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Interval Angle-closure Glaucoma

Disease Details

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Description: Interval angle-closure glaucoma is a subtype of glaucoma characterized by the episodic obstruction of the drainage angle in the eye, leading to increased intraocular pressure and potential optic nerve damage.
Type: Interval angle-closure glaucoma is not a standard medical term; however, angle-closure glaucoma generally refers to a type of glaucoma where the drainage angle in the eye is blocked, leading to increased intraocular pressure.

As for genetic transmission, angle-closure glaucoma can have a hereditary component, though it often results from anatomical factors that may be passed down through families. It is thought to be polygenic, meaning multiple genes contribute to its development rather than a single gene responsible for inheritance.
Signs And Symptoms: Interval angle-closure glaucoma is a form of glaucoma characterized by intermittent episodes of increased intraocular pressure due to the closure of the anterior chamber angle, through which aqueous humor normally drains.

**Signs and Symptoms:**
1. **Intermittent Blurred Vision:** Vision may become intermittently blurred during episodes.
2. **Eye Pain:** Patients often experience pain in the affected eye.
3. **Halos Around Lights:** Seeing halos around lights, especially in low light conditions.
4. **Redness:** The eye might appear red during episodes.
5. **Headache:** Headaches, often on the same side as the affected eye.
6. **Nausea and Vomiting:** These can accompany the acute episodes of elevated intraocular pressure.
7. **Decreased Vision:** Over time, if untreated, there may be a progressive decrease in vision.

It is important to seek medical attention if experiencing these symptoms to prevent permanent vision loss.
Prognosis: The prognosis for interval angle-closure glaucoma largely depends on the timeliness and effectiveness of the treatment. Early detection and prompt management can significantly improve outcomes and prevent severe vision loss. If left untreated, the condition can lead to permanent optic nerve damage and irreversible blindness. Regular monitoring and follow-up with an eye care professional are essential to manage the condition and preserve vision.
Onset: Interval angle-closure glaucoma typically has an acute onset, often presenting suddenly with symptoms such as severe eye pain, headache, nausea, blurred vision, and seeing halos around lights. The condition can lead to rapid and irreversible vision loss if not promptly treated.
Prevalence: There is limited specific data on the exact prevalence of interval angle-closure glaucoma (also known as intermittent angle-closure glaucoma) as it can be underdiagnosed. However, angle-closure glaucoma in general is more common in certain populations, such as East Asians and Inuit, and it typically affects older adults. Angle-closure glaucoma constitutes about 10% of all glaucoma cases globally.
Epidemiology: Interval-angle closure glaucoma, also known as primary angle-closure glaucoma (PACG), involves the risk factors, prevalence, and demographics associated with the condition.

**Epidemiology of Primary Angle-Closure Glaucoma (PACG)**:
- **Prevalence**: PACG is less common than open-angle glaucoma but is a significant cause of blindness worldwide. The prevalence varies significantly by ethnicity and geography.
- **Ethnic and Regional Variations**: It is most prevalent in East Asian populations, particularly among Chinese, Vietnamese, and Inuit individuals. It is less common in African and European populations. In populations over 40 years old, the prevalence ranges from 0.1% to 4%.
- **Gender Differences**: PACG is more common in women than men, often attributed to anatomical differences such as shorter axial eye length and shallower anterior chamber depth.
- **Age**: The risk of developing PACG increases with age, with most cases occurring in individuals over the age of 50.

Factors contributing to the increased risk of PACG include anatomical predispositions (e.g., smaller anterior chamber, thicker lens), genetic factors, and potentially other systemic conditions. Awareness of these epidemiological factors is critical for early detection and prevention strategies in high-risk populations.
Intractability: Interval angle-closure glaucoma can be challenging to manage, but it is not considered intractable. Early diagnosis and timely treatment are crucial. Management strategies include medications to lower intraocular pressure, laser therapy such as laser peripheral iridotomy, and sometimes surgical intervention to prevent or reduce optic nerve damage and vision loss. Continual monitoring by an eye care professional is essential to adjust treatments as necessary and manage the condition effectively.
Disease Severity: Interval angle-closure glaucoma, also known as intermittent angle-closure glaucoma, is a type of glaucoma where the angle of the anterior chamber intermittently becomes closed.

**Disease Severity:**
This condition can be serious as it may lead to sudden increases in intraocular pressure, causing symptoms like eye pain, blurred vision, halos around lights, and potentially leading to optic nerve damage and permanent vision loss if not appropriately managed.

