Angle closure in Caucasians-A pilot, general ophthalmology clinic-based study

Yaniv Barkana, Inbal Dekel, Yakov Goldich, Yair Morad, Isaac Avni, David Zadok

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To assess the rate of clinically significant angle closure in a predominantly Caucasian, clinic-based population, and consequently find out whether gonioscopy should be included in the routine ophthalmic examination. METHODS: Patients aged ≥40 years with hyperopia ≥1 D were consecutively recruited in a community general ophthalmology clinic. Detailed darkroom gonioscopy was done, and primary angle closure was diagnosed if there was iridotrabecular apposition >180 degrees not secondary to an identifiable ocular disorder. Biometric parameters were measured and compared between the eyes with and without angle closure. RESULTS: Eighty-four eyes from 84 patients (aged 61.3±8.9 y) were enrolled. There were 52 female (62%) and 32 male. Fourteen patients (16.7%) were diagnosed with angle closure. A statistically significant difference was observed between the eyes with and without angle closