正常眼压青光眼的基本问题及其认识方法

正常眼压青光眼在临床和研究上存在的诸多困惑,既出自疾病本身,更多地源于我们临床型思维和认识方法的局限性。正常眼压青光眼临床表现与病理本质关系复杂并相距甚远,基于临床思维的各种研究难以真正解决发病机制问题。正常眼压青光眼的基本问题和特殊性恰在“正常眼压”及其与视神经损害的关系上。正常群体眼压范围不等于正常个体眼压区间;眼压高低不是质的差异,仅是量的差别;眼压即使正常,对眼组织也有“生理性”压迫作用。因此,要从病因、病理生理、病理,到临床表现,全面合理地解释正常眼压青光眼的眼压与视神经损害的关系。

The basic problems of normal tension glaucoma and their understanding methods

Many perplexities and difficulties in the clinical and research of normal tension glaucoma(NTG)arise not only from the disease itself,but also from the limitations of our clinical thinking and understanding methods.The relationship between the clinical manifestations and its pathological nature is complicated and far apart in NTG.So various studies based on clinical thinking are difficult to really solve the pathogenesis problems.The basic problems and particularity of NTG are pointed out asnormal intraocular pressure(IOP)and its relationship with optic nerve damage.The range of IOP in normal population is not equal to IOP in normal individual.IOP values are not qualitative differences,only quantitative differneces.In NTG,even if the IOP is normal,it has aphysiologicalcompression effect on the eye tissue.Therefore,it is necessory to comprehensively and reasonably explain the relationship between the IOP and the optic nerve damage from the etiology,phathophysiology,pathology,to clinical manifestations in NTG.