**Nan:**
The term "nan" is not applicable in the context of interval angle-closure glaucoma. If "nan" is intended to refer to a specific aspect of the disease, please provide additional details for a more accurate response.
Healthcare Professionals: Disease Ontology ID - DOID:13549
Pathophysiology: Interval angle-closure glaucoma, also known as intermittent angle-closure glaucoma, involves periods of elevated intraocular pressure due to transient obstruction of the trabecular meshwork by the iris. This obstruction impairs aqueous humor outflow, leading to increased pressure within the eye. The condition typically occurs in those with anatomically narrow anterior chamber angles. Factors such as pupil dilation, stress, or use of certain medications may precipitate these episodes. The intermittent nature can lead to variable symptoms and may result in optic nerve damage if not properly managed.
Carrier Status: Carrier status is not applicable for interval angle-closure glaucoma, as it is not a condition caused by a single gene mutation that can be simply carried and passed down. Interval angle-closure glaucoma involves periodic episodes of angle closure, leading to increased intraocular pressure and potential vision loss. Genetic factors may contribute to the risk, but it is not defined by a carrier state.
Mechanism: Interval angle-closure glaucoma, also known as intermittent angle-closure glaucoma, is characterized by periodic episodes of elevated intraocular pressure (IOP) due to the closure of the anterior chamber angle. Here are key points about its mechanisms:

**Mechanism:**
- **Anatomical Predisposition:** Individuals with a shallower anterior chamber or a narrower angle are predisposed to angle closure. This is often seen in hyperopic (farsighted) eyes.
- **Pupillary Block:** This is a common mechanism where the flow of aqueous humor through the pupil is obstructed, leading to pressure buildup behind the iris. This causes the iris to bow forward and block the trabecular meshwork, preventing aqueous humor drainage and increasing IOP.
- **Plateau Iris Configuration:** In some cases, the peripheral iris may be positioned anteriorly due to anatomical variances, leading to angle closure regardless of the pupillary block status.

**Molecular Mechanisms:**
- **Familial and Genetic Factors:** Genetic predispositions may influence the anatomical structures that predispose individuals to angle closure. Genes related to eye development and fluid regulation in the anterior chamber are areas of interest.
- **Aqueous Humor Dynamics:** Proteins and signaling pathways involved in the production and drainage of aqueous humor are crucial. Disruption in the balance of these mechanisms could lead to angle closure.
- **Molecular Responses to Increased IOP:** Elevation in IOP can trigger cellular responses including stress signaling pathways, inflammation, and changes in extracellular matrix composition within the trabecular meshwork, potentially exacerbating outflow resistance.

Understanding these mechanisms is essential for developing targeted treatments and preventive strategies for interval angle-closure glaucoma.
Treatment: Interval angle-closure glaucoma, often termed intermittent angle-closure glaucoma, requires prompt and effective treatment to prevent vision loss. Treatment typically involves:

1. **Medications**: Immediate use of medications to lower intraocular pressure (IOP). These can include:
- **Oral or topical carbonic anhydrase inhibitors**
- **Topical beta-blockers**
- **Alpha agonists**
- **Prostaglandin analogs**

2. **Laser Therapy**:
- **Laser Peripheral Iridotomy (LPI)**: Creates a small hole in the iris to improve aqueous humor outflow, often the preferred initial intervention.

3. **Surgical Treatment**:
- If laser therapy is ineffective or not suitable, surgical options such as trabeculectomy or placement of a drainage implant may be necessary.

4. **Monitoring and Follow-up**: Regular monitoring of intraocular pressure and optic nerve health to ensure treatment efficacy and prevent progression.

Consultation with an ophthalmologist is essential for a tailored treatment plan based on individual patient conditions.
Compassionate Use Treatment: Interval angle-closure glaucoma is a form of glaucoma that involves intermittent acute episodes of angle closure, potentially leading to elevated intraocular pressure and optic nerve damage.

**Compassionate Use Treatment:**
Compassionate use, also known as expanded access, allows patients with serious or life-threatening conditions to access investigational drugs or treatments outside of clinical trials. For interval angle-closure glaucoma, patients may qualify for these programs, particularly when conventional treatments have failed or are unsuitable.

**Off-label Treatments:**
Off-label use of medications is common in managing glaucoma. For angle-closure glaucoma, examples include:
- **Acetazolamide:** Primarily used as a diuretic, this medication can reduce intraocular pressure by decreasing fluid production in the eye.
- **Timolol:** Although normally used for open-angle glaucoma, it can also be used off-label to reduce intraocular pressure in angle-closure cases.

