Angle-Closure Diseases and Associated Risk Factors in Elderly Chinese - The Shihpai Eye Study 2006

Abstract

Purpose: : To evaluate angle-closure diseases including primary angle-closure glaucoma (PACG), primary angle closure (PAC), and PAC suspect (PACS), and associated risk factors in an elderly Chinese population over 72 years of age in Taiwan.

Methods: : In 2006, the remaining 824 cohort of 1361 participants of the 1999 Shihpai eye survey were invited to return for a second comprehensive ocular examination including slit lamp examination, the van Herick test, gonioscopy, applanation tonometry, dilated fundus examination and optic disc photography. Subjects with suspected glaucomatous optic neuropathy or occludable angles were referred for a definitive exanimation including visual field testing.

Results: : Gonioscopy was performed in 444 participants (97.6% of 455 participants). Occludable angles were identified in 205 subjects among this study population (45%). PACG was diagnosed in 18 subjects (4.0%). Forty-three (9.4%) and 144 subjects (31.6%) were diagnosed to have PAC and PACS respectively. Subjects with angle closure were more likely to be female, had a higher intraocular pressure, shallower anterior chamber depth, shorter axial length, and lower endothelial cell density than those with normal open angles. In multivariate analysis, axial length (OR per millimeter increase, 0.56; 95% CI, 0.42-0.73; P<0.001), intraocular pressure (OR per mmHg increases 1.13, 95% CI, 1.03-1.22; P = 0.006), and a van Herick grading less than 2 (OR, 18.87; 95% CI, 11.1-31.9; P<0.001) were independently associated with angle closure.

Conclusions: : Angle closure diseases are common among this elderly Chinese population. The van Herick test is useful in identifying subjects at risk of angle closure.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • anterior segment • optic disc