scholarly journals Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study

2021 ◽  
Author(s):  
Feng Gao ◽  
Jiajian Wang ◽  
Junyi Chen ◽  
Xiaolei Wang ◽  
Yuhong Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Anterior Segment ◽  
Young Patients ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Uncommon Presentation ◽  
Underlying Causes

Abstract Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.

scholarly journals Anterior segment imaging-based subdivision of subjects with primary angle-closure glaucoma

Eye ◽  
2016 ◽  
Vol 31 (4) ◽  
pp. 572-577 ◽  
Author(s):  
M E Nongpiur ◽  
E Atalay ◽  
T Gong ◽  
M Loh ◽  
H K Lee ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Anterior Segment Imaging

scholarly journals Case Report: The efficacy of early phacoemulsification in the intraocular pressure control in primary angle closure glaucoma associated with cataract in a young female

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 372
Author(s):  
Carmen-Ecaterina Leferman ◽  
Madalina Cazacut ◽  
Alin Dumitru Ciubotaru
Keyword(s):  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
The Elderly ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Caucasian Woman ◽  
Blurred Vision ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Initial Symptoms

Glaucoma is a leading cause of irreversible blindness worldwide. Among different types of glaucoma, irreversible bilateral visual impairment is more common in primary angle closure glaucoma (PACG) patients. PACG and cataract often coexist and are both more prevalent among the elderly population, being rare in children and young adults. Here, we discuss the case of a 39-year-old Caucasian woman with unilateral PACG associated with cataract. The patient presented with a several-day history of left sided headache, decreased and blurred vision as well as pain and redness of the left eye (LE). She reported similar episodes in the previous year. Visual acuity (VA) of the LE was limited to counting fingers and intra-ocular pressure (IOP) of the LE was 42 mmHg. Anterior segment examination of the LE revealed: edematous cornea, a peripheral anterior chamber depth corresponding to Van Herick’s grade 0, mid-dilated pupil and lens opacities with visible glaukomflecken. Gonioscopic evaluation revealed iridotrabecular contact for 360º, no visible angle structures and a flat–mild convex iris contour. Spectral domain optical coherence tomography suggested only a thinning of neuro-retinal rim at the lower pole. Following treatment of the initial symptoms, phacoemulsification with intra-ocular lens implant was performed. IOP improved and no IOP-lowering medication was required. The patient was monitored for VA, IOP, field of vision changes, and optic disc evaluation every six months for 2 years and no glaucomatous change occurred. The patient also denied ocular symptoms during this period. This case supports the effectiveness of early phacoemulsification in the IOP control in patients with PACG.

Elucidation of presence of increased risk formation of primary angle-closure glaucoma among patients with hyperopia in department of refractive surgery

2021 ◽  
pp. 162-164
Author(s):  
N.V. Samokhvalov ◽  
◽  
E.L. Sorokin ◽  
A.N. Marchenko ◽  
Y.E. Pashentsev ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Refractive Surgery ◽  
Young Patients ◽  
Anterior Chamber Depth ◽  
Acute Attack ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Increased Risk

Important physiological feature of the anatomically «short» eye is the disproportionately large volume of the lens relative to the volume of the eye. A gradual and continuous increase in the volume of the lens contributes to the anterior displacement of the irido-lenticular diaphragm, causing the functional block of the anterior chamber angle. This leads to persistent disorders of the hydrodynamics of the eye, up to the development of an acute attack of angle-closure glaucoma. Purpose. To study incidence of increased risk formation of primary angle-closure glaucoma (PACG) and its acute attack in young patients with moderate and high hyperopia (Hm). Material and methods. Clinical material was presented by 58 patients (116 eyes) with indicators of axial length of the eyes less than 23 mm. The main group consisted of 33 patients (66 eyes) with moderate and high Hm. The comparison group was represented by 25 patients (50 eyes) with PACG. Results. The study made it possible to identify group of increased risk of the formation of PACG, which included 19 people (58%), from selected general population of young patients with moderate and high Hm. Conclusion. Comparative analysis of morphometric parameters of structures of the anterior segment of the anatomically «short» eyes in young patients with moderate and high Hm, on the one hand, and in patients with PACG, on the other, revealed statistically significant differences between them in the anterior chamber depth in the central zone, the thickness of the lens, the anterior chamber volume, the peripheral anterior chamber depth, of the anterior chamber angle. Key words: primary angle-closure glaucoma, acute attack of angle-closure glaucoma, hyperopia, refractive surgery.

scholarly journals Long-Term Outcomes of Primary Trabeculectomy in Diabetic Patients without Retinopathy with Primary Angle-Closure Glaucoma

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Jian Liu ◽  
Miaomiao Zhang ◽  
Bin Li ◽  
Jianrong Wang
Keyword(s):  
Case Series ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Control Group ◽  
Diabetic Patients ◽  
Surgical Success ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

Purpose. To evaluate primary trabeculectomy with adjunctive mitomycin-C (MMC) in diabetic patients without retinopathy with primary angle-closure glaucoma (PACG). Design. This is a retrospective case series comparison. Participants. This retrospective trial compared outcomes of 88 eyes that underwent trabeculectomy in patients with diabetes mellitus (DM) without retinopathy and in 97 patients without DM. Methods. In this study, the intraocular pressure (IOP), visual acuity, visual field, and postoperative complications were compared between the two groups. Qualified surgical success is defined as an IOP between 6 and 18 mmHg with or without topical antiglaucoma medication. Results. After a follow-up of 5 years, the IOP decreased from a mean basal IOP of 27.8±7.3 mmHg to 15.0±5.6 mmHg in the DM group and from 27.3±6.0 mmHg to 12.4±5.3 mmHg in the control group. The mean number of antiglaucoma medications was 3.4±1.3 and 3.3±1.2 preoperatively (P=0.587) whereas it was 1.7±1.5 and 1.1±1.4 at the 5-year follow-up (P=0.049). The 5-year qualified surgical success rates were 42.9% and 65.4% for both groups (P=0.046; log-rank test). Encysted blebs were seen in 21 (23.9%) patients in the DM group and in 12 (12.4%) patients in the control group (P=0.041). Conclusion. PACG patients with DM without retinopathy undergoing primary trabeculectomy with MMC may have a lower long-term surgical survival rate compared with patients without DM.

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