Follow-up of Angle-closure Glaucoma Suspects

Wilensky, Jacob T.; Kaufman, Paul L.; Frohlichstein, Diane; Gieser, David K.; Kass, Michael A.; Ritch, Robert; Anderson, Robert J.

doi:10.1016/s0002-9394(14)73585-8

Cited by 145 publications

(78 citation statements)

References 13 publications

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“…The incidence of occludable angles in first-degree relatives of patients with PACG has been reported to be 3.5-6 times higher 10 than that of the general population. In our study among Asians of Indian ethnicity family members had an 8-9 times higher incidence of primary angle closure.…”

Section: Discussionmentioning

confidence: 92%

“…[5][6][7][8][9] A positive family history of PACG is an additional risk factor. The inheritance of PACG is believed to be polygenic, [10][11][12][13] although both autosomal dominant and recessive inheritance pattern are seen in pedigrees with a high prevalence of PACG. The importance of anatomical factors in PACG has evoked considerable curiosity as to whether they are genetically determined.…”

Section: Introductionmentioning

confidence: 99%

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Study of biometric parameters in family members of primary angle closure glaucoma patients

Sihota

Ghate

Mohan

et al. 2007

Eye

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Objectives To measure ocular biometric parameters in all possible untreated family members of index primary angle closure glaucoma (PACG) patients and to correlate these values among affected, unaffected, and suspected family members. Methods Anterior chamber depth (ACD), axial length (AL), lens thickness (LT), relative lens position, and central corneal thickness (CCT) were measured in first-and seconddegree relatives of index patients. These biometric parameters were compared among the relatives and index patients as well as among affected, unaffected, and suspected family members. Results Of the 108 family members included in the study, 34 (31.6%) were affected with primary angle closure, 19 (17.6%) were suspect, and 55 (50.7%) were unaffected family members. In comparison to index cases, ACD was 14.56% more in affected, 21.7% more in primary angle closure suspects and 34.92% more in unaffected family members. LT was 10.73, 11.1, 16% less and AL was 0.11, 3.53 and 5.37% more in affected, suspected, and unaffected family members, respectively. Lens position and CCT were not statistically different in the various subgroups. Conclusions ACD is narrowest, lens thickest, and AL shortest in family members affected with PACG compared to suspected and unaffected members. Although LT and ACD could change with advancing age, AL appears to be a marker to identify members at risk of angle closure glaucoma.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Study of biometric parameters in family members of primary angle closure glaucoma patients

Sihota

Ghate

Mohan

et al. 2007

Eye

View full text Add to dashboard Cite

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“…Certainly, previous authors have questioned the value of such tests, suggesting that they have no increased predictive value than a slit-lamp examination combined with gonioscopy. 9,20,21 The potential for occludability under natural circumstances is only one factor in deciding whether to proceed to YPI. Many respondents advocated YPI in eyes requiring repeated mydriasis for diagnosis or treatment of, for example, diabetic retinopathy and the Rotterdam study 5 estimates the incidence of AACG under such circumstances at 3.8 per 10 000 while another study, also in a Caucasian population, suggests up to 15% of AACG cases could be considered as drug induced.…”

Section: Discussionmentioning

confidence: 99%

“…Eight patients (6.2%) developed an acute angle-closure attack with symptoms during the follow-up period and an additional 17 patients (13.2%) were found to have angles closed with synechiae or by apposition on follow-up gonioscopy. 9 Recently, Thomas et al have shown, in an Asian cohort, that 22% of primary angle closure suspects developed raised intraocular pressure (IOP) or synechiae over a 5-year period 10 and in a separate smaller group with known primary angle closure 28.5% progressed to glaucoma as evidenced by disc damage and perimetry defects over the same period. 11 Despite these studies, there is still paucity of larger studies with long-term data on the natural history of treated and untreated narrow angles, particularly among Caucasian populations.…”

Section: Introductionmentioning

confidence: 99%

UK national survey of prophylactic YAG iridotomy

Sheth

Goel

Jain

2004

Eye

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Purpose Acute angle-closure glaucoma is a common ophthalmic emergency and individuals with shallow anterior chambers and suspected narrow angles are increasingly referred to the hospital eye service for assessment. There appears to be variation in subsequent management, with no national consensus or college guidelines. This study ascertains the current use of prophylactic YAG iridotomy in patients with no known history of an acute angle-closure glaucoma attack, and also the methods used in patient selection.

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“…[6][7][8][9] A positive family history of PACG is an additional risk factor, with a 3.5 to six times higher prevalence of occludable angles in first-degree relatives of PACG patients. [10][11][12][13][14] The inheritance of PACG is believed to be polygenic [15][16][17] although AD and AR inheritance patterns are seen in pedigrees with a high prevalence of PACG. Similar anatomical dimensions in patients and their relatives may explain their predisposition to PACG and conversely any dissimilarity may explain why many relatives are not affected.…”

mentioning

confidence: 99%

An evaluation of the darkroom prone provocative test in family members of primary angle closure glaucoma patients

Sihota

Mohan

Dada

et al. 2006

Eye

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Purpose To compare ocular biometric parameters with darkroom prone provocative test (DRPPT) in family members of primary angle closure glaucoma (PACG) patients. Methods One hundred and forty-nine family members of 46 PACG patients underwent ocular examination included slit lamp biomicroscopy, gonioscopy, fundus examination using þ 90 D lens, Goldmann applanation tonometry, darkroom prone provocative test, perimetry on Humphrey's field analyzer II and optic disc evaluation using HRT II. Ultrasonic ocular biometry and the DRPPT were then performed. IOPX 8 mmHg rise from baseline with iridocorneal touch was considered as a positive test. Results Of the 149 family members examined, 55 (36.9%) were found to have PACG. Forty (72.7%) of these had subacute PACG and 15 (27.3%) were found to have chronic PACG. Thirty-nine (70.3%) of the affected members showed a positive DRPPT. Mean anterior chamber depth (ACD) was 2.0370.3, 2.370.4, 2.770.3 mm (P ¼ 0.0001) and mean lens thickness was 4.4170.39, 3.9970.5, 3.9370.4 mm (P ¼ 0.0001) in DRPPT positives, borderlines and negatives respectively. ROC curve (ACD) plotted showed cutoff value of 2.07 mm (sensitivity 88.57%) for screening. Conclusion Anterior chamber is shallowest, lens is thickest and axial length is shortest in affected and DRPPT positive, family members of PACG patients.

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Follow-up of Angle-closure Glaucoma Suspects

Cited by 145 publications

References 13 publications

Study of biometric parameters in family members of primary angle closure glaucoma patients

Study of biometric parameters in family members of primary angle closure glaucoma patients

UK national survey of prophylactic YAG iridotomy

An evaluation of the darkroom prone provocative test in family members of primary angle closure glaucoma patients

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