葛坚青光眼临床研究现状__培训课件.ppt

Trends in Neurosciences, 2006,29(11):632-637 视神经保护的植物疗法机理 中华医学会眼科学分会青光眼组 中华医学会中华眼科杂志编辑委员会 2008.5 北京香山 我国原发性青光眼 诊断和治疗的专家共识 中华眼科杂志，2008，44（9）：862-3 主要内容 青光眼的基本检查 原发性开角型青光眼诊断 原发性闭角型青光眼诊断 4. 原发性开角型青光眼诊断的处理 5. 原发性闭角型青光眼诊断的处理 青光眼的基本检查 眼压检查 在现有各种眼压计测量方法的基础上，建议使用Goldmann压平眼压计进行眼压测量。 推荐 测量24小时动态眼压 (6 times/d) 视野计 可使用各种方法检查 推荐使用计算机自动视野计 青光眼的最基本检查 眼底检查 在使用直接检眼镜检查的基础上，建议采用裂隙灯前置镜检查法和眼底图像记录技术进行眼底检查 房角镜 静态与动态检查 Scheie分类法进行分级 Unmet Needs 尽快推广青光眼诊治共识 尽快开展多中心随机对照临床研究 中国OHTS, AIGS, EMGT… 青光眼治疗的“3A”模式： (Accessible ，Affordable，Accountable) 远景规划 --珠江新城院区 （2011年） 谢  谢  ！ * * CIGTS的目的：初始治疗选择药物或者手术对于新发现的OAG患者的长期效果比较 * * 方法：眼底立体照相随访5年 * 视野进展的相关因素研究：607例新诊断OAG患者随机接受药物或手术治疗，然后每6个月随访一次视野。 * * A Consistently Low IOP Reduces Vision Loss This slide demonstrates the importance of maintaining a consistently low IOP over time. After surgery to reduce IOP, patients with IOP consistently below 18 mm Hg over the 6-year follow-up period had, on average, visual field progression close to zero. Mean IOP during this period in this group of patients was very low (12.3 mm Hg). At later time points during follow-up, the visual field worsened significantly more in patients with IOP of 18 or over at any visit compared with patients who always had IOP under 18. For example, the average visual field defect worsened more in patients with IOP 18 at 75 to 100% of visits (the mean IOP was 14.7 mm Hg in these patients) compared with patients with IOP under 18 mm Hg at all visits (the mean IOP was 12.3 mm Hg in these patients). Reference The advanced glaucoma intervention study (AGIS). 7. The relationship between control of intraocular pressure and visual field deterioration. The AGIS Investigators. Am J Ophthalmol. 2000;130:429-440. * * * * * * * * * * * * * In creating a fixed combination, regardless of its components, there are clear practical and clinical benefits for combining more than 1 medication in a single bottle. The 1-bottle, once-daily administration o