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C. Supawavej, K. Nouri-Mahdavi, E. Bitrian, J. A. Giaconi, J. Caprioli; Comparison of Patterns of Glaucomatous Disc Damage in Chronic Angle-Closure Glaucoma and Primary Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2716.
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To compare qualitative and quantitative patterns of glaucomatous disc damage in a cohort of chronic primary angle-closure glaucoma (PACG) eyes with a control group of eyes with POAG.
The clinical database at UCLA’s Glaucoma Division was screened for eyes with a diagnosis of PACG meeting the following criteria: available good-quality HRT images (SD15.0 dB) within 1 year of the eligible images, IOP >8 mmHg at the time of exam, and absence of other neurological or retinal diseases. A control group of POAG eyes meeting the same criteria and matched for severity of field loss (± 1dB) and race were recruited for comparison. The optic disc photographs were reviewed and patterns of glaucomatous damage and likelihood of glaucomatous damage (score of 1-10) determined by two experienced observers and disagreements adjudicated by a third reviewer. Patterns of disc damage, glaucoma likelihood scores, and HRT’s stereometric parameters were compared between the two groups.
A total of 62 eyes (31 eyes in each group) were included. The average MD was -4.5 ± 0.48 and -4.5± 0.47 dB in the PACG and POAG eyes, respectively. The PACG patients tended to be younger (66.6± 1.8 vs. 68.8 ± 2.3 years; p=0.45), were more hyperopic (+0.6 ± 0.5 D vs. -1.7 ± 0.5 D; p=0.002) and had higher IOPs at the time of imaging (16.7 ± 0.8 vs. 14.5 ± 0.6 mmHg; p= 0.03). The average glaucoma likelihood scores were similar between the two groups (5.7 ± 3.1 vs. 6.2 ± 2.9; p=0.5). Focal damage was not more prevalent in POAG eyes (p>0.05). There was no difference in disc size or any other HRT parameters between the PACG and POAG groups after adjusting for disc size (p>0.05 for all comparisons).
Patterns of glaucomatous nerve damage are not different in primary chronic ACG eyes as compared to POAG eyes. Further research on structure-function relationship in PACG eyes is needed to determine if findings from POAG eyes apply to PACG eyes.
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