scholarly journals Normal Tension Primary Ppen-Angle Glaucoma with Progressive Synechial Angle Closure in Senior Chinese

2021 ◽  
Author(s):  
Zhigang Fan ◽  
Zhenni Zhao ◽  
Xiaowei Yu ◽  
Dandan Zhang ◽  
Nannan Sun ◽  
...  
Keyword(s):  
Anterior Chamber Depth ◽  
Normal Tension Glaucoma ◽  
Angle Closure ◽  
Mean Deviation ◽  
Glaucomatous Optic Neuropathy ◽  
Fiber Layer ◽  
Treatment Targets ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Senior Population

Abstract Background: This study is to address a unique subtype of combined-mechanism glaucoma (CMG), normal tension glaucoma (NTG) with progressive synechial angle closure in the Chinese senior population, whose clinical course and treatment targets are quite different from classic primary angle-closure glaucoma (PACG). Methods: In this retrospective study, 12 patients with NTG plus primary angle closure suspect or primary angle closure were included in the CMG group, and 12 classic PACG patients with matched extent of glaucomatous optic neuropathy (GON) were included in the control (PACG) group. Clinical features and detailed histories of disease development were investigated and compared between these two groups.Results: There were 6 females and 6 males in CMG group, 3 males and 9 females in PACG group. No statistical significances were found in age (63.42 ± 5.90 vs. 59.42 ± 7.47 years), preoperative intraocular pressure (20.75 ± 5.06 vs. 21.25 ± 4.47 mmHg), anterior chamber depth (ACD) (1.98 ± 0.28 vs. 1.94 ± 0.21mm), mean deviation of visual field (24.37 ± 6.54 vs. 22.01 ± 0.85 dB), average retinal nerve fiber layer thickness (48.00 ± 14.00 vs. 57.25 ± 14.10 μm), cup-to-disc (C/D) ratio (0.89 ± 0.07 vs. 0.87 ± 0.07) and axial length (22.69 ± 0.76 vs. 22.47 ± 0.69 mm) between the two groups (P > 0.05). The extent of synechial angle closure in PACG group was more extensive than that in CMG group, as evaluated by the number of “clock hours” (3.96 ± 1.14 vs. 9.38 ± 1.99, P < 0.05), although the severity of GON was comparable.Conclusion: If NTG develops with synechial angle closure, it might be misdiagnosed as PACG. We need to recognize and scrutinize this specific subtype of CMG, which is very common in the Chinese senior population, but widely neglected. In contrast to classic PACG, treatment targets in NTG with progressive synechial angle closure is primarily in consistent with those in NTG.

scholarly journals Optical coherence tomography angiography of the macular retina in primary angle closure glaucoma

2019 ◽  
Author(s):  
Yang Zhang ◽  
Shunhua Zhang ◽  
Chan Wu ◽  
Yao Zhang ◽  
Ailing Bian ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Control Group ◽  
Mean Deviation ◽  
Case Group ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

Abstract Background: To detect the macular vessel density (MVD) changes in primary angle closure glaucoma (PACG) and to investigate the correlation between MVD and other glaucomatous changes. Methods: A case-control study. Eyes of 22 PACG patients with an episode of acute primary angle closure (APAC) in one of the two eyes. Structural OCT scans were used to obtain peripapillary retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) thickness and C/D area ration. OCT angiography (OCTA) was used to measure MVD. Results: In the control group, the dense macular blood vessels were visible on OCTA， the macular vessels were sparse in the case group, and with an enlarged fovea avascular zone. There was a reduction in MVD in the case group compared with the controls (P<0.01). No correlations between MVD, VF mean deviation (MD), C/D area ratio, GCC thickness or RNFL thickness were found in the control group. In the case group, the Pearson correlation analysis showed that MVD was significantly correlated with BCVA (r=0,65, P=0.001), GCC (r=0.50, P=0.018) and VF MD (r=-0.54, P=0.009). In the case group, the multiple stepwise regression analysis, in which MVD were considered the dependent variables, showed that BCVA and GCC were significant predictors. Conclusions: Macular microvascular network attenuated and MVD reduced significantly caused by APAC. MVD was strongly linked to BCVA and GCC.

scholarly journals Asymmetric Patterns of Visual Field Loss in Primary Angle Closure Glaucoma, High Tension Glaucoma, and Normal Tension Glaucoma

2021 ◽  
Author(s):  
Junhong Jiang ◽  
Cong Ye ◽  
Cong Zhang ◽  
Wenqing Ye ◽  
Xiaoyan Wang ◽  
...  
Keyword(s):  
Central Region ◽  
Early Stage ◽  
Normal Tension Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
High Tension

