TY - JOUR
T1 - Primary angle closure glaucoma
T2 - What we know and what we don't know
AU - Sun, Xinghuai
AU - Dai, Yi
AU - Chen, Yuhong
AU - Yu, Dao Yi
AU - Cringle, Stephen J.
AU - Chen, Junyi
AU - Kong, Xiangmei
AU - Wang, Xiaolei
AU - Jiang, Chunhui
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG. Recent Genome Wide Association Studies identified several new PACG loci and genes, which may shed light on the molecular mechanisms of PACG. The current classification systems of PACG remain controversial. Focusing the anterior chamber angle is a principal management strategy for PACG. Treatments to open the angle or halt the angle closure process such as laser peripheral iridotomy and/or iridoplasty, as well as cataract extraction, are proving their effectiveness. PACG may be preventable in the early stages if future research can identify which kind of angles and/or persons are more likely to benefit from prophylactic treatment. New treatment strategies like adjusting the psychological status and balancing the sympathetic-parasympathetic nerve activity, and innovative medicines are needed to improve the prognosis of PACG. In this review, we intend to describe current understanding and unknown aspects of PACG, and to share the clinical experience and viewpoints of the authors.
AB - Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG. Recent Genome Wide Association Studies identified several new PACG loci and genes, which may shed light on the molecular mechanisms of PACG. The current classification systems of PACG remain controversial. Focusing the anterior chamber angle is a principal management strategy for PACG. Treatments to open the angle or halt the angle closure process such as laser peripheral iridotomy and/or iridoplasty, as well as cataract extraction, are proving their effectiveness. PACG may be preventable in the early stages if future research can identify which kind of angles and/or persons are more likely to benefit from prophylactic treatment. New treatment strategies like adjusting the psychological status and balancing the sympathetic-parasympathetic nerve activity, and innovative medicines are needed to improve the prognosis of PACG. In this review, we intend to describe current understanding and unknown aspects of PACG, and to share the clinical experience and viewpoints of the authors.
KW - Diagnosis
KW - Nomenclature
KW - Pathogenesis
KW - Primary angle closure glaucoma
KW - Treatments
UR - http://www.scopus.com/inward/record.url?scp=85008331054&partnerID=8YFLogxK
U2 - 10.1016/j.preteyeres.2016.12.003
DO - 10.1016/j.preteyeres.2016.12.003
M3 - Article
C2 - 28039061
SN - 1350-9462
VL - 57
SP - 26
EP - 45
JO - Progress in Retinal and Eye Research
JF - Progress in Retinal and Eye Research
ER -