June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Patient features associated with a higher sibling risk of angle closure disease
Author Affiliations & Notes
  • Pradeep Y Ramulu
    Ophthalmology, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Shwetha Mudalegundi
    Ophthalmology, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Aleksandra Mihailovic
    Ophthalmology, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Nazlee Zebardast
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Rengaraj Venkatesh
    Aravind Eye Institute, Pondicherry, India
  • Kavitha Srinivasan
    Aravind Eye Institute, Pondicherry, India
  • Footnotes
    Commercial Relationships   Pradeep Ramulu Ivantis, W.L. Gore, Heru, Roche, Code C (Consultant/Contractor), Perfuse Therapeutics, Code R (Recipient); Shwetha Mudalegundi None; Aleksandra Mihailovic None; Nazlee Zebardast None; Rengaraj Venkatesh None; Kavitha Srinivasan None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4012 – A0354. doi:
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      Pradeep Y Ramulu, Shwetha Mudalegundi, Aleksandra Mihailovic, Nazlee Zebardast, Rengaraj Venkatesh, Kavitha Srinivasan; Patient features associated with a higher sibling risk of angle closure disease. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4012 – A0354.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess if specific findings gathered during an examination of patients with a known angle closure diagnosis (probands) could better determine the risk of angle closure in the patient’s sibling.

Methods : Patients 30 years and older with suspect primary angle closure (PACS) or primary angle closure/primary angle closure glaucoma (PAC/G) seen at the Aravind Eye Hospital in Pondicherry, Tamil Nadu, and a biological sibling above age 30 years, were recruited as ‘probands’ and ‘siblings’ (n=346 pairs). Demographics, ocular history, and an ophthalmic examination with Anterior Segment Optical Coherence Tomography (ASOCT) were obtained. Siblings were classified as having open angles (OA), PACS, or PAC/G per ISGEO criteria. Models were created to analyze the contribution of specific proband factors in predicting sibling angle closure diagnosis.

Results : When predicting (1) any sibling angle closure (PACS or PAC/G ) vs. open angles, (2) sibling PAC/G vs PACS or OA, or (3) PAC/G vs. PACS amongst siblings with angle closure, models incorporating proband ASOCT data outperformed models including proband diagnosis alone or proband diagnosis plus demographic (age/gender) and exam metrics (gonioscopy, optic nerve exam, visual acuity, and intraocular pressure). For example, in the prediction of PAC/G vs. PACS amongst siblings with angle closure, the model using only proband diagnosis had the lowest explained variability (0.64%). Adding proband demographics and ocular exam metrics improved model accuracy to a limited extent (1.99% of variability explained), while adding ASOCT Metrics created a significant improvement (17% of variability explained, p<.0001 vs other models). The model incorporating ASOCT metrics resulted in the lowest Bayesian Information Criterion (101.9 vs. 123.6 for the diagnosis-only model and 119.7 for the diagnosis + demographics + exam metrics model).

Conclusions : Utilizing ASOCT information from angle closure patients can help better predict sibling angle closure status, leading to more efficient and cost-effective screening of family members.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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