眼科 ›› 2012, Vol. 21 ›› Issue (1): 19-23.

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正常眼压性青光眼病因学相关因素与分型

陈燕云, 梁远波, 乔利亚   

  1. 100730 首都医科大学附属北京同仁医院  北京同仁眼科中心  北京市眼科与视觉科学重点实验室(陈燕云、乔利亚);香港中文大学眼科及视觉科学学系(梁远波)
  • 收稿日期:2011-09-14 出版日期:2012-01-25 发布日期:2012-01-12
  • 通讯作者: 通信作者:梁远波,Email:yuanboliang@gmail.com

Types and pathogenesis of normal tension glaucoma

 CHEN  Yan-Yun, LIANG  Yuan-Bo, QIAO  Li-Ya   

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Lab., Beijing 100730, China
  • Received:2011-09-14 Online:2012-01-25 Published:2012-01-12

摘要: 正常眼压性青光眼(NTG)的青光眼性视神经损伤和视野丢失在临床表现和发病机制上与原发性开角型青光眼(POAG)有一定差异。我们将NTG的发病机制可分为缺血缺氧型(存在低血压,合并心肌缺血、头痛和偏头痛、血浆内皮素-1水平增加、血小板聚集能力增加、缺血性颅脑病变等)、免疫异常型(存在单克隆丙种球蛋白血症以及抗视紫红质抗体、热休克蛋白的自身抗体、神经元特异性烯醇酶抗体、抗磷脂抗体异常)、神经退行性病变相关型(如Alzheimer病、Parkinson病)、内分泌异常型(如甲状腺功能低下)、眼压与颅内压失衡等,这将有助于NTG患者临床治疗方式的转变。(眼科,2012,21:19-23)

关键词: 正常眼压性青光眼/病因学, 正常眼压性青光眼/病理生理学

Abstract: The clinical manifestation (including glaucomatous optic nerve damage and visual field damage) and pathogenesis of normal tension glaucoma are in some degree different from primary open angle glaucoma. In this review, the hypothesis of normal tension glaucoma pathogenesis is divided into different subgroups, including hypoxia ischemia subgroup (a link with arterial hypotension, myocardial ischemia, headache and migraine, increased plasma levels of endothelin-1, increased platelet aggregation, or ischemia encephalopathy, etc), abnormal autoimmunity subgroup (with monoclonal gammopathy, anti-rhodopsin antibody, autoantibodies to Heat Shock Proteins , neuron-specific enolase autoantibodies, or antiphospholipid antibodies), neurodegenerative diseases related subgroup (Alzheimer disease, Parkinson disease), abnormal endocrinological subgroup(e.g., hypothyroidism). The hypothesis of normal tension glaucoma pathogenesis subgroups will benefit for the clinical management. (Ophthalmol CHN, 2012, 21: 19-23)

Key words: normal tension glaucoma/pathogenesis, normal tension glaucoma/ pathophysiology