Anatomical risk factors in primary angle-closure glaucoma

Abstract

A population of 539 persons was examined in 1979, using LCD and ACD estimations acc. to van Herick et al. and by Haag Streit pachymetry, respectively. ACD had been measured already in 1969, due to a remarkable occurrence of primary angle-closure glaucoma (PACG) in the survey population of Greenland Eskimos (District of Uummannaq). The present follow up study in 1989 aimed at persons presently above age 40, who had showneither an LCD value graded as 0 (contact) or 1 (< 0.25 of corneal thickness=CT),or a value of 2 (=0.25 CT) if an ACD value of <=2.70mm (CT included) had also been found. PACG patients or suspects known in 1979 already were excluded from the present analyses. A total of 75 persons was now examined. Five had developed acute (n=2) or intermittent PACG (n=3)during the ten year period.At the survey 3 intermittent and 4 latent PACG cases were detected, yielding in ten years a PACG prevalence of 12/75=16% (sex ratio: M/F=2/10). One male case of severe secondary (partly inflammatory) ACG was also found. Past and present LCD and ACD values are given as well as gonioscopical status. Creeping, synechial angle-closure was frequent. Among probands who could not be examined, mostly due to death before 1989, 5/54 had developed PACG during the ten year period. Non-probands according to above criteria were mostly not examined. Yet their records were scrutinized for any event suspect of PACG. Thus among 258 persons above age 40 no PACG case was found.In conclusion: a fairly simple, anatomical slit lamp screening (of LCD and ACD) was found effectively to select a subgroup which proved to be at risk of PACG-development in the following ten year period.