AAO临床指南：原发性前房角关闭（2010年）
AAO PPP:Primary Angle Closure(2010)
2011-10-01
AAO PPP:Primary Angle Closure(2010)ORIENTATIONDISEASE DEFINITIONPrimary angle closure is appositional or synechial closure of the anterior chamber angle caused by multiple mechanisms.1-3 Pupil block is considered to be a key element in the pathogenesis of most instances of PAC. The pressure in the posterior chamber is higher than the anterior chamber, causing an anterior bowing of the iris, which may crowd the angle in predisposed eyes. Certain factors can increase this pressure disparity between the two chambers (e.g., pupil dilation and thickening of the crystalline lens with age), which can result in iris apposition to the anterior chamber angle structures. In a minority of cases, this can happen acutely, resulting in acute angle closure.Other important mechanisms play a role in angle closure, including the relative position and thickness of the ciliary body, the location of the iris insertion into the ciliary body, and the volume of the iris. Furthermore, it is clear that the crystalline lens size, shape, or position may play an important role in determining which eyes develop angle closure. Prolonged or repeated contact of the peripheral iris with the trabecular meshwork may lead to functional damage of the trabecular meshwork and the development of peripheral anterior synechiae (PAS). Angle closure may or may not be associated with elevated intraocular pressure (IOP) or glaucomatous optic neuropathy, and may occur in either an acute or chronic form. Secondary forms of angle closure can also occur (e.g., iridocorneal endothelial syndrome, inflammation, or neovascularization). This PPP focuses on PAC.
