眼压升高是青光眼发生和发展的主要危险因素,视神经损害是各类青光眼的最终结局.围绕这两大核心问题,近年来青光眼的临床和基础研究都取得了很大的进展.青光眼影像学技术发现了新的相关危险因素,并通过在体、实时眼压测量装置的应用提高了对眼压波动的认识;新型青光眼药物的研发和手术方式的改进拓宽了治疗方法的选择范围;基因治疗与干细胞治疗为青光眼的根治提供了新的途径;联合影像学研究及深度学习技术的开发增加了青光眼早期检测和诊断的准确性;视神经保护和再生研究也取得了一定进展.然而,由于青光眼发病机制的复杂性,关于致病基因、环境、解剖等多因素在青光眼发病中的联合作用机制仍待进一步研究.研发新的影像学诊断技术以及基于大数据的人工智能辅助诊断软件平台、寻找基于不同作用机制的新型降压药物、探索视神经保护和再生的有效手段,成为青光眼诊疗技术研究新的课题和方向,青光眼研究仍然面临很大的挑战.%Elevation of intraocular pressure (IOP) is the most eminent risk factor for the presence and progression of glaucoma,which leads to optic nerve damages ultimately.With the advance of ocular imaging technology,several new structural and functional risk factors have been identified.The introduction of in vivo IOP measuring devices enables the real-time monitoring the IOP fluctuation.New anti-glaucoma drugs and surgical methodshave made more options for glaucoma treatment.Gene therapy and stem cell therapy have potential futures for glaucoma.Incorporation of imaging and deep learning techniques could enhance early detection and diagnosis of glaucoma.There were progresses in optic protection and regeneration.More studies are warrant to investigate the joint mechanism of gene,environment,anatomy and other factors,to develop new imaging techniques and artificial intelligence-assisted diagnostic software platform based on big data,to find new antihypertensive drugs based on different targets,and to assess the efficacy and safety of optic protection and regeneration therapies.
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