Medical management of angle closure glaucoma

Management of angle closure glaucoma requires an understanding of the underlying pathophysiologic mechanisms. Treatment is aimed at eliminating pupillary block and other causes of angle closure, re-opening the angle, and preventing further damage to the optic nerve by lowering intraocular pressure. Medical therapy plays an important role in the successful management of this condition. This article describes commonly used pharmacologic agents, as well as newer classes of drugs such as topical carbonic anhydrase inhibitors, prostaglandin analogues and selective alpha2- adrenergic agonists. Use of these drugs in several clinically distinct angle closure syndromes and modes of presentation are discussed.

[1]  S. K. Seah,et al.  Randomised Trial Comparing Brimonidine and Timolol in the Initial Management of Acute Angle Closure , 2002 .

[2]  G. Johnson,et al.  The Burden of Trachoma in the Rural Nile Delta of Egypt : a Survey of Menofiya Governorate The Epidemiology of Ocular Trauma in Singapore : Perspective from the Emergency Service of a Large Tertiary Hospital , 2005 .

[3]  C. Tham,et al.  The Efficacy and Safety of Combined Phacoemulsification, Intraocular Lens Implantation, and Limited Goniosynechialysis, Followed by Diode Laser Peripheral Iridoplasty, in the Treatment of Cataract and Chronic Angle-closure Glaucoma , 2001, Journal of glaucoma.

[4]  T. Aung,et al.  Long-term clinical course of primary angle-closure glaucoma in an Asian population. , 2000, Ophthalmology.

[5]  R K John,et al.  Angle-closure glaucoma in an urban population in southern India. The Andhra Pradesh eye disease study. , 2000, Ophthalmology.

[6]  D. Machin,et al.  The prevalence of glaucoma in Chinese residents of Singapore: a cross-sectional population survey of the Tanjong Pagar district. , 2000, Archives of ophthalmology.

[7]  S. K. Seah,et al.  Trabeculectomy for acute primary angle closure. , 2000, Ophthalmology.

[8]  Y. Chan,et al.  Comparison of the intraocular pressure-lowering effect of latanoprost and timolol in patients with chronic angle closure glaucoma: a preliminary study. , 2000, Ophthalmology.

[9]  Y. F. Chen,et al.  Efficacy of latanoprost as an adjunct to medical therapy for residual angle-closure glaucoma after iridectomy. , 2000, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[10]  Y. Choong,et al.  Acute angle closure glaucoma: An evaluation of a protocol for acute treatment , 1999, Eye.

[11]  R. Ritch,et al.  Combined phacoemulsification and goniosynechialysis for uncontrolled chronic angle-closure glaucoma after acute angle-closure glaucoma. , 1999, Ophthalmology.

[12]  C. Tham,et al.  Immediate argon laser peripheral iridoplasty as treatment for acute attack of primary angle-closure glaucoma: a preliminary study. , 1998, Ophthalmology.

[13]  P. Foster,et al.  Incidence of acute primary angle-closure glaucoma in Singapore. An island-wide survey. , 1997, Archives of ophthalmology.

[14]  S. Shirato,et al.  Stevens-Johnson syndrome induced by methazolamide treatment. , 1997, Archives of ophthalmology.

[15]  P. Foster,et al.  Glaucoma in Mongolia. A population-based survey in Hövsgöl province, northern Mongolia. , 1996, Archives of ophthalmology.

[16]  A. Alm,et al.  Effects on intraocular pressure and side effects of 0.005% latanoprost applied once daily, evening or morning. A comparison with timolol. Scandinavian Latanoprost Study Group. , 1995, Ophthalmology.

[17]  M. Yablonski,et al.  Effects of brimonidine on aqueous humor dynamics in human eyes. , 1995, Archives of ophthalmology.

[18]  R. Brubaker,et al.  The effects on aqueous dynamics of PhXA41, a new prostaglandin F2 alpha analogue, after topical application in normal and ocular hypertensive human eyes. , 1993, Archives of ophthalmology.

[19]  M. Yablonski,et al.  Effects of PhXA41, A New Prostaglandin F2α Analog, on Aqueous Humor Dynamics in Human Eyes , 1993 .

[20]  N. Congdon,et al.  Issues in the epidemiology and population-based screening of primary angle-closure glaucoma. , 1992, Survey of ophthalmology.

[21]  I. Gomolin,et al.  Acetazolamide Blood Concentrations are Excessive in the Elderly: Propensity for Acidosis and Relationship to Renal Function , 1989, Journal of clinical pharmacology.

