Development of angle closure and associated risk factors: The Handan eye study

Abstract

Purpose To investigate the development of angle closure from baseline open angle and associated risk factors in a rural Chinese population through a longitudinal study over a 5‐year period. Methods Subjects aged ≥30 years and older with bilateral open angles at baseline of the Handan Eye Study who participated in the follow‐up and had undergone both baseline and follow‐up gonioscopic examinations were included. Subjects with any form of angle closure, glaucoma, incisional ocular surgery or other conditions that could influence the results were excluded. The development of angle closure was defined as the presence of primary angle closure suspect (PACS) or primary angle closure (PAC)/primary angle closure glaucoma (PACG) during the follow‐up in normal subjects with baseline bilateral open angles. Logistic regression was performed to identify the baseline risk factors for the development of angle closure. Results A total of 457 subjects with bilateral open angles at baseline aged 53.0 (45.5, 58.0) years were enrolled. 94.7% of the included cases developed PACS, 5.3% developed PAC and no one developed PACG after 5 years. In logistic regression, significant risk factors for the development of angle closure were shallower central anterior chamber depth (ACD) (p = 0.002) and narrower mean angle width (p < 0.001). Conclusions This study reports the development from baseline open angle to angle closure after a 5‐year follow‐up. We confirm that the mean angle width and central ACD were independent predictive risk factors for the development of any form of angle closure.

Distribution of White-to-White Corneal Diameter and Anterior Chamber Depth in Chinese Myopic Patients

“…Females have shallow ACD as compared to males in the eastern population putting them at higher risks of acute attack of angle-closure and PACG. In the Handan Eye study, 6,830 eligible subjects aged 30 years or older with open-angle were recruited and undergone gonioscopic examinations at baseline and follow-up visits; the results showed that shallow central ACD was a significant risk factor for development of any form of angle closure after 5-year follow up ( OR = 0.110, P = 0.003) ( 5 ). In our study, ACD was significantly different among different myopia groups.…”

“…Implantation of an incorrect size ICL may lead to complications after the surgery, such as corneal endothelial damage, uveitis, and glaucoma ( 4 ). Besides, shallow central ACD was found to be an independent predictive risk factor for the development of any form of angle closure in the Handan Eye study ( 5 ) and in the Namil Study ( 6 ). Thus, it is important to identify such patients so that prophylactical treatment can be used to prevent an acute attack of angle-closure and primary angle-closure glaucoma (PACG).…”

Primary glaucomas in adults: Epidemiology and public health‐A review

“…The development of people‐centred health systems and the incorporation of modern technology for screening, if well connected to treatment and rehabilitation services, could reduce the number of undiagnosed glaucoma and alleviate the burden of the disease 112 84 and PACG (Asian descendants, hyperopia, female sex, and aged 40 years or older) 106–108 …”

“…There is a conspicuous body of information regarding specific risk factors for PACG. In summary, female sex, hyperopia, Asian descendants, age, and anterior chamber parameters have been repeatedly associated with the diagnosis of PACG 106–108 …”

“…In summary, female sex, hyperopia, Asian descendants, age, and anterior chamber parameters have been repeatedly associated with the diagnosis of PACG. 106 Human resources and barriers to eye care services…”