Unit12-AOphthalmicDiseases-青光眼.docVIP

Unit 12 Ophthalmic Diseases 眼部疾病 Text A Glaucoma 青光眼 Introduction Primary open-angle glaucoma onset 原发性开角型青光眼 Glaucoma is a progressive optic neuropathy for which the major risk factor for visual loss is elevated intraocular pressure (IOP) 1 . In primary open-angel glaucoma ( POAG) ,the most common of the glaucomas，raised IOP occurs secondarily to a gradual reduction in the drainage of aqueous humour （房水）via the trabecular mesh work. Glaucoma can be present，however，in the presence of normal IOP ( normal-tension glaucoma). 青光眼是一种退行性视神经病变，眼压升高(IOP)是其导致视力丧失的最主要风险因素。在原发性开角型青光眼疾病中，最常见的青光眼是由于眼压升高并通过小梁网导致房水减少。然而，在正常眼压升高下不会导致青光眼。 Primary angle-closure glaucoma 原发性闭角型青光眼 Primary angle-closure glaucoma (PACG) is a condition in which elevation of IOP occurs as a result of obstruction of aqueous outflow by partial or complete closure of the angle by the peripheral iris. Unlike POAG, the diagnosis depends largely on examination of the anterior segment and careful gonioscopy. A normal optic nerve head and visual field do not preclude a diagnosis of PACG. This disease occurs in anatomically predisposed eyes and is frequently bilateral, although presentation of the acute form is often unilateral. Based on the mechanism of angle closure, two forms of PACG e are recognized： (a) pupillary block and (b) plateau iris syndrome, which is rare. 原发性闭角型青光眼(PAGG)是条件性病变，主要取决于外围虹膜部分或完全封闭的角度大小，及阻碍房水外流导致眼压升高的程度。不像原发性开角型青光眼，PAGG诊断很大程度上依赖于眼前节和仔细的前房角镜检查。PAGG诊断不应该排除正常视神经乳头和视野检查。这种疾病发生于解剖结构异常眼并双侧频发，尽管严重的发病形式是单侧的。基于角度关闭的机制，PAGG的两种主要病理形式已被认识：主要是瞳孔关闭，稀有形式是高原虹膜综合征。 Risk Factors 风险因素 Glaucoma is a progressive disease. However, the rate at which it progresses varies markedly from person to person. It was once believed that the only important factor to be controlled was the IOP，but it has become clear that many other factors affect the course of the disease. Because the major damage that occurs in most persons with glaucoma is deterioration of the optic nerve, the most important risk factor is the ability o