Two Decades of Angle-Closure Glaucoma Research.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Anterior Segment Disease

Background:

• Primary angle-closure disease (PACD) is a major cause of visual impairment worldwide, especially in Asia, with projected increases in primary angle-closure glaucoma (PACG) cases.
• PACD affects multiple ocular structures, including the cornea, trabecular meshwork, lens, and retina, leading to diverse vision-threatening complications.
• Management often requires multidisciplinary expertise, integrating cornea, cataract, glaucoma, and retinal surgical techniques.

Purpose of the Study:

• To review advancements in understanding and managing Primary Angle-Closure Disease (PACD).
• To highlight the shift in therapeutic strategies for PACD, emphasizing clear lens extraction.
• To discuss the role of emerging genetic risk stratification in personalized PACD care.

Main Methods:

• Review of seminal studies and research networks.
• Analysis of established demographic and ocular risk factors.
• Exploration of advancing molecular genetic mechanisms.

Main Results:

• Redefined management protocols for angle-closure, reducing prophylactic laser iridotomy for asymptomatic cases.
• Established clear lens extraction as a central therapeutic intervention for PACD.
• Advancing understanding of genetic factors for future individualized risk stratification.

Conclusions:

• Clear lens extraction represents a paradigm shift in PACD management.
• Future advancements in genetic research promise personalized risk assessment and targeted interventions.
• Multidisciplinary collaboration is crucial for optimizing outcomes in PACD patients.