Clinical Presentation, Severity and Progression of Primary Angle Closure in Malays
- Author:
Ahmad Tajudin Liza-Sharmini
;
Yusof Nor Sharina
;
Dolaboladi Ali Jaafari
;
Zaid Nik Azlan
;
Yaakub Azhany
;
Embong Zunaina
- Publication Type:Journal Article
- From:
The Medical Journal of Malaysia
2014;69(1):21-26
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: There is limited knowledge on primary angle
closure (PAC) in Malays. Understanding the clinical
presentation and progression of PAC in Malays is important
for prevention of blindness in Southeast Asia.
Material and methods: A retrospective record review study
was conducted on Malay patients seen in the eye clinic of
two tertiary hospitals in Kelantan, Malaysia. Based on the
available data, Malay patients re-diagnosed as primary angle
closure suspect (PACS), primary angle closure (PAC), and
primary angle closure glaucoma (PACG) based on the
International Society Geographical Epidemiological
classification. Clinical data was collected from initial
presentation including the presence of acute primary angle
closure until at least 5 years follow up. Progression was
defined based on gonioscopic changes, vertical cup to disc
ratio (VCDR), intraocular pressure (IOP) and Humphrey
visual field (HVF) analysis. Progression and severity of
PACG was defined based Hodapp-Parrish-Anderson
classification on reliable HVF central 24-2 or 30-2 analysis.
Results: A total of 100 patients (200 eyes) with at least 5
years follow up were included. 94 eyes (47%) presented with
APAC. During initial presentation, 135 eyes (67.5%) were
diagnosed with glaucomatous changes with 91 eyes already
blind. After 5 years of follow up, 155 eyes (77.5%)
progressed. There was 4 times risk of progression in eyes
with PAC (p=0.071) and 16 times risk of progression in PACG
(p=0.001). Absence of laser peripheral iridotomy was
associated with 10 times the risk of progression.
Conclusion: Angle closure is common in Malays. Majority
presented with optic neuropathy at the initial presentation
and progressed further. Preventive measures including
promoting public awareness among Malay population is
important to prevent blindness.
- Full text:P020150724572046316086.pdf
