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Open-angle glaucoma

ბოლო მიმოხილვა: 12 Dec 2025
ბოლო განახლება: 12 Jun 2025

შეჯამება

განსაზღვრება

病史和体格检查

关键诊断因素

  • cup-to-disk ratio >0.5
  • notching of optic nerve cup
  • symptomatic peripheral vision loss
  • increased intraocular pressure
  • scotomas
  • loss of nerve fiber layer
  • optic disk hemorrhage
完整详情

其他诊断因素

  • corneal hysteresis
完整详情

危险因素

  • intraocular pressure >21 mmHg
  • age >50 years
  • family history of glaucoma
  • genetic abnormalities
  • black ethnicity or Hispanic ethnicity
  • myopia
  • diabetes mellitus
  • hypertension
  • low ocular perfusion pressure
  • thin central corneal thickness
  • corneal hysteresis
  • calcium-channel blockers
完整详情

诊断性检查

首要检查

  • tonometry
  • gonioscopy
  • direct ophthalmoscopy
  • indirect ophthalmoscopy
  • slit-lamp biomicroscopy
  • visual field testing
  • optical coherence tomography scanning
完整详情

需考虑的检查

  • digital imaging
  • pachymetry
  • nerve fiber layer analysis
完整详情

新兴检查

  • corneal hysteresis

治疗流程

急症处理

eye drops preferred or laser trabeculoplasty contraindicated/failed

laser trabeculoplasty preferred or eye drops contraindicated /failed

eye drops contraindicated /failed and rapidly progressive disease

持续性治疗

treatment failure

撰稿人

作者

Nishani Amerasinghe, MBBS, BSc(Hons), FRCOphth

Consultant Ophthalmic Surgeon

Glaucoma Specialist

University Hospital Southampton NHS Trust

Southampton

UK

利益声明

NA is president-elect of the UK and Éire Glaucoma Society and has acted as an unpaid advisor to NICE and The Royal College of Ophthalmologists. NA has served on an advisory panel for Santen and has received travel honoraria and speaker's fees from Thea Pharmaceuticals, Santen, and Allergan. NA has received research funding from AbbVie Pharmaceuticals.

Irena Serov-Volach, MD

Senior Glaucoma and Cataract Fellow

Ophthalmology department

Eye Unit

Epsom and St Helier University Hospitals NHS Trust

London

UK

利益声明

ISV has received consultancy/travel fees from Glaukos.

鸣谢

Dr Nishani Amerasinghe and Dr Irena Serov-Volach would like to gratefully acknowledge Dr Robert B. Avery and Dr Michael N. Wiggins, the previous contributors to this topic.

利益声明

RBA and MNW declare that they have no competing interests.

同行评议者

Andrew Chen, MD

Assistant Professor

University of Washington

Seattle

WA

利益声明

AC declares that he has received research funding from Janssen LLC.

Sheila Sanders, MD

Professor of Ophthalmology

University of Kentucky

South Limestone

Lexington

KY

Declarações

SS declares that she has no competing interests.

Mohamed Khodeiry, MD

Glaucoma Fellow

University of Kentucky

South Limestone

Lexington

KY

Declarações

MK declares that he has no competing interests.

Roshini Sanders, FRCS, FRCOphth

Consultant Ophthalmologist

Queen Margaret Hospital

Dunfermline

Fife

UK

Declarações

RS declares that she has no competing interests.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

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Referências

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Principais artigos

Weinreb RN, Leung CK, Crowston JG, et al. Primary open-angle glaucoma. Nat Rev Dis Primers. 2016 Sep 22;2:16067. Resumo

International Council of Ophthalmology. ICO guidelines for glaucoma eye care. Feb 2016 [internet publication].Texto completo

American Academy of Ophthalmology. Primary open-angle glaucoma preferred practice pattern. Nov 2020 [internet publication].Texto completo

American Academy of Ophthalmology. Primary open-angle glaucoma suspect preferred practice pattern. Nov 2020 [internet publication].Texto completo

National Institute for Health and Care Excellence. Glaucoma: diagnosis and management. Jan 2022 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Open-angle glaucoma images
  • Diagnósticos diferenciais

    • Normal-tension glaucoma
    • Angle-closure glaucoma
    • High myopia
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Glaucoma summary benchmarks - 2024
    • Trabeculectomy with a biodegradable collagen matrix implant for glaucoma
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Glaucoma

    Mais Folhetos informativos para os pacientes
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