Primary angle-closure glaucoma (PACG) is a common cause of blindness. Angle closure is a fundamental pathologic process in PAGC. With the development of imaging devices for the anterior segment of the eye, a better understanding of the pathogenesis of angle closure has been reached. Aside from pupillary block and plateau iris, multiple-mechanisms are more common contributors for closure of the angle such as choroidal thickness and uveal expansion, which may be responsible for the presenting features of PACG. Recent Genome Wide Association Studies identified several new PACG loci and genes, which may shed light on the molecular mechanisms of PACG. The current classification systems of PACG remain controversial. Focusing the anterior chamber angle is a principal management strategy for PACG. Treatments to open the angle or halt the angle closure process such as laser peripheral iridotomy and/or iridoplasty, as well as cataract extraction, are proving their effectiveness. PACG may be preventable in the early stages if future research can identify which kind of angles and/or persons are more likely to benefit from prophylactic treatment. New treatment strategies like adjusting the psychological status and balancing the sympathetic-parasympathetic nerve activity, and innovative medicines are needed to improve the prognosis of PACG.

In this review, we intend to describe current understanding and unknown aspects of PACG, and to share the clinical experience and viewpoints of the authors.

原发性闭角型青光眼（PACG）是失明的常见原因。闭角是PAGC的基本病理过程。随着用于眼前节的成像装置的发展，已经对角闭合的发病机理有了更好的了解。除了瞳孔阻滞和高原虹膜外，多种机制是闭合角的更常见原因，例如脉络膜厚度和葡萄膜扩张，这可能是PACG呈现特征的原因。最近的基因组广泛关联研究确定了几个新的PACG基因座和基因，这可能有助于阐明PACG的分子机制。当前的PACG分类系统仍存在争议。聚焦前房角是PACG的主要治疗策略。诸如激光外围虹膜切开术和/或虹膜成形术以及白内障摘除术等用于打开角度或停止角度闭合过程的治疗方法都证明了其有效性。如果将来的研究可以确定哪种角度和/或人更可能受益于预防性治疗，则PACG可能在早期阶段是可预防的。需要新的治疗策略，例如调整心理状态和平衡交感神经-副交感神经活动，以及需要创新药物来改善PACG的预后。

在这篇综述中，我们打算描述PACG的当前理解和未知方面，并分享作者的临床经验和观点。