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开角型青光眼

最后审阅: 12 Oct 2024
最后更新: 10 Nov 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 杯盘比>0.5
  • 视神经杯切迹
  • 周边视力缺损
  • 眼压升高
  • 暗点
  • 视网膜神经纤维层丢失
  • 视网膜出血
完整详情

其他诊断因素

  • 角膜滞后量
完整详情

危险因素

  • 眼压>21 mmHg
  • 年龄>50 岁
  • 青光眼家族史
  • 黑种人族裔或西班牙裔
  • 近视
  • 糖尿病
  • 高血压
  • 低眼灌注压
  • 中央角膜厚度薄
  • 角膜滞后量
  • 钙离子通道阻滞剂
完整详情

诊断性检查

首要检查

  • 眼压测量
  • 前房角镜检查
  • 直接检眼镜检查
  • 间接检眼镜检查
  • 裂隙灯生物显微镜检查
  • 视野检测
完整详情

需考虑的检查

  • 视盘照相
  • 超声角膜测厚
  • 光学相干断层扫描
  • 视网膜神经纤维层分析
完整详情

新兴检查

  • 角膜滞后量

治疗流程

急症处理

首选滴眼液或有激光小梁成形术禁忌/激光小梁成形术治疗失败

首选激光小梁成形术或有滴眼液使用禁忌/滴眼液治疗失败

滴眼液禁忌/治疗失败和疾病快速进展

持续性治疗

治疗失败

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

Richard A. Harper, MD

Associate Professor of Ophthalmology

Department of Ophthalmology

Jones Eye Institute

University of Arkansas for Medical Sciences

Little Rock

AR

利益声明

RAH declares that he has no competing interests.

Roshini Sanders, FRCS, FRCOphth

Consultant Ophthalmologist

Queen Margaret Hospital

Dunfermline

Fife

UK

利益声明

RS declares that she has no competing interests.

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