Perspective Chapter: Role of the Vitreoretinal Interface Condition in the Development of Glaucoma

Abstract

Until now, there are no objective criteria to understand the moment of transition of eyes, anatomically predisposed to primary angle-closed glaucoma, from the risk group to the real form of PACG. IOP on the predisposed eyes may remain normal until advanced age without treatment. The aim of this study is to identify factors that can act as a trigger mechanism that starts such transition and the role of vitreous-retinal interface (VRI) condition in this process. A risk group that included 259 eyes (37–88 years old) predisposed to PACG was formed. The criteria for forming the group were gonioscopy, predictive coefficients Lowe and Chirshikov, provocative Hyams test, and ultrasound examination. Monitoring was carried out for up to 4 years. In the risk group, there were eyes in which the state of predisposition was transformed into a real form of PACG during monitoring. Such a transition was accompanied by the occurrence of PVD, which was not detected at the beginning of the monitoring. In eyes with normal IOP predisposed to PACG, PVD appearance leads to destabilization of the vitreous body position inside the vitreous cavity, possibility for iris-lenticular diaphragm displacement forward, appearance of hydrodynamic blocks and undulating IOP increases, and appearance of the real form of PACG.