EyeWorld Korea September 2014 Issue

September 2014 19 EWAP GLAUCOMA Views from Asia-Pacific YAO Ke, MD Professor, Eye Institute of Zhejiang University Eye Center, Second Affiliated Hospital of Zhejiang University, College of Medicine 88 Jiefang Road, Hangzhou, 310009, China Tel./Fax no. +86-571-87783897 xlren@zju.edu.cn ೥ नҀ פ ֳણ(angle closure glaucoma, AC*)અ ੭࠾ ݬ ੸ ઌ૚ਁ ޓ ܅گ ੌ د ݳ ٙ ৈ१ৈઌ ଙ ز ਁࣳ ৢ 1. a2. %ܾ ً ׬ د 1,2 . ૻӵઌ ଙ ز ਁࣳ ੘ ࠋ ऀ ೥न Ҁ פ ֳણ(primary angle-closure glaucoma, PAC*)੸ ੘ ࠋ ऀ ґ ࠒ Ҁ פ ֳણ(primary open-angle glaucoma, P2A*) دࡂ ً ඕഡٙ ԓ ੭࠾ ݬ ੸ Ӌܹઘਁࣳ ੭અടҲ ً ׬ ৔ ࡅ .د ੘ਁࣳ ઺ ࠒ Ӵ૒ѿ ૘੸ 0 ف ೊ ࠕ ف ֳણ ൝ઘ ݴ ઘ૲ ાടؘٙ ஢੻ಶ ࣥஔെ ߸ӄ(ultrasound Eiomicroscopy, 8%0)੹ ࣏ੋടਉ ઺ ࠒ Ҁઊ ૘ң֢ ઍ ࡘ ೥न ٻ ৰ ઔ ؘ ҫ੹ ࠋ ҽഡ .د PASѿ 180٩ ݴ ׉଒ ৌؘ ൝ઘ ڝ ਁࣳ ٳ Ӗୱ ز ੹ ਯ൛ടԞ ੥ന ࢆ ݱ Ӌ ࡻӯહ ൭Әહઌ ૲࠹ ܩ ࡘ ઊસ ൙୼઻ґी(laser peripheral iridotomy, /P,)੹ ૲ ܾ ५१ഡ .د ࠕ ֳણӘ פ ֳણ ़ी੹ തՌ ട޷ ഡ ࠤ અ ़ीܾ ણԞҁ פ ֳણ੹ ౿ૂടӋ ࠕ ֳણ ़ ी ކ യ੹ ࠋ ڹ ࣥഢ ़ ઔؘ ,2P ࣛ०੹ ਙ ࠒ ഢ ़ ઔ .د 2011 ך ऀઌ ࠕ ֳણ AA2 ࣷ൑ ௗ ݑ ೂౣ ѿઊ ܅ڙ ઌ(AA2 Preferred Practice Pattern *uidelines Cataract in the Adult Eye 2011)ਁ ݱگ ޷ ࠕ ֳણ ़ीઅ ઍୱ હ੾଑੸ ൝ઘઅ ੄Ӵਁ ސ ଒ ৌؘ १ܲ Ԟ ؟ઊ޵ ࠕ ֳણ ़ीܾ ഥ ݼ હઌ १ܲ ґࣷ ѿ؟ऀ੹ ૂӖഡ د 3 . AC* ൝ઘਁࣳ ಉ޻ ़ ીஔ હ஺ ކ ഡ د ؘ ҫ੸ Ӡ ࠨ ੥ഡ ץ અѿ ച੄ട ࠕ .د ֳણ હ஺ी ކ ઊ ઺ ࠒ ઊ ૘੸ ӄ ੌ ,2P ݴ ૵ઍ ़ ઔ଒ ކ ೥नҀઊ 180٩ ઊࣛઌ PAC*ਁࣳ ԓ ൭Әਁ ف നؘࣳ ઑࣛ਌ Ӵਭ १സ੹ ً നৡ ഡ .د *oniosynechialysis ݴ നৡ ടؘ଒ਁ ف ഡ ҿી੸ ੥സӘ ઊ ښ ੹ ץ અഡ ൲ਁ ৊Ә઺ ߚ અѿ ֳܱৡ ഡ ࡅ .د ઌ੸ Ԟҁઊ ޓ ੌ ਠܑ ٻ ଒ ৌ੸ PASѿ 180٩ ઊࣛਁࣳ 270٩ ઊട ޷ ࠕ ֳણ ़ीӘ തՌ goniosynechialysis ݴ ५१ഡ .د ࣼ੭૲઻ૂी੹ ഢ ച੄ѿ ઔؘ, ಡඥ ৊৒ઊ ׬੸ AC* ൝ઘ ڝ ਁҲ ઍୱહ੶ܾ ࠕ ֳણ ़ी੹ १٩ഢ଒ ߜ ݴ ੹ ച੄ѿ ઔ ކ .