Abstract The data directly comparing the spatial pattern of VF defects between primary angle-closure glaucoma (PACG), high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) is not available. We aim to compare the asymmetric patterns of VF defects in patients with PACG, NTG and HTG across different severity levels. A total of 162 eyes of 114 patients with PACG, 111 eyes of 74 patients with HTG and 148 eyes of 102 patients with NTG were included. VF examinations were performed with standard automated perimetry (HFA, SITA-standard strategy, 24-2), and defects were categorized into 3 stages (early, moderate, and advanced) and each hemifield was divided into 5 regions according to Glaucoma Hemifield Test (GHT). The mean total deviation (TD) of each GHT region was calculated. The relationship between the values of pattern standard deviation (PSD) and mean TD was assessed. In the early stage, nasal region of PACG, central region of HTG and all five regions of NTG in the superior hemifield had significantly worse mean TD than their counterparts in the inferior hemifield. In the moderate stage, three regions of NTG in the superior hemifield had significantly worse mean TD than their inferior counterparts. In the advanced stage, central region of PACG, and central and paracentral regions of HTG in the superior hemifield had significantly worse mean TD than their inferior counterparts. When participants were matched by age, sex and mean deviation, in PACG and HTG eyes, all 5 GHT regions in the superior hemifield had worse mean TD than that that of their inferior-hemifield counterparts; however, the differences were not statistically significant. In NTG eyes, the paracentral, nasal, arcuate 1 and arcuate 2 regions in the superior hemifield had significantly worse mean TDs than their inferior counterparts. The superior hemifield is affected more severely than the inferior hemifield in all 3 subtypes of primary glaucoma. This asymmetric tendency was more pronounced in NTG compared to PACG and HTG.

scholarly journals Association of peripheral anterior synechiae with anterior segment parameters in eyes with primary angle closure glaucoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yunhua Loo ◽  
Tin A. Tun ◽  
Eranga N. Vithana ◽  
Shamira A. Perera ◽  
Rahat Husain ◽  
...  
Keyword(s):  
Severe Disease ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Multivariate Logistic Regression Analysis ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Mean Deviation ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Anterior Segment Parameters

AbstractTo investigate the association of peripheral anterior synechiae (PAS) with intraocular pressure (IOP) and anterior-segment parameters in subjects with primary angle-closure glaucoma (PACG). A total of 267 subjects with PACG were recruited and underwent gonioscopy and anterior-segment optical coherence tomography (ASOCT). Customized software was used to measure ASOCT parameters, including angle opening distance (AOD750) and trabecular-iris-space-area (TISA750) at 750 µm from the scleral spur, anterior chamber depth, width, area and volume (ACD, ACW, ACA, ACV), iris thickness (IT750), iris area (IAREA), and lens vault (LV). Presenting IOP was defined as the first IOP reading before the initiation of IOP-lowering treatment. The mean age of the 267 subjects was 67.0 ± 8.9 years, 140 (52.4%) were male, and 246 (92.1%) were of Chinese ethnicity. PAS was present in 122 (45.7%) subjects, and was most frequently found in the superior quadrant (79.5%). Subjects with PAS had greater presenting IOP (28.7 ± 12.9 vs 22.4 ± 9.7 mmHg, p < 0.001), narrower AOD750 (p < 0.001), smaller TISA750 (p < 0.001), ACD (p = 0.04), ACA (p = 0.02), ACV (p = 0.01) and larger LV (p = 0.01) compared to PACG eyes without PAS. No significant differences were noted for iris parameters. A multivariate logistic regression analysis showed that higher presenting IOP (β = 0.20, p < 0.001), worse visual field mean deviation (β = − 0.20, p = 0.01) and narrower AOD750 (β = − 0.25, p = 0.03) were the only parameters that significantly correlated with the extent of PAS in clock hours. Almost one-half of the subjects with PACG demonstrated PAS; these eyes were associated with higher presenting IOP, smaller anterior segment dimensions and more severe disease.

scholarly journals Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Japanese Patients ◽  
Median Number ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Number Of Patients ◽  
Multiple Drugs

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.

scholarly journals ABCC5, a Gene That Influences the Anterior Chamber Depth, Is Associated with Primary Angle Closure Glaucoma

PLoS Genetics ◽  
2014 ◽  
Vol 10 (3) ◽  
pp. e1004089 ◽  
Author(s):  
Monisha E. Nongpiur ◽  
Chiea Chuen Khor ◽  
Hongyan Jia ◽  
Belinda K. Cornes ◽  
Li-Jia Chen ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

scholarly journals Comparison of optical coherence tomography angiography metrics in primary angle-closure glaucoma and normal-tension glaucoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ruyue Shen ◽  
Yu Meng Wang ◽  
Carol Y. Cheung ◽  
Poemen P. Chan ◽  
Clement C. Tham
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Disease Severity ◽  
Optical Coherence Tomography Angiography ◽  
Normal Tension Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Rnfl Thickness

