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Z Alsagoff, LP K Ang, T Aung, PT K Chew; Visual Field Loss For Chronic Angle-closure Glaucoma In An Asian Population . Invest. Ophthalmol. Vis. Sci. 2002;43(13):294.
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Purpose: To analyze the presenting visual fields of patients with chronic angle-closure glaucoma (CACG) in an Asian population. Methods: Threshold visual fields of 129 eyes of 93 consecutive patients with CACG, who presented at a Singapore hospital from January 1990 to December 1994, were analyzed. CACG was defined as the presence of glaucomatous optic neuropathy and compatible visual field loss associated with a closed angle in the same eye. There were 2 groups of patients studied. Group A consisted of those with a past history of acute angle-closure (that had resolved after treatment). Group B consisted of those with no previous acute episode. The first reliable visual field of the presenting eye in Group A, or the worse eye in asymptomatic patients, was assessed using the Advanced Glaucoma Intervention Study (AGIS) scoring system, and graded according to severity as mild, moderate, severe and end stage visual field defects, based on scores of 0-5, 6-11, 12-17, 18-20 respectively. Results: The mean age of the patients was 62 years (range: 36-92 years). In Group A (50 patients), the majority of eyes had mild visual field defects (21 eyes, 42.0%), while those with end-stage defects were the least frequent (7 eyes, 14.0%). This was in contrast to patients in Group B (43 patients), where the majority had end-stage visual field defects (19 eyes, 44.2%), with a smaller proportion having mild visual field defects (10 eyes, 23.2%). There was no correlation between the levels of presenting intraocular pressure with the severity of visual field defect. Conclusions: CACG eyes with previous acute angle-closure are less likely to present with severe visual field damage. In contrast, the majority of eyes with asymptomatic CACG have severe to end-stage visual field defects when first examined. The visual morbidity of primary angle closure glaucoma may be related to the finding that the asymptomatic form of the disease is so visually destructive. None
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