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W. Ng, G. S. Ang, A. Azuara-Blanco; Primary Angle Closure Glaucoma: A Descriptive Study in a Scottish Caucasian Population. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4333.
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To describe the frequency, and the ocular and demographic variables among Caucasian patients with Narrow Angles (NA), Primary Angle Closure (PAC) and Primary Angle Closure Glaucoma (PACG) in the North East of Scotland newly referred to the glaucoma clinic.
A retrospective review on all newly diagnosed Caucasian patients with NA, PAC and PACG who were seen in an Academic Department (Aberdeen Royal Infirmary) over a 2 year period. Secondary angle closures were excluded. Frequency of PACG and Acute Angle-Closure attacks was compared with the number of new referrals to the glaucoma clinic and estimated population for North East of Scotland.Definitions:NA: Narrow anterior chamber angle on gonioscopy (i.e. trabecular meshwork appositionally closed without indentation in at least 3 quadrants) and IOP≤ 21 mmHgPAC: NA and IOP(Intraocular Pressure) > 21mmHg, or presence of peripheral anterior synechiaePACG: PAC with evidence of glaucomatous damage (reproducible visual field defects or glaucomatous optic disc damage)
104 patients were analysed. PACG patients made up nearly 50% of the cohort. 13 had bilateral PACG. 12 patients had Acute Angle-Closure attacks. PACG makes up 0.015% of North East of Scotland population estimates. The yearly frequency of Acute Angle-Closure attacks in the North East of Scotland is 0.003%.The total number of patients referred to the glaucoma unit in 1 year was 318 of which 109 had glaucoma regardless of aetiology. 23% of these glaucoma referrals had Primary Angle Closure Glaucoma.
PACG and Acute Angle-Closure attacks are uncommon in Caucasians. However, PACG represents more than 20% of new glaucoma referrals which makes up a fair proportion of glaucoma work load in Aberdeen Royal Infirmary. The age of PACG presentation was nearly 70 which suggests that in Caucasians it may present at a later age. An inversed pyramid was observed with regards to the frequency of NA, PAC and PACG . The reason for more patients with glaucomatous damage is debatable. Whether this is due to poor detection or a faster disease progression in Caucasians remains uncertain.
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