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Related Concept Videos

Angle Closure Glaucoma: Treatment01:28

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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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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Twenty-Four-Hour Intraocular Pressure in Chronic Primary Angle-Closure Disease.

Wasu Supakontanasan1, Yanin Suwan1, Suthaphat Nilphatanakorn1

  • 1Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok.

Journal of Glaucoma
|August 11, 2023
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Summary

Primary angle closure glaucoma shows the highest 24-hour intraocular pressure (IOP) fluctuation. Peripheral anterior synechiae degree correlates with IOP patterns in primary angle-closure disease, even with normal IOP. This highlights IOP variability in angle-closure disease.

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Intraocular Pressure Dynamics

Background:

  • Primary angle closure (PAC) and primary angle closure glaucoma (PACG) can present with normal intraocular pressure (IOP).
  • Twenty-four-hour IOP fluctuation is a critical, yet understudied, parameter in diagnosing and managing angle-closure disease.
  • Peripheral anterior synechiae (PAS) are a hallmark of angle-closure disease, potentially influencing IOP dynamics.

Purpose of the Study:

  • To investigate 24-hour IOP patterns in chronic primary angle-closure disease.
  • To evaluate the association between the degree of PAS and the 24-hour IOP pattern in these patients.

Main Methods:

  • A prospective cohort study involving 59 eyes of 35 Asian patients with chronic primary angle-closure disease.
  • 24-hour IOP monitoring using Goldmann applanation tonometry at 2-hour intervals.
  • Comparison of peak, mean, trough IOP, and 24-hour IOP fluctuation across different stages of the disease.

Main Results:

  • Eyes with PAC and PACG exhibited significantly higher peak IOP and 24-hour IOP fluctuation compared to primary angle closure suspect (PACS) eyes.
  • PACG eyes demonstrated the highest 24-hour IOP fluctuation.
  • The degree of PAS was significantly associated with peak, mean, and 24-hour IOP fluctuation in PAC and PACG eyes.

Conclusions:

  • Twenty-four-hour IOP fluctuation is significantly elevated in PACG and PAC compared to PACS.
  • Despite higher peak IOP and fluctuation, trough IOP remained below 21 mmHg in most PAC and PACG eyes.
  • The extent of PAS is a key factor influencing the 24-hour IOP pattern in primary angle-closure disease.