د ऀ ೥नҀ פ ֳણ ൝ઘ֢ މ Ԟ פ ֳણ ൝ઘਁҲ ؘ ࠕ ֳણ ़ीઊ פ ֳણઅ ଔര੹ ޅ ؘٙ ா࡚ട଒ ৌӋ ࣼ੭૲ ઻ૂीઊ ച੄ടӋ ࡜ ѿഗടԞ ߚڹ ਁ ࡅ ઌ੸ ઊ ܟ ഡ ҽനਁ ਯ઺ඥ ٳ અട଒ؘ ৌؘ .د ഡ೟, ࣼ੭૲ ઻ૂ ी Ԟؘ ா࡚ඥ ٻشࠋ ৼӋ ३݊ഢ ކ ട .د ़ીஔ ஢੻ಶ ੭൛ ࣼ੭૲઻ૂी(PhacotraE- eculectomy)੸ ࠕ ֳણ ़ी ކ ടؘ ҫ , دࡂ 2P ౿ૂѿ ً ઝ ઊ ݗ ৰ଒Ӌ ीԞѿ ࡃ ઠട ଒٩ ৌ .د ़ીஔ ஢੻ಶ ੭൛ ࣼ੭૲઻ૂी੸ ़ी ൲ ઺ ࠒ ઊ ৪ৈ଒ؘ ҫ੹ ૵ઊӋ, ࠕ ֳણ ़ी ކ ഡ ൲ ,2Pѿ ࢆ ݱ Ҳ ଑ѿടؘ ҫ੹ ਙ ࠒ ട޵, Ӌ٩ פ ֳણ ൝ઘ ڝ અ ચਉ १ܲ੹ ࡂ ൑ഡ .د ReferenceV 1. He 0, )oster PJ, *e J, et al. Prevalence and clinical characteristics of glau- coma in adult Chinese: a population-Eased study in /iZan District, *uang]hou. ,nvest 2phthalmol 9is Sci. 2006;47:2782…2788. 2. Casson RJ, NeZland HS, 0uecke J. Prevalence of glaucoma in rural 0yanmar: the 0eiktila Eye Study. %r J 2phthalmol. 2007;91:710…714. 3. American Academy of 2phthalmology Cataract and Anterior Segment Panel. Preferred Practice Pattern *uidelines.Cataract in the Adult Eye. San )rancisco, CA: American Academy of 2phthalmology; 2011. AvailaEle at: ZZZ.aao.org ppp Editors±note: Dr. <ao has no financial interests related to his comments. Edgar U. LEUENBERGER, MD, DPBO Associate Professor, Asian Eye Institute and University of the East RM College of Medicine 9F Phinma Plaza, Rockwell Center, Makati City, Philippines Tel. no. +632-8982020 Fax no. +632-8982002 EUL@asianeyeinstitute.com ೥ नҀ੹ ३ङടҲ ࣷ࠺ടؘ ࠒ ࠩ੸ ंԔ ڢ ੶ܾ limEal chamEer depth ݴ ҩ࣏ട Ӌ ത઒Ә ࡻത઒ ઺ ࠒ Ҁӄҩ࣏ ݴ ടؘ ҫઊ , .