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Mechanisms in ocular hypertension.

R Mapstone

    The British Journal of Ophthalmology
    |May 1, 1979
    PubMed
    Summary

    Intermittent partial angle closure may cause ocular hypertension. Provocative tests revealed angle closure or pigment release in over half of patients, supporting this hypothesis for ocular hypertension management.

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    Area of Science:

    • Ophthalmology
    • Glaucoma Research

    Background:

    • Ocular hypertension is a risk factor for glaucoma.
    • The etiology of ocular hypertension is not fully understood.
    • Intermittent partial angle closure is a potential, yet understudied, cause.

    Purpose of the Study:

    • To investigate the hypothesis that intermittent partial angle closure contributes to ocular hypertension.
    • To identify specific responses to provocative pharmacologic testing in patients with ocular hypertension.

    Main Methods:

    • 139 eyes from 76 patients with ocular hypertension underwent provocative testing with pilocarpine and phenylephrine.
    • Gonioscopy was used to assess angle closure.
    • Pigment release into the aqueous humor was evaluated.
    • Iridectomy was performed on a subset of eyes, followed by repeat provocative testing.

    Main Results:

    • 32% of eyes showed gonioscopic angle closure.
    • 25% of eyes exhibited significant pigment release without angle closure.
    • 11% of eyes showed both angle closure and pigment release.
    • 59% of eyes showed neither response.
    • Post-iridectomy provocative testing yielded significantly different results.

    Conclusions:

    • The study provides evidence supporting the hypothesis that intermittent partial angle closure is a cause of ocular hypertension.
    • Pharmacologic provocative testing can reveal underlying angle dynamics in ocular hypertension.
    • These findings may inform strategies for managing ocular hypertension and preventing glaucoma progression.

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