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Monisha Esther Nongpiur, Kenric R Fan, Jestin W Chiew, Yap Sae Cheong, Shamira Perera, Tin Aung; Anterior Segment Parameters in Subjects with Asymmetric Primary Angle Closure Glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5123. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the association between anterior segment parameters and asymmetric primary angle closure glaucoma (PACG).
Two hundred and fifty eight subjects with PACG in at least one eye were recruited from glaucoma clinics. Each subject underwent anterior-segment optical coherence tomography (AS-OCT, Visante, Carl Zeiss Meditec, Dublin, CA) imaging, gonioscopy and visual field (VF) assessment. Visual field asymmetry was defined as a five point difference between the eyes using the Advanced Glaucoma Intervention Study (AGIS) scoring system; and unilateral VF defect was defined as an AGIS score of 0 in the better eye and an interocular score asymmetry of ≥5.
Based on the study definitions, 53 subjects (20.5%) had VF asymmetry and 33 (12.8%) had unilateral VF defect. The mean age of the 53 subjects was 62.1±7.3 years and there were 26 (49.1%) females. Compared to the better eyes, the worse eyes had significantly higher presenting intraocular pressure (IOP, 32.7±15.7 vs 18.7±8.1; p<0.001), greater vertical-cup-disc ratio (p<0.001) and use of more glaucoma medications (p<0.001). The worse eyes of those with VF asymmetry were also characterized by significantly smaller anterior chamber width (ACW, p=0.02) and smaller posterior corneal arc length (PCAL, p=0.016). The analysis in subjects with unilateral VF defect was largely similar, with the affected eye characterized by significantly narrower gonioscopic angle width (p=0.004), smaller ACW (p=0.01), smaller PCAL (p=0.006), and smaller anterior vault (p=0.015).
In our clinic-based study of PACG, we observed that 20% of the subjects had VF asymmetry and about 12% had unilateral VF defect. Asymmetric PACG was associated with asymmetry in anterior segment parameters.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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