[22]  O. Geyer,et al.  A double-masked study of timolol and pilocarpine combined. , 1988, American journal of ophthalmology.

[23]  R. Brubaker,et al.  Aqueous flow is reduced by the alpha-adrenergic agonist, apraclonidine hydrochloride (ALO 2145). , 1988, Ophthalmology.

[24]  L. Mogk,et al.  Blood dyscrasias and carbonic anhydrase inhibitors. , 1988, Ophthalmology.

[25]  P. Airaksinen,et al.  A double-masked study of timolol and pilocarpine combined. , 1988, American journal of ophthalmology.

[26]  R. Lowe.  Persistent symptoms after peripheral iridectomy for angle closure glaucoma. , 1987, Yan ke xue bao = Eye science.

[27]  R. Ritch,et al.  The treatment of acute angle-closure glaucoma revisited. , 1984, Annals of ophthalmology.

[28]  J. Wilensky,et al.  Laser iridectomy in the management of chronic angle-closure glaucoma. , 1984, American journal of ophthalmology.

[29]  R. Ritch.  Argon laser treatment for medically unresponsive attacks of angle-closure glaucoma. , 1982, American journal of ophthalmology.

[30]  M. Kass,et al.  Timolol and acetazolamide. A study of concurrent administration. , 1982, Archives of ophthalmology.

[31]  R. Brubaker,et al.  The effects of timolol maleate and acetazolamide on the rate of aqueous formation in normal human subjects. , 1982, American journal of ophthalmology.

[32]  R. Mapstone.  Acute shallowing of the anterior chamber. , 1981, The British journal of ophthalmology.

[33]  P. Airaksinen,et al.  Management of acute closed-angle glaucoma with miotics and timolol. , 1979, The British journal of ophthalmology.

[34]  P. Hung,et al.  Provocation and mechanism of angle-closure glaucoma after iridectomy. , 1979, Archives of ophthalmology.

[35]  T. Zimmerman,et al.  Timolol, dose response and duration of action. , 1977, Archives of ophthalmology.

[36]  R. Mapstone,et al.  Miotics in closed-angle glaucoma. , 1975, The British journal of ophthalmology.

[37]  R. Mapstone.  Closed-angle glaucoma. Theoretical considerations. , 1974, The British journal of ophthalmology.

[38]  R. Lowe.  Acute angle closure glaucoma: acetazolamide therapy. , 1973, Australian journal of ophthalmology.

[39]  D. Coleman,et al.  Pilocarpine: Effect on the Anterior Chamber and Lens Thickness , 1972 .

[40]  S. Drance,et al.  The effects of miotics on anterior-chamber depth. , 1969, American journal of ophthalmology.

[41]  W. Ferguson,et al.  Adverse effects after glycerol orally and mannitol parenterally. , 1966, Archives of ophthalmology.

[42]  P. Chew,et al.  Argon laser iridoplasty in chronic angle closure glaucoma , 2004, International Ophthalmology.

[43]  E. Greve.  Primary angle closure glaucoma: Extracapsular cataract extraction or filtering procedure? , 2004, International Ophthalmology.

[44]  T. Aung,et al.  Acute primary angle-closure: long-term intraocular pressure outcome in Asian eyes. , 2001, American journal of ophthalmology.

[45]  Romano Pe,et al.  Association for Research in Vision and Ophthalmology. , 2000 .

[46]  L. Rosenberg,et al.  Combination of systemic acetazolamide and topical dorzolamide in reducing intraocular pressure and aqueous humor formation. , 1998, Ophthalmology.

[47]  C. Camras.  Comparison of latanoprost and timolol in patients with ocular hypertension and glaucoma: a six-month masked, multicenter trial in the United States. The United States Latanoprost Study Group. , 1996, Ophthalmology.

[48]  M. Yablonski,et al.  Effects of PhXA41, a new prostaglandin F2 alpha analog, on aqueous humor dynamics in human eyes. , 1993, Ophthalmology.

[49]  Y. Kitazawa,et al.  Use of apraclonidine to reduce acute intraocular pressure rise following Q-switched Nd:YAG laser iridotomy. , 1989, Ophthalmic surgery.

[50]  P. Atkinson,et al.  Extracapsular cataract extraction and posterior chamber lens implantation in patients with primary chronic angle-closure glaucoma: Effect on intraocular pressure control , 1989, Eye.

[51]  M. Kass,et al.  Timolol and acetazolamide. , 1983, Annals of ophthalmology.

[52]  R. Ritch.  The treatment of chronic angle-closure glaucoma. , 1981, Annals of ophthalmology.