国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (2): 81-87.doi: 10.3760/cma.j.cn115500-20241019-25201

• 综述 •    下一篇

近视眼并发原发性闭角型青光眼的解剖特点及机制

柳研  曹国凡  朱君雅  张林雨   

  1. 南京医科大学眼科医院,南京 210029
  • 收稿日期:2024-10-19 出版日期:2025-04-22 发布日期:2025-04-10
  • 通讯作者: 曹国凡,Email:caoguofan587@163.com

Anatomical characteristics and mechanisms of primary angle closure glaucoma in myopic eyes

Liu Yan, Cao Guofan, Zhu Junya, Zhang Linyu   

  1. he Affiliated Eye Hospital of Nanjing Medical University, Nanjing 210029, China
  • Received:2024-10-19 Online:2025-04-22 Published:2025-04-10
  • Contact: Cao Guofan, Email: caoguofan587@163.com

摘要: 近视通常被认为是原发性闭角型青光眼(primary angle-closure glaucoma,PACG)的一种保护因素。然而,随着环境因素的变化和近距离视觉活动的增加,近视的患病率显著上升,但PACG的发病率却并未下降。研究发现近视作为对PACG的保护作用实际是指轴性近视而不是屈光性近视。非瞳孔阻滞机制在高度近视的房角关闭患者中比在一般房角关闭人群中更常见。长眼轴PACG患者的房角关闭多以非瞳孔阻滞机制尤其是高褶虹膜构型为主。晶状体厚度的增加和位置前移形成较浅的前房,前房宽度变窄及角膜边缘扁平导致房角狭窄,虹膜面积、厚度、曲率的变化,以及睫状体、神经血管因素等也均在轴性近视眼的房角关闭进程中起到一定的促进作用。 (国际眼科纵览,2025, 49: 81-87

关键词: 原发性闭角型青光眼, 近视, 眼轴, 前房深度

Abstract: Myopia is generally considered a protective factor for primary angle-closure glaucoma (PACG). However, with the change of environmental factors and the increase of near visual activity, the prevalence of myopia increased significantly, but the incidence of PACG did not decrease accordingly. Myopia, as a protective effect on PACG, actually refers to axial myopia rather than refractive myopia. The non pupillary block mechanism is more common in patients with high myopia and angle closure than in the general angle closure population. The angle closure in PACG patients with long axial length is mainly caused by non pupillary block mechanisms, especially the high pleated iris configuration. The increase in lens thickness and forward movement form a shallow anterior chamber, narrowing the width of the anterior chamber and flattening the corneal edge leading to angle narrower. Changes in iris area, thickness, curvature, as well as ciliary and neurovascular factors also play a certain promoting role in the process of angle closure in axial myopia. (Int Rev Ophthalmol, 2025, 49:  81-87)

Key words: primary angle-closure glaucoma, myopia, axial length, anterior chamber depth