د ridotraEecular (,T) contact, ૲ ࡘ࠹ ઺ ࠒ ੭୲(peripheral anterior synechiae, PAS), ׬੸ ,2P, פ ֳણऀ १३ӄ࠾଑ (glaucomatous optic neuropathy, *2N)ઊ ઔӋ ৺Ӌਭ Ӛܳઊ ઔ੹ ,ڹ ൝ઘ ڝ ੹ د ੻ 4ґ Ӷ੶ܾ ࡚ ݩ ഢ ़ ઔ :د ੘ ࠋ ऀ ೥नҀ અ଑(primary angle closure suspect, PACS), ੘ ࠋ ऀ ೥नҀ(primary angle closure, PAC), ੘ ࠋ ऀ ೥नҀ פ ֳણ(prima- ry angle closure glaucoma, PAC*), Ԛऀ ೥नҀ ੥സ(acute angle closure crisis, AACC). Ҳ د ѿ ઊ ڝ ൝ઘ ڝ ਁҲ ઺৊ ࡘ ਕࣛ ણࡻ ݴ ࣏ੋട޷ ઑࣛઅѿ ઺ ࠒ ԩઊ, lens vault, ൙୼ ڂ Ռ, ,T contact, Ӌ੘൙୼ ૔થ ݴ ೤ѿഢ ़ ઔ .د ԓ ݼ Ӌ ֢ࣳ ѿણ ൭Әહ ઌ ௗ ݑ ઺ ܛ ੹ ބ ܳടӋ, ҿӘ ݴ ೤ѿട޵, ൝ઘ ݴ ӯ੮ടؘٙ ़ ࠃ ٳ ઘ ٳ ԞԞܾ ࡘ ౡ ৴੸ ૲੄ ી ݴࡂ ࣏ੋഢ ़ ઔ .د ़ીஔ ݴ ૂңടؘ ҫઊ ೥नҀ Ԟ઺અ ૲੄ ࡘ ࡚੹ ݗد ؘ ҫઊ଒ ކ ௗ ݑ ؘ ൝ઘਁҲ ѿણ ৊઺ടӋ ѿણ ࡻੋ-൭ੰહઌ ҫ੹ ࠅ ౕ੶ܾ നৡ ഡ ࠕ .د ֳણ હ஺ीઅ شࠋ ܾ ൝ઘਭ ीઘਁҲ ௝।હ १ीઊ ً ॕӋ ৊઺ടҲ ٻ ৼ .د ԓ ܣ ਁ٩ ࡜ӴടӋ, ҆ਐ, ޏ ,ݼࠆ ޅ Ҁ ޅ ઊ֢ ൠ ࡘ ࠉ ૚ Ҏઊ १ܲ੹ ੥൉ടؘ ഥ࠾଑ ࠋ ࣥ ੥സ੹ Ӌܱനৡ ഡ .د ,T contactѿ மघ 180٩ਁ ઔӋ, PASѿ ৺Ӌ, ,2Pਭ १३ӄઊ ીࣛઊ޵, १ܲӘ ़ીஔ ѿ ۣܷട޵, ൝ઘѿ ଑ࣛ੹ ࡂ ઊ଒ ৌؘ PACSઅ ӄੌ ࡅ ઌ੸ ઍܳઅ ઺ ࠒ Ҁӄҩ࣏ ݴ ട ਉ Ӛ୵ഢ ҫઊ .د ઺৊ ࡘ 2CTѿ ٳ Ӗୱ ز ൜ઌਁ ٩੒ઊ ٽ ҫઊ .د ઊ ބ અ ౿଑Ә ڂ ౿੹ ൑घടң֢ ޅޏ ҩ࣏ܾ ࡽ ࠤ ടҲ ൜ણी੹ നৡ ടؘ ൝ઘઅ ӄੌ ࡅ ઌ੸ ച੄ਁ ܩ ܅گ ઊસ ൙୼઻ґीӘ ൙୼ऀൌी੹ ടؘ ҫ੹ ࣳॣ଒ ৌؘ .د ़ીஔ ൓్ઊ ७ട ޷ ࠕ ֳણ ़ी੹ ടؘ ҫઊ ؽ ਌ട .د ,T contactѿ மघ 180٩ਁ ઔӋ, PAS֢ ׬੸ ,2P ࠉٳ ݴ ട޵, १३ӄઊ ીࣛઌ PAC અ ӄੌ PAC* ܾ ଔര ٻ ؘ ҫ੹ ਙ ࠒ ടԞ ੥ന دࡂ હԔહઌ ף ܲ੹ നৡ ഡ .د ઊ ܟ ഡ १֢ ݼ ਠਁࣳ ؘ ܩ ઊસ ൙୼઻ґीӘ ൙୼ऀൌीઊ ࡅ ઌઅ 1ୱ ௗ ݑ ࣷ౗ઊ , .د 2P ѿ ӆङനࣳ ࣛ०ടң֢ १Ҁહ੶ܾ ੭અഡ ࠕ ֳણઊ ઔ د ޷ ़ીஔ હ஺ी੹ ५१ഡ .د PAS, ׬੸ ,2P, *2Nઊ ઔؘ અഠહ੶ܾ ౿ૂ ٻ ଒ ৌؘ PAC*અ ӄੌ, ࠕ ֳણ ़ीઊ ൭Әѿ ઔ੹ ҫઊ .د ઊ ܟ ഡ ાԕࠩ੸ ਉӘࠩ ކ ు ً ൭Әહઊ޵ ࣼ੭૲઻ૂीઅ ഥ࠾଑ ੹ ਙ ࠒ തઊ ઒଑ ٻ ৼ .د ֳӘહ ௗ ݑ ਭ ܩ ઊસ ൙୼ऀൌीઊ AACCਭ Ӛܳ ټ ൝ઘઅ ࡜೟҆Ә ׬੸ ,2P ݴ ౿ ૂടؘ ઍୱહ ࠒ ࠩ੶ܾ ઌી ࠊ ৔ .د ԓ ൲ਁ, ம૚ १ीܾ ࠕ ֳણ ़ी੹ ഢ ़ ઔ .د ੄௷ ,ف െ ف અ ࠕ ֳણ ़ीܾ ਌Ӵઘ ڝ ੸ ೥नҀ ଖ൝ ௗ ݑ અ ൭ੋऀ੹ ৊઺ടҲ ਌Ӵഢ ़ ઔৼ ࡅ .د ઌ੸ ம३ ઑࣛ ௗ ݑ ѿઊ ܅ڙ ઌ੹ ބ ܳടؘٙ ٩੒ઊ ٽ ़ ઔؘ ઺ ंӆ ف Ԑ޾ ઑࣛ १സઅ ҿӘ ݴ Ԟ ف ടӋ ઔ .د Editors±note: Dr. /euenEerger has no financial interests related to his comments.