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
其他诊断因素
- corneal hysteresis
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
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
需考虑的检查
- digital imaging
- pachymetry
- nerve fiber layer analysis
新兴检查
- corneal hysteresis
治疗流程
eye drops preferred or laser trabeculoplasty contraindicated/failed
laser trabeculoplasty preferred or eye drops contraindicated /failed
eye drops contraindicated /failed and rapidly progressive disease
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
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
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.

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