Clinical Presentation, Severity and Progression of Primary Angle Closure in Malay and Chinese Patients
- Author:
Ahmad Tajudin Liza-Sharmini
;
Guan Fook Ng
;
Yusoff Nor-Sharina
;
Md Isa Khairil Anuar
;
Zaid Nik Azlan
;
Yaakub Azhany
- Publication Type:Journal Article
- From:
The Medical Journal of Malaysia
2014;69(6):245-251
- CountryMalaysia
- Language:English
-
Abstract:
Objective: To compare the clinical presentation, severity and
progression of primary angle closure between Chinese and
Malays residing in Malaysia.
Methods: A comparative retrospective record review study
was conducted involving one hundred (200 eyes) Malay and
fifty eight (116 eyes) Chinese patients. They were selected
from medical records of Hospital Universiti Sains Malaysia,
Kelantan and Hospital Pulau Pinang, Penang, Malaysia. The
selected patients were re-diagnosed based on the
International Society of Geographical and Epidemiological
classification. The clinical data on presentation including
the presence of systemic diseases were documented.
Progression of the disease was based on available reliable
visual fields and optic disc changes of patients who have
been on follow-up for at least five years.
Results: Malay patients presented at older age (61.4 years
SD 8.4) compared to Chinese (60.6 years SD 8.3). There was
significant higher baseline Intraocular Pressure (IOP) among
Malays (34.7 SD 18.5mmHg) compared to Chinese (30.3 SD
16.7mmHg) (p=0.032). The Chinese patients presented with
significantly better visual acuity (p<0.001) and less
advanced cup to disc changes (p=0.001) compared to
Malays. Malay patients progressed faster than the Chinese.
Majority progressed within 1 year of diagnosis. Malays
without laser peripheral iridotomy (LPI) have a 4 fold (95% CI
1.4, 10.9) risk of progression. Higher baseline IOP, more
advanced visual field defect and absence of LPI was
identified as significant predictors associated with
progression.
Conclusion: The Malays presented with more advanced
angle closure glaucoma as compared to the Chinese in
Malaysia. Aggressive disease progression was observed in
Malays with the onset of optic neuropathy. Effective public
awareness and aggressive management is important to
prevent blindness in the Malaysian population.
- Full text:P020150724614656940870.pdf
