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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Primary angle closure glaucoma: What we know and what we don't know.

Xinghuai Sun1, Yi Dai2, Yuhong Chen2

  • 1Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, China; Key Laboratory of Myopia of State Health Ministry (Fudan University) and Key Laboratory of Visual Impairment and Restoration of Shanghai, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, China.

Progress in Retinal and Eye Research
|January 1, 2017
PubMed
Summary

Primary angle-closure glaucoma (PACG) involves complex mechanisms beyond pupillary block. Understanding these factors and genetic links is crucial for developing effective treatments and preventative strategies for this common cause of blindness.

Keywords:
DiagnosisNomenclaturePathogenesisPrimary angle closure glaucomaTreatments

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Area of Science:

  • Ophthalmology
  • Genetics
  • Pathophysiology

Background:

  • Primary angle-closure glaucoma (PACG) is a significant cause of blindness globally.
  • Angle closure is the core pathological process in PACG.
  • Advancements in anterior segment imaging have improved understanding of angle closure mechanisms.

Purpose of the Study:

  • To review current understanding and identify knowledge gaps in PACG.
  • To discuss the pathogenesis, classification, and management of PACG.
  • To share clinical experience and author viewpoints on PACG.

Main Methods:

  • Review of recent literature, including imaging studies and Genome Wide Association Studies (GWAS).
  • Analysis of established and emerging mechanisms of angle closure (e.g., choroidal thickness, uveal expansion).
  • Discussion of current and potential future treatment strategies.

Main Results:

  • Multiple mechanisms, including choroidal thickness and uveal expansion, contribute to angle closure in PACG.
  • GWAS have identified new genetic loci and genes associated with PACG.
  • Current classification systems for PACG are debated, and angle-focused treatments like laser peripheral iridotomy and cataract extraction are effective.

Conclusions:

  • PACG pathogenesis is multifactorial, involving anatomical, genetic, and potentially systemic factors.
  • Effective management focuses on opening the anterior chamber angle.
  • Future research should explore prophylactic treatments and novel therapeutic approaches, including psychological and neurological interventions, to improve PACG prognosis.