新生血管性青光眼的发病机制及治疗进展

Pathogenesis and treatment of neovascular glaucoma

新生血管性青光眼属于难治性青光眼,病理表现为虹膜及房角新生血管形成、新生血管膜收缩牵拉,使虹膜和房角黏连关闭,阻碍房水外流导致眼压升高,产生剧烈眼痛或头痛,进而损害视神经,造成视力急剧下降,严重者可导致失明。目前,治疗新生血管性青光眼主要有全视网膜激光光凝术、注射抗血管内皮生长因子、局部或全身应用降眼压药物以及抗青光眼手术等多种方法,从而尽可能地减少新生血管形成、保留视功能和改善症状。但由于新生血管性青光眼复杂的发病机制和病理改变,在临床上其治疗较原发性青光眼更为困难,预后也更差。因此,通过了解其发病机制和治疗方法,可以更好地在不同病情下选择最科学的治疗策略。故文章将对新生血管性青光眼的发病机制和治疗进行归纳和总结,并作一综述。

Neovascular glaucoma is classified as a type of refractory glaucoma.Its pathological manifestation is the formation of neovascularization of iris and chamber angle,and then the formation of neovascularization membrane.The contraction and traction of neovascularization membrane make the iris and chamber angle adhesion close,which leads to the obstruction of aqueous humor outflow and the sharp increase of intraocular pressure.Excessive intraocular pressure not only causes severe headache and eye pain,but also damages the optic nerve and affects the patient’s vision,which can lead to blindness.At present,there are many methods for the treatment of neovascular glaucoma,such as panretinal photocoagulation,anti-vascular endothelial growth factor,local or systemic administration of intraocular pressure lowering drugs and anti-glaucoma surgery.The aim is to reduce neovascularization,preserve visual function and improve symptoms as much as feasible.However,due to the complex pathogenesis and pathological changes of neovascular glaucoma,the treatment of neovascular glaucoma is more difficult than primary glaucoma,and the prognosis is worse.Understanding its pathogenesis and treatment methods can aid in selecting the most appropriate treatment strategy based on individual circumstances.Therefore,this review will summarize the pathogenesis and treatment of neovascular glaucoma.