**Experimental Treatments:**
Experimental treatments for angle-closure glaucoma may include:
- **Laser Peripheral Iridotomy:** While not experimental per se, advancements in laser technology and techniques continue to evolve. This procedure creates a small hole in the iris to improve fluid outflow.
- **Minimally Invasive Glaucoma Surgery (MIGS):** Emerging surgical techniques designed to reduce intraocular pressure with minimal tissue disruption. Some MIGS procedures are still under clinical investigation for their efficacy in angle-closure glaucoma.
- **Novel pharmacological agents:** Research is ongoing into new classes of drugs that better manage intraocular pressure without severe side effects.

Consultation with a healthcare provider specializing in glaucoma is essential to determine the most appropriate treatment plan for individual cases.
Lifestyle Recommendations: For interval angle-closure glaucoma, the following lifestyle recommendations can help manage the condition:

1. **Regular Eye Exams**: Schedule consistent check-ups with an ophthalmologist to monitor intraocular pressure and eye health.
2. **Medication Adherence**: Strictly follow prescribed treatments, including eye drops and oral medications.
3. **Hydration and Diet**: Maintain a balanced diet rich in fruits and vegetables, and stay hydrated, as dehydration can affect intraocular pressure.
4. **Avoid Over-the-Counter Medications**: Be cautious with medications like antihistamines or decongestants that could increase eye pressure.
5. **Controlled Light Exposure**: Use proper lighting when reading or engaging in activities to avoid strain.
6. **Safe Physical Activities**: Engage in moderate exercises, but avoid activities that involve heavy lifting or positions that invert the body, as these can increase eye pressure.
7. **Stress Management**: Practice relaxation techniques such as yoga or meditation to manage stress, which can impact eye pressure.

Always consult with a healthcare provider for personalized advice.
Medication: For intermittent angle-closure glaucoma, medications used often include:

1. **Beta-blockers** (e.g., Timolol) to reduce intraocular pressure (IOP).
2. **Prostaglandin analogs** (e.g., Latanoprost) to increase the outflow of aqueous humor.
3. **Alpha agonists** (e.g., Brimonidine) to decrease aqueous humor production and increase outflow.
4. **Carbonic anhydrase inhibitors** (e.g., Dorzolamide) to decrease aqueous humor production.
5. **Miotic agents** (e.g., Pilocarpine) to constrict the pupil and facilitate the opening of the angle.

The specific choice of medication may vary based on individual patient factors and the severity of the condition.
Repurposable Drugs: Repurposable drugs for interval angle-closure glaucoma are not well-documented, as treatment typically focuses on managing the acute condition and preventing recurrence through controlling intraocular pressure. Common treatments include medications such as:

1. **Pilocarpine**: A cholinergic agent that helps constrict the pupil and open the angle.
2. **Timolol**: A beta-blocker that reduces aqueous humor production.
3. **Acetazolamide**: A carbonic anhydrase inhibitor that decreases fluid production in the eye.
4. **Prostaglandin analogs (e.g., Latanoprost)**: These increase the outflow of intraocular fluid.

Research on repurposable drugs for specific use in interval angle-closure glaucoma is limited. For precise treatment guidance, consultation with an ophthalmologist is recommended.
Metabolites: Metabolites in the context of interval angle-closure glaucoma are not typically a primary focus in the diagnosis or management of the condition. Interval angle-closure glaucoma is primarily characterized by the periodic rise in intraocular pressure caused by closure of the anterior chamber angle, which impedes the outflow of aqueous humor. The focus is more on the anatomical and physiological changes in the eye rather than specific metabolic alterations.
Nutraceuticals: There is limited evidence to suggest that nutraceuticals play a significant role in managing interval angle-closure glaucoma. Standard treatment typically focuses on medications to reduce intraocular pressure, laser therapy, or surgery. Nutraceuticals such as omega-3 fatty acids, antioxidants, and certain vitamins may support overall eye health but should not be relied upon as primary treatments for this condition. Always consult with an eye specialist for tailored medical advice and treatment plans for angle-closure glaucoma.
Peptides: Interval-angle closure glaucoma is a subtype of glaucoma where the drainage angle intermittently closes, leading to elevated intraocular pressure.

Peptides: There is ongoing research into the role of peptides in glaucoma treatment. Some peptides may exhibit neuroprotective properties or influence intraocular pressure regulation.

Nanotechnology (nan): Nanotechnology is being explored in glaucoma for improved drug delivery systems, such as nano-carriers that can provide sustained and targeted delivery of anti-glaucoma medications, potentially enhancing treatment efficacy and reducing side effects.