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Pharmacological and environmental factors in primary angle-closure glaucoma
Ian Subak-Sharpe1, Sancy Low, Winifred Nolan
1Moorfields Eye Hospital, London, UK.
British Medical Bulletin
|November 26, 2009
Summary
Certain drug classes can trigger angle closure in susceptible individuals, increasing glaucoma risk. Prompt referral for gonioscopic examination is crucial for high-risk patients starting new medications.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Numerous drug classes are known to induce angle closure in individuals predisposed to this condition.
- Mechanisms of drug-induced angle closure include sympathomimetic, parasympatholytic, and idiosyncratic reactions.
Purpose of the Study:
- To provide a clinical summary of primary angle-closure glaucoma (PACG) and its management.
- To highlight the risks associated with drug-induced angle closure.
Main Methods:
- A comprehensive review of the ophthalmic literature.
- Clinical summarization of primary angle-closure glaucoma and its management.
Main Results:
- External stimuli, including medications and environmental factors, can precipitate acute or asymptomatic angle closure.
- Angle closure, even when asymptomatic, poses a significant risk for developing glaucoma.
Conclusions:
- Patients at risk for PACG commencing drug therapy that may provoke or worsen angle closure require referral for ophthalmological gonioscopic examination.
- Anterior segment optical coherence tomography (AS-OCT) shows promise for rapidly identifying individuals at risk of vision loss from drug-induced angle-closure glaucoma.
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