Determinants and characteristics of angle-closure disease in an elderly Chinese population.

Yu-Chieh Ko, Catherine J Liu, Wen-Ming Hsu, Ching-Yu Cheng, Tung-Mei Kuang, Pesus Chou

Index: Ophthalmic Epidemiol. 22(2) , 109-15, (2015)

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Abstract

To determine factors associated with angle-closure disease, particularly in those with structural or functional damage to the eyes, in an elderly Chinese population.A total of 460 individuals aged over 72 years were recruited. The association of angle-closure diseases, including primary angle-closure suspect (PACS), primary angle-closure (PAC) and primary angle-closure glaucoma (PACG), with various systemic and ocular characteristics was evaluated using multivariate logistic regression analyses.Of 374 phakic subjects, 199 (53.2%) had angle-closure disease, including 135 PACS, 46 PAC, and 18 PACG. The majority of those with untreated PACG (10/13, 76.9%) had presenting intraocular pressure (IOP) < 20 mmHg. Independent risk factors for angle-closure disease were lower Van Herick grading, shallower central anterior chamber depth (ACD), and higher post-mydriatic IOP (all p < 0.05). Central and peripheral ACD estimation correlated weakly, only 60.8% of angle-closure eyes had generalized narrowing of ACD as a Van Herick grading ≤ 2 and central ACD ≤ 2.83 mm. A criterion considering either central or peripheral ACD identified 91% of angle-closure eyes, including all PACG. A higher post-mydriatic IOP was associated with a diagnosis of PAC or PACG among angle-closure eyes (p = 0.002).Both central and peripheral ACD should be evaluated and shallowing of either one should be an indication for gonioscopic examination to maximize detection of angle-closure disease in elderly Chinese persons. PAC and PACG were associated with higher post-mydriatic IOP than PACS, although subjects with PACG frequently presented with normal IOP.