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T. Aung, R. Lavanya, T.-Y. Wong, D. S. Friedman, S. K. Seah, K. Kashiwagi, P. J. Foster; Determinants of Angle Closure in Elderly Singaporeans. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5056.
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To investigate systemic and ocular risk factors for angle closure (AC) in elderly Singaporeans.
This was a cross-sectional study of 2,042 phakic subjects aged 50 years or older recruited from a primary care clinic in Singapore. Subjects underwent a detailed questionnaire, refraction, gonioscopy and biometry. Angle closure by gonioscopy was defined as the presence of at least 180 degrees of angle in which the posterior pigmented trabecular meshwork was not visible on non-indentation gonioscopy in the primary position. Univariable and multivariable analysis were performed to determine risk factors for AC.
The prevalence of AC in this study population was 19.3% (n=395). 89.4 % of the study population were Chinese. In univariate analysis, subjects with AC were older, women, of Chinese descent, had lower Body mass index (BMI), shorter axial length (AL), shallower anterior chamber depth (ACD) and higher intraocular pressure. In multivariate analysis, female gender (odds ratio[OR] 1.43, 95%CI: 1.06- 1.92, p=0.02), Chinese ethnicity (OR3.58, 95%CI: 2.03- 6.29, p<0.001), central ACD <2.80 mm vs ≥ 3.00 mm (OR 42.5, 95%CI: 27.4- 66.2) and AL (OR per mm increase 0.69, 95%CI: 0.58-0.81) were independently associated with AC.
In this community based study of elderly Singaporeans, significant independent predictors of AC were female gender, Chinese race, shorter AL and shallower central ACD. Racial and gender differences in risk of AC were not fully explained by variations in AL or ACD.
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