{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:08:04Z","timestamp":1792789684676,"version":"4.5.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,12,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>In previous decades, glaucoma has been primarily attributed to elevated intraocular pressure (IOP), but this has gradually been replaced by the development of optic neuropathy as the central concept of glaucoma in developed countries. However, there still remain strong controversies in the definition of glaucoma in China. In this current review, we are going to discuss these controversies and elaborate on the historical transitions of the definition of glaucoma both in China and developed countries. Furthermore, we will briefly describe the \u201cocular-cranial pressure gradient\u201d theory and discuss the relationship between glaucoma and degenerative diseases of the central nervous system (CNS) in order to show the complex pathogenesis of glaucoma and the importance for the modification to the definition of glaucoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>We performed a comprehensive search in both PubMed and SinoMed using the following keywords: (a) \u201cprimary glaucoma\u201d and \u201cguideline,\u201d (b) \u201cocular-cranial pressure gradient,\u201d and (c) \u201cglaucoma,\u201d \u201cAlzheimer's disease,\u201d and \u201cParkinson's disease.\u201d The literature search included the related articles with no restrictions on publication date.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection:<\/jats:title>\n                    <jats:p>The primary references were Chinese and English articles including (a) original guidelines and expert consensuses of primary glaucoma, (b) reviews focusing on the differences between various versions of these guidelines and consensuses, and (c) papers about ocular-cranial pressure gradient theory and the relationship between glaucoma and CNS degenerative diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The definitions and classifications of both primary open-angle glaucoma and primary angle-closure glaucoma differ between Chinese glaucoma consensuses and international primary glaucoma guidelines. Chinese definitions and classifications put more emphasis on the IOP, while international guidelines put more emphasis on the presence of optic neuropathy. The ocular-cranial pressure gradient theory and the research on the relationship between glaucoma and CNS degenerative diseases have provided new directions for exploring the pathogenesis of glaucoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>As regards the definition and classification of primary glaucoma, we find that there are still some discrepancies between Chinese expert consensuses and international guidelines. Glaucoma is a disease with complex etiologies, while its common characteristic is a specific optic neuropathy. The current definition and understanding of glaucoma is an ongoing and evolving process, reflecting our latest available evidence on its pathogenesis. Chinese ophthalmology community may need to update our guidelines, accommodating these latest developments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0366-6999.246069","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T13:02:22Z","timestamp":1767099742000},"page":"2852-2859","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Transitions of the Understanding and Definition of Primary Glaucoma"],"prefix":"10.4103","volume":"131","author":[{"given":"Si-An","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen-Ni","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan-Nan","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Gang","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-11-20251230","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1136\/bjo.2005.081224","article-title":"The number of people with glaucoma worldwide in 2010 and 2020","volume":"90","author":"Quigley","year":"2006","journal-title":"Br J Ophthalmol"},{"key":"R3-11-20251230","first-page":"69","article-title":"Current situation and development trend of glaucoma research in China (in Chinese)","volume":"2","author":"Ge","year":"2004","journal-title":"Chin J Ophthalmol Otorhinol"},{"key":"R8-11-20251230","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/00004397-199803830-00011","article-title":"Understanding the new primary open-angle glaucoma preferred practice pattern","volume":"38","author":"Lee","year":"1998","journal-title":"Int Ophthalmol Clin"},{"key":"R9-11-20251230","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ophtha.2015.10.053","article-title":"Primary open-angle glaucoma preferred practice pattern(\u00ae) guidelines","volume":"123","author":"Prum","year":"2016","journal-title":"Ophthalmology"},{"key":"R10-11-20251230","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.ophtha.2015.10.055","article-title":"Primary open-angle glaucoma suspect preferred practice pattern(\u00ae) guidelines","volume":"123","author":"Prum","year":"2016","journal-title":"Ophthalmology"},{"key":"R13-11-20251230","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1001\/archopht.120.6.701","article-title":"The ocular hypertension treatment study: A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma","volume":"120","author":"Kass","year":"2002","journal-title":"Arch Ophthalmol"},{"key":"R14-11-20251230","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.ajo.2004.04.054","article-title":"Risk assessment in the management of patients with ocular hypertension","volume":"138","author":"Weinreb","year":"2004","journal-title":"Am J Ophthalmol"},{"key":"R15-11-20251230","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1136\/bjo.86.2.238","article-title":"The definition and classification of glaucoma in prevalence surveys","volume":"86","author":"Foster","year":"2002","journal-title":"Br J Ophthalmol"},{"key":"R16-11-20251230","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ophtha.2015.10.049","article-title":"Primary angle closure preferred practice pattern(R) guidelines","volume":"123","author":"Prum","year":"2016","journal-title":"Ophthalmology"},{"key":"R17-11-20251230","first-page":"1706","article-title":"Primary angle closure glaucoma in Chinese and Western populations","volume":"115","author":"Wang","year":"2002","journal-title":"Chin Med J"},{"key":"R18-11-20251230","first-page":"1061","article-title":"Primary angle closure-a new term in the definition of primary angle closure glaucoma (in Chinese)?","volume":"12","author":"He","year":"2005","journal-title":"Chin J Ophthalmol"},{"key":"R19-11-20251230","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1001\/archopht.1996.01100140435011","article-title":"Glaucoma in Mongolia. 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