terminology and guidelines for glaucoma ii - Kwaliteitskoepel

More documents

Recommendations

Info

$Refractiechirurgie - Nederlands Oogheelkundig Gezelschap$

Systemic Risk factors for primary angle-closure 8,11 • Female • Family history if primary angle-closure • Necessity of using sympathomimetics or sympatholytics • Race: Eskimo, Asians Primary angle-closure. Descriptions of Glaucoma types 12,13 Primary angle-closure glaucoma is divided into 3 subtypes: • Acute Angle-Closure Glaucoma (AACG) • Intermittent Angle-Closure Glaucoma (IACG) • Chronic Angle-Closure Glaucoma (CACG) Etiology: iridotrabecular contact and/or adhesion Pathomechanism: decreased aqueous outflow due to TM occlusion Features: angle-closed at gonioscopy, without a discernible cause 2.4.1.1 - Acute Angle-Closure Glaucoma (AACG) Etiology: circumferential iris apposition to the trabecular meshwork with rapid and excessive increase in intraocular pressure (IOP) that does not resolve spontaneously. Pathomechanism: see Ch. 2.4.1 Features: Signs: IOP elevated often to 50-80 mm Hg Decreased visual acuity Corneal edema, initially mostly epithelial edema Shallow or flat peripheral anterior chamber Peripheral iris pushed forward and in contact with Schwalbe’s line. Gonioscopy: angle-closure 360 degrees Pupil mid-dilated and reduced or no reactivity Venous congestion and ciliary injection Fundus: disc edema, with venous congestion and splinter hemorrhages, or the disc may be normal or show glaucomatous escavation Bradycardia or arrhythmia Gonioscopy clues from the other eye Symptoms: Blurred vision “Halos” around lights Pain Frontal headache of variable degree on the side of the affected eye Nausea and vomiting, occasionally Palpitations, abdominal cramps, occasionally 2.4.1.2 - Intermittent Angle-Closure Glaucoma (IACG) Etiology: similar but milder clinical manifestations than AACG, it resolves spontaneously. Pathomechanism: see ch. 2.4.1 Features: Signs: May vary according to amount of appositional closure of chamber angle and mimic acute angle-closure in a mild form. When not on miotics, pupil is round and reactive Ch. 2 - 15 EGS
The optic disc rim may show atrophy with an afferent pupillary defect Symptoms: Mild, intermittent symptoms of acute angle-closure type 2.4.1.3 - Chronic Angle-Closure Glaucoma (CACG) Etiology: permanent synechial closure of any extent of the chamber angle as confirmed by indentation gonioscopy. Pathomechanism: see Ch. 2.4.1 Features: Signs: Peripheral anterior synechiae of any degree at gonioscopy IOP elevated to a variable degree depending on the extent of angle-closure, above 21 mm Hg Visual acuity according to functional status (may be normal) Damage of optic nerve head compatible with glaucoma Visual field defects “typical” of chronic glaucoma may be present Superimposed intermittent or acute angle-closure possible Symptoms: Visual disturbances according to functional states Usually no pain; sometimes discomfort Transient “haloes” when intermittent closure of the total circumference causes acute IOP elevations 2.4.2 - STATUS POST ACUTE ANGLE-CLOSURE ATTACK Etiology: previous episode of acute angle-closure attack Pathomechanism: see Ch. 2.4.1 Features: Signs: Patchy iris atrophy Iris torsion/spiralling Posterior synechiae Pupil either poorly reactive or non reactive “Glaukomflecken” of the anterior lens surface Peripheral anterior synechiae on gonioscopy Endothelial cell count can be decreased 2.4.3 - THE “OCCLUDABLE” ANGLE; ACR (Angle-Closure Risk) Etiology: pupillary block, plateau iris or lens; each component plays different roles in different eyes Pathomechanism: see Ch. 2.4.1 Features: Signs: Iridotrabecular apposition and/or PAS IOP elevation may be present Fellow eye of acute angle-closure attack Fellow eye of documented non-secondary angle-closure Ch. 2 - 16 EGS
Page 2 and 3:
ISBN: 88-87434-13-1 Editrice DOGMA
Page 4 and 5:
ACKNOWLEDGEMENT This work was made
Page 6 and 7:
2.2.5 - Primary Open-Angle Glaucoma
Page 8 and 9:
Foreword These Definitions and Guid
Page 10 and 11:
INTRODUCTION The aim of the book is
Page 12 and 13:
Since resources are limited worldwi
Page 14 and 15:
II - RANDOMIZED CONTROLLED TRIALS F
Page 16 and 17:
II.3 - COLLABORATIVE NORMAL TENSION
Page 18 and 19:
No stratification for stage of dise
Page 20 and 21:
II. 6. 3 - from CNTG 1. Therapy tha
Page 22 and 23:
References 1) The Ocular Hypertensi
Page 24 and 25:
I - QUESTIONS TO ASK TO YOUR GLAUCO
Page 26 and 27:
III - ABNORMAL THRESHOLD VISUAL FIE
Page 28 and 29:
V - GONIOSCOPIC OPEN ANGLES SOME DI
Page 30 and 31:
VII - TREATMENT STEPLADDER JUVENILE
Page 32 and 33:
IX - MONOTHERAPY (in alphabetic ord
Page 34 and 35: XI - MANAGEMENT ACUTE ANGLE CLOSURE
Page 36 and 37: XIII - ANTIMETABOLITES FOR WOUND MO
Page 38 and 39: CHAPTER 1 PATIENT EXAMINATION
Page 40 and 41: Other methods 22-25 : Air-puff tono
Page 42 and 43: References 1) Martin XD. Normal int
Page 44 and 45: 1.2 - GONIOSCOPY Gonioscopy is a fu
Page 46 and 47: 1 2 3 4 Fig. 1 Dynamic indentation
Page 48 and 49: The Spaeth classification Insertion
Page 50 and 51: References 1) Palmberg P. Gonioscop
Page 52 and 53: small - size mid - size large - siz
Page 54 and 55: Fig. 5 A) Cirumlinear vessel, B) Ba
Page 56 and 57: 1.3.4.3 - OCT The Optical Coherence
Page 58 and 59: 31) Carpineto P, Ciancaglini M, Zup
Page 60 and 61: central 24 or 30 central degrees re
Page 62 and 63: A retinal sensitivity value worse t
Page 64 and 65: HODAPP CLASSIFICATION 31 EARLY GLAU
Page 66 and 67: References 1) Bengtsson B, Heijl A,
Page 68 and 69: 1.5 - BLOOD FLOW 1.5.1 - VASCULAR F
Page 70 and 71: 28) Flammer J, Orgul S, Costa VP, O
Page 72 and 73: All forms of glaucoma should be cla
Page 74 and 75: 2.2 - PRIMARY OPEN-ANGLE GLAUCOMAS
Page 76 and 77: 2.2.4 - PRIMARY OPEN-ANGLE GLAUCOMA
Page 78 and 79: 2.3 - SECONDARY OPEN-ANGLE GLAUCOMA
Page 80 and 81: 2.3.1.6 - Glaucoma due to intraocul
Page 82 and 83: 2.4 - PRIMARY ANGLE-CLOSURE Primary
Page 86 and 87: OCCLUDABLE ANGLE: “Occludable”
Page 88 and 89: 2.5.3 - SECONDARY ANGLE-CLOSURE GLA
Page 90 and 91: CHAPTER 3 TREATMENT PRINCIPLES and
Page 92 and 93: Furthermore, blindness may occur de
Page 94 and 95: T A R G E T I O P Target IOP range
Page 96 and 97: Practical points for topical medica
Page 98 and 99: 3.3.1.1 - Category: ADRENERGIC AGON
Page 100 and 101: 3.3.1.2 - Category: ADRENERGIC ANTA
Page 102 and 103: 3.3.1.3 - Category: CARBONIC ANHYDR
Page 104 and 105: 3.3.1.4 - Category: PARASYMPATHOMIM
Page 106 and 107: 3.3.1.5 - Category: PROSTAGLANDIN D
Page 108 and 109: Drug interactions Precipitation occ
Page 110 and 111: COMBINATION THERAPY Starting* Addit
Page 112 and 113: 3.3.2.2 - Category: ADRENERGIC ANTA
Page 114 and 115: Pregnancy and nursing mothers Only
Page 116 and 117: 3.5 - LASER SURGERY 3.5.1 - LASER I
Page 118 and 119: 3.5.2 - LASER TRABECULOPLASTY 77-89
Page 120 and 121: 3.5.4 - CYCLOPHOTOCOAGULATION Indic
Page 122 and 123: Although medical therapy is still t
Page 124 and 125: 3.6.4 - COMPLEX CASES Complicated g
Page 126 and 127: Post-operative use Concentration: 0
Page 128 and 129: 25) Janz NK, Wren PA, Lichter PR, M
Page 130 and 131: (Rescula TM ) in patients with glau
Page 132 and 133: in white patients with open-angle g
Page 134 and 135:
CHAPTER 4 TREATMENT GUIDELINES
Page 136 and 137:
4.2 - PRIMARY OPEN-ANGLE GLAUCOMAS
Page 138 and 139:
4.2.7 - OCULAR HYPERTENSION (OH) Al
Page 140 and 141:
4.3.1.7 - Glaucoma associated with
Page 142 and 143:
• Withdrawal of aqueous from vitr
Page 144 and 145:
4.5 - SECONDARY ANGLE-CLOSURE GLAUC
Page 146 and 147:
4.5.3 - SECONDARY ANGLE-CLOSURE GLA
Page 148 and 149:
NOTES
Page 150 and 151:
NOTES
Page 152:
NOTES
show all

terminology and guidelines for glaucoma ii - Kwaliteitskoepel

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?