will highlight our study of several risk factors for development of the open angle glaucoma like (1) elevated intraocular pressure, (2) myopia, (3) suspicious large optic disc cup, (4) cupping with disc haemorrhages and (5) nerve fibre defect. The general and systemic conditions which are implicated as risk factore are (1)family history of glaucoma, (2)increase in age, (3)diabetes mellitus, (4) cardio vascular conditions like central retinal vein occlusion etc. (5) the endocrine disorders with increased thyroid and increased cortico steroids responsiveness in patients with glaucoma will be discussed. 相似文献
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Primary open angle glaucoma is the second most important cause of permanent blindness in the Asia-Pacific region. Thus it is very important to identify epidemiological and other risk factors which are associated with open angle glaucoma. The risk for glaucoma optic nerve damage increases with the age and with the level of the intraocular pressure. In this paper, I will highlight our study of several risk factors for development of the open angle glaucoma like (1) elevated intraocular pressure, (2) myopia, (3) suspicious large optic disc cup, (4) cupping with disc haemorrhages and (5) nerve fibre defect. The general and systemic conditions which are implicated as risk factors are (1) family history of glaucoma. (2) increase in age, (3) diabetes mellitus, (4) cardiovascular conditions like central retinal vein occlusion etc. (5) the endocrine disorders with increased thyroid and increased corticosteroids responsiveness in patients with glaucoma will be discussed. 相似文献
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Wahl J 《Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft》2011,108(11):1011-1015
Increased intraocular pressure is currently the only manipulable risk factor for glaucoma. In ocular hypertension the intraocular pressure is increased but the optic nerve head and visual field are thought to show no damage. Classification into glaucoma by means of the optic nerve head is often possible only over a period of time because there is a large overlap between the already pathological and still normal findings. In the Ocular Hypertension Treatment Study (OHTS) the effectiveness of prophylactic treatment was demonstrated. In the OHTS and the European Glaucoma Prevention Study (EGPS) risk factors have been identified, such as increased intraocular pressure, size of the excavation of the optic nerve head, decreased central corneal thickness, increased pattern standard deviation in the visual field and age. Before treatment of ocular hypertension is initiated these risk factors and the patient's personal situation should be considered. The higher the intraocular pressure, the smaller the central corneal thickness and the larger the excavation of the optic nerve and the younger the patient, the earlier treatment should be started. 相似文献
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E.M. Hoffmann J. Lamparter 《Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft》2016,113(8):715-728
The term ocular hypertension has been used for more than 30 years. It is defined as an elevated intraocular pressure above the statistical norm without detectable optic nerve head or visual field damage. The number of patients with ocular hypertension in Germany is estimated to be approximately 3–5 million. Increased intraocular pressure is a risk factor for conversion to primary open-angle glaucoma. Most patients with ocular hypertension (and no risk factors) can be followed on a regular basis without any treatment. Each visit should include measurement of intraocular pressure, optic nerve head examination with a slit lamp, imaging and perimetric examinations. Currently known risk factors are high intraocular pressure, higher age, myopia, a thin cornea and darkly pigmented skin. If risk factors are present, antiglaucomatous therapy is indicated. 相似文献
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Glaucoma is one of the most common causes of blindness in the world. Well-known risk factors include age, race, a positive family history and elevated intraocular pressures. A newly proposed risk factor is decreased cerebrospinal fluid pressure (CSFP). This concept is based on the notion that a pressure differential exists across the lamina cribrosa, which separates the intraocular space from the subarachnoid fluid space. In this construct, an increased translaminar pressure difference will occur with a relative increase in elevated intraocular pressure or a reduction in CSFP. This net change in pressure is proposed to act on the tissues within the optic nerve head, potentially contributing to glaucomatous optic neuropathy. Similarly, patients with ocular hypertension who have elevated CSFPs, would enjoy a relatively protective effect from glaucomatous damage. This review will focus on the current literature pertaining to the role of CSFP in glaucoma. Additionally, the authors examine the relationship between glaucoma and other known CSFP-related ophthalmic disorders. 相似文献
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眼压异常升高是原发性开角型青光眼最主要的危险因素。临床目前一直沿用以眼压为靶点的青光眼诊疗模式。近年来发现,循环血流、体质指数、颅内压、营养代谢、中医偏颇体质类型、某些系统性疾病等多种系统性危险因素可能与青光眼发生、发展和转归相关。纠正系统性危险因素能否延缓青光眼进展被日益关注,成为潜在的青光眼辅助诊疗靶点。本文对各类青光眼系统性危险因素进行介绍,倡导重视系统性危险因素,提出以系统危险因素评估和个性化眼体同治相结合的青光眼诊疗体系。(眼科, 2022, 31: 325-329) 相似文献
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Uveitic glaucoma is a range of disorders that results in optic nerve damage from elevated intraocular pressure secondary to intraocular inflammation. As compared to primary open angle glaucoma, uveitic glaucoma is associated with a more aggressive disease course caused by very high intraocular pressure levels that wax and wane. Diagnosis is often based on clinical presentation, disease course, and associated systemic manifestations. Diagnostic imaging plays an important role in both diagnosis and management. While the mechanisms of uveitic glaucoma vary, treatment requires strict control of the inflammation and may involve additional intraocular pressure lowering techniques. Management often dictates an interdisciplinary approach as systemic association and treatment is common. When topical management does not slow the progression of optic nerve damage and vision loss, surgical intervention is required. A significant portion of patients with uveitic glaucoma will eventually require surgical intervention and the appropriate referrals should be made. By nature, success rates of surgical intervention in uveitic glaucoma patients are lower than non‐inflammatory causes of elevated intraocular pressure and glaucomatous damage. Chronic inflammation, multiple mechanisms, systemic associations, and unpredictable response to treatment make uveitic glaucoma challenging to manage. This review will discuss the pathophysiology, diagnosis, and management of uveitic glaucoma to provide a guide for eye‐care providers. 相似文献
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青光眼是目前全球范围内致盲性最高的疾病之一,是以进行性视网膜神经节细胞丧失、不可逆的视野损害等病理性改变为特征,最终导致视神经萎缩及视功能丧失的疾病。目前青光眼的发病机制并不完全清楚,其中视神经损伤的机制有多种学说,包括眼压因素及非眼压因素,非眼压因素包括血管因素、免疫作用、远端轴突病变、氧化应激作用、细胞因子的变化及自噬等机制。本文综述了有关青光眼视神经损伤机制的研究进展,为进一步研究青光眼视神经病变提供依据。 相似文献
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尚欢 《中华实验眼科杂志》2017,(11):1052-1056
青光眼是导致不可逆盲的首要原因,包括视野缺损和视神经的慢性退行性病变,如视网膜神经节细胞(RGCs)的凋亡和视神经轴突的逐步缺失.目前普遍认为高眼压是青光艰的主要危险因素,降低眼压是减缓青光眼发生和发展的首选治疗方法.近年来发现免疫因素是青光眼视神经损害的非压力依赖性危险因素之一.大部分免疫,甚至非免疫性生物效应都通过细胞因子来调控,而CD4+辅助性T细胞是细胞因子产生和调节的主要来源,其中Th1和Th2相关细胞因子在青光眼的发病机制中起着不可或缺的作用,并关系着RGCs的存活和凋亡.本文就近年Th1和Th2主要的相关细胞因子及Th1/Th2平衡与青光眼潜在关系的研究进展进行综述. 相似文献