高度近视与原发性开角型青光眼关系的研究进展

临床和实验研究均发现,青光眼患者近视发生率高于非青光眼人群。反之,近视,尤其高度近视(high myopia,HM)人群较其它人群更常伴有青光眼。当HM与原发性开角型青光眼(primary open-angle glaucoma,POAG)并存时,病情变得尤其复杂。两者发病机制之间的关系,目前在分子和基因水平的研究重点是:胶原基因学说和升压基因学说。从病理学角度讲,高度近视与青光眼都是胶原病变;此外,二者的小梁网细胞在糖皮质激素诱导下易表达特异性蛋白,这可能与高度近视、原发性开角型青光眼的TIGR(trabecular meshwork induced glucocorticoid response protein)基因突变有关。本文从流行病学、发病机制、临床特征及诊断注意要点等方面对高度近视与原发性开角型青光眼的关系及研究进展进行综述。

It is found that there is a higher rate of myopia among the patients with glaucoma in the clinical and experimental studies. And the symptom expressions are rather complicated in the patients with high myopia（HM） combined primary open-angle glaucoma（POAG）. For their pathogenesis studies, there are two theories： collagen gene theory and hypertension gene theory. For pathological aspect, both HM and POAG are considered as a disease of characteristic of collagen lesion. More over, both HM and POAG have the special protein expression in trabecular meshwork cells induced by steroids, which is probably closely related to TIGR（trabeeular meshwork induced glucocorticoid response protein） mutation. Now we review the relationship between HM and POAG from the aspects of epidemiological features, pathogenesis, clinic features, as well as diagnosis.