AbstractTo investigate the peripapillary vascular metrics in early normal tension glaucoma (NTG) and early primary angle closure glaucoma (PACG) eyes using optical coherence tomography angiography (OCT-A). One or both eyes of each subject were imaged for a 3 × 3 mm peripapillary region by swept-source OCT-A (DRI-OCT Triton, Topcon, Japan) and assessed by an automated MATLAB program. OCT-A metrics including circumpapillary vessel density (cpVD) and fractal dimension (cpFD) were compared. Their association with visual field (VF) parameters and retinal nerve fiber layer (RNFL) thickness were determined. Sixty-eight eyes of 51 PACG, 68 eyes of 48 NTG, and 68 eyes of 49 control subjects were cross-sectionally analyzed. NTG eyes had significantly lower global cpVD (52.369 ± 0.781%) compared with PACG eyes (55.389 ± 0.721%, P = 0.004) that had comparable disease severity and average RNFL thickness. Multivariable analysis revealed that, for PACG and NTG eyes, decreased cpVD ([PACG] β = −4.242; CI: −8.120, −0.363 vs [NTG] β = −5.531; CI: −9.472, −1.590) and cpFD ([PACG] β = −8.894;CI: −11.925, −5.864 vs [NTG] β = −12.064; CI: −17.095, −6.932) were associated with decreased RNFL thickness (all P ≤ 0.032); with a stronger association between decrease cpFD and decreased RNFL thickness in NTG eyes (P = 0.028). Decreased cpVD was associated with decrease mean deviation (MD) in NTG eyes (β = −0.707; CI: −1.090, −0.324; P ≤ 0.001) and not associated with the visual field parameters in PACG eyes. Early NTG had lower global cpVD compared with early PACG, despite similar disease severity and average RNFL thickness.

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.

scholarly journals Ten-year incidence of primary angle closure in elderly Chinese: the Liwan Eye Study

2018 ◽  
Vol 103 (3) ◽  
pp. 355-360 ◽  
Author(s):  
Lanhua Wang ◽  
Wenyong Huang ◽  
Shengsong Huang ◽  
Jian Zhang ◽  
Xinxing Guo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incident Angle ◽  
Significant Risk ◽  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Study Participants ◽  
Angle Width

PurposeTo determine the 10-year incidence of all forms of primary angle closure (PAC) in phakic eyes and its risk factors in an urban Chinese population aged 50 years and older.MethodsSurvivors of 1405 baseline participants were invited to attend the 10-year follow-up visit in the Liwan Eye Study. Participants with established baseline angle closure, including primary angle closure suspects (PACS), PAC and primary angle closure glaucoma (PACG), or those who underwent bilateral cataract surgery during the 10-year period, as well as those who did not tolerate gonioscopic examinations, were excluded from this analysis. Incident PAC was present when those with open angles at baseline developed angle closure in any form in either eye during the 10-year period.ResultsAmong 791 participants who returned during the 10-year follow-up visit, 620 (78.4%) provided data on PAC incidence. The 10-year cumulative incidence of any forms of PAC was 20.5% (127/620, 95% CI 17.4% to 24.9%), including 16.9%, 2.4% and 1.1% with incident PACS, PAC and PACG in either eye, respectively. In multiple logistic regression, significant risk factors for incident angle closure were greater baseline lens thickness (OR=1.82 per mm, p=0.003), shallower anterior chamber depth (OR=3.18 per mm decreased, p=0.010) and narrower angle width (OR=1.63 per decreased angle width, p<0.0001).ConclusionsApproximately one in five people aged 50 years and older developed some form of angle closure over a 10-year period. Small ocular dimensions and hyperopia at baseline were associated with the development of angle closure.

scholarly journals CORRELATION BETWEEN LOCUS POLYMORPHISM OF COL11A1 GENE AND OCULAR BIOMETRY IN ACUTE AND CHRONIC PRIMARY ANGLE CLOSURE GLAUCOMA

2021 ◽  
pp. 41-45
Author(s):  
FITRATUL ILAHI ◽  
ANDIKA PRAHASTA ◽  
RIKA SUSANTI ◽  
JAMSARI JAMSARI
Keyword(s):  
Dna Isolation ◽  
Anterior Chamber Depth ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Blood Samples ◽  
Biometric Parameters ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Ocular Biometry ◽  
Significant Difference

Objective: The objective of this study is to analyze the correlation between locus polymorphisms of genetics variants of rs3753841 (COL11A1) and ocular biometry, including anterior chamber depth (ACD), axial length (AL), and lens thickness (LT) in acute and chronic primary angle-closure glaucoma (PACG) patients. Methods: A total of 50 patients consisting of 25 acute PACG and 25 chronic PACG patients were included in this study. Ocular biometric parameters including anterior ACD, AL, and LT measurement were performed in all subjects using A-scan biometry. DNA isolation from blood samples was performed using PCR sequencing for genotyping locus polymorphisms of rs3753841 (COL11A1). Results: Mean ACD was shallower (2.40±0.40 mm), mean AL was shorter (21.86±1.31 mm), and mean LT was thicker (5.01±0.49 mm) in acute PACG compared to chronic PACG group, yet with no significant difference (p>0.05). We found a statistically significant difference of rs3753841 (COL11A1) polymorphism, with heterozygous mutant was mostly found in chronic PACG and homozygous mutant was mostly found in acute PACG patients (p<0.05). Significant correlations were also found between the locus polymorphism and ocular biometry (ACD and AL) in chronic PACG (p<0.05). Conclusion: We confirmed the polymorphisms of rs3753841 (COL11A1) in both groups and its significant correlation with ocular biometry (ACD and AL) in chronic PACG.

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