Glaucoma Yi Dai. MD. PhD Associate Professor Eye ent hospital ydai@fudan.edu.cn 复旦大学附厲眼耳鼻喉科医院
Glaucoma Yi Dai, MD, PhD Associate Professor Eye & ENT Hospital ydai@fudan.edu.cn
Epidemiology 2nd leading cause of blindness worldwide 60 Million people worldwide may be affected by glaucoma in 2010 One Third (20 million)may be Chinese By 2020- estimated to be 24 million Est. 10 million undiagnosed glaucoma cases in rural China Higher prevalence of ACG among Chinese Compared with data before 2000, incidence of OAG has increased 5-fold. while acg remain the same 复旦大学附厲眼耳鼻喉科医院
• 2nd leading cause of blindness worldwide • 60 Million people worldwide may be affected by glaucoma in 2010 – One Third (20 million) may be Chinese – By 2020 – estimated to be 24 million – Est. 10 million undiagnosed glaucoma cases in rural China – Higher prevalence of ACG among Chinese – Compared with data before 2000, incidence of OAG has increased 5-fold, while ACG remain the same Epidemiology
Intraocular pressure (IOP) Normal range 10-21mmHg 24h fluctuation <-8mmH g Inter-eye difference <= 5mmHg Glaucoma usually associated with IOP elevation 复旦大学附厲眼耳鼻喉科医院
Intraocular pressure （IOP） • Normal range 10~21mmHg • 24h fluctuation <= 8mmHg • Inter-eye difference <= 5mmHg • Glaucoma usually associated with IOP elevation
Tonometry 角膜和压平头刚接 触时反光的半圆环 复旦大学附厲眼耳鼻喉科医院
Tonometry
Aqueous Humor Dynamics IOP=F/C+EVP Aqueous humor circulation Trabecular outflow Uveoscleral outflow 复旦大学附厲眼耳鼻喉科医院
Aqueous Humor Dynamics IOP=F/C+EVP • Aqueous humor circulation – Trabecular outflow – Uveoscleral outflow
Classification ° Primary glaucoma primary angle closure glaucoma (PACG) primary open angle glaucoma(POAg) ° Secondary glaucoma Congenital glaucoma 复旦大学附厲眼耳鼻喉科医院
Classification • Primary glaucoma – primary angle closure glaucoma (PACG) – primary open angle glaucoma (POAG) • Secondary glaucoma • Congenital glaucoma
Primary angle closure glaucoma e复具大学附
Primary angle closure glaucoma
Acute angle closure glaucoma Risk factors Age(50 year old) Race South-East Asian, Chinese, etc.) Gender(female) Refractive error(hyperopes) Family history 复旦大学附厲眼耳鼻喉科医院
Acute angle closure glaucoma • Risk factors – Age (>50 year old) – Race (South-East Asian, Chinese, etc. ) – Gender (female) – Refractive error (hyperopes) – Family history
Pathogenesis Anatomical predisposed eyes Short axial length, small cornea, shallow anterior chamber, narrow angle, thicker, anteriorly placed lens Peripheral iris bombe Pupillary block Precipitating factors Dim illumination Emotional stress Acute angle closure Drugs(anticholinergics adrenergic, systemic drugs 复旦大学附厲眼耳鼻喉科医院
Pathogenesis • Anatomical predisposed eyes – Short axial length, small cornea, shallow anterior chamber, narrow angle, thicker, anteriorly placed lens – Peripheral iris bombe – Pupillary block – Acute angle closure • Precipitating factors – Dim illumination – Emotional stress – Drugs (anticholenergics, adrenergics, systemic drugs）
复旦大学附厲眼耳鼻喉科医院