By C. Hong, T. Yamamoto, K.H. Park, Y.Y. Kim
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For example, if the initial IOP is 16 mmHg (within the normal range), then the initial perfusion pressure is 7 mmHg (normal IOP 16 mmHg – normal EVP 9 mmHg). If 1/2 of the circumferential angle is occluded, then the perfusion pressure would be 14 mmHg, and the IOP would be 23 mmHg (14 + 9 = 23 mmHg). ”39 That is, in a healthy eye, an occlusion of the 3/4 of the angle circumference would result in significant IOP elevation. Peripheral anterior synechiae PAS refer to a condition in which the iris adheres to the angle.
32. Gross FJ, Tingey D, Epstein DL. Increased prevalence of occludable angles and angle-closure glaucoma in patients with pseudoexfoliation. Am J Ophthalmol 1994;117:333-6. 33. Sihota R, Lakshmaiah NC, Agawal HC, et al. Ocular parameters in the subgroups of angle closure glaucoma. Clin Exp Ophthalmol 2000;28:253-8. 34. Sihota R, Saxena R, Agarwal H C. Entropion uveae: early sphincter atrophy, signposting primary angle closure glaucoma. Eur J Ophthalmol 2004;14:290-7. 35. Yang M, Aung T, Husain R, et al.
Gonioscopic findings of patch (left) and broad (right) peripheral anterior synechiae. Arrows indicate the extents of the synechiae. 47 This phenomenon has been interpreted in several ways. 48 The concept of creeping angle-closure,26 in which PAS slowly advances forward circumferentially, making the iris insertion appear to become more and more anterior, contributes to our understanding of chronic angle-closure glaucoma. The exact cause of the development of creeping angle closure needs to be determined.