Purchase this article with an account.
A. A. Madu, A. E. Fleury, P. Channa, U. Mian; Ultrasound Biomicroscopic Prevalence of Plateau Iris Among Hispanic and Black Angle Closure Suspects. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4348.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The diagnosis of plateau iris is often reserved for young female patients ages 30-50 years (Wang et al eMedicine 2005). Recently Kumar et al (AAO 2006) presented a high prevalence of plateau iris among Asian primary angle closure suspects. The purpose of this study is to determine the ultrasound biomicroscopic prevalence of plateau iris configuration among Black and Hispanic primary angle closure suspects.
Two glaucoma specialists, independently reviewed 120 sequential high frequency anterior segment ultrasounds of angle closure suspects over 2 six month periods. The observers were masked to the gonioscopic and clinical findings. Each patient had one eye study consisting of a minimum of 8 quadrants performed in the light and dark. Patients with a history of trauma were excluded. A total of 105 patients were included in the analysis.
In order to have plateau iris configuration, the observers had to agree on at least 2 quadrants of anteriorization of the ciliary processes. Fifty eight of 105 (55.2%) patients were noted to have plateau iris configuration. There were 81/105 (77.14% ) females. There were 66 Hispanics, 52 females and 14 males. Fifty five percent of the Hispanic females (29/52) and 7/14 (50%) Hispanic males had plataeau iris configuration. Of the Black patients, 24/33 (72.7) were female and 11/24 (45.8%) females and 6/9 (66%) males had plateau iris configuration.
There is a high prevalence of plateau iris configuration among Black and Hispanic angle closure suspects. The majority of these patients are female. Pupillary block is generally a minimal component of plateau iris and iridotomy is not entirely effective in relieving the closed angle configuration predisposing the patient to possible angle closure glaucoma. Anterior segment ultrasound is useful in the identification and diagnosis of plateau iris configuration. Identification of these patients necessitates the addition of argon laser iridoplasty to iridotomy thereby minimizing the possibility of angle closure glaucoma.
This PDF is available to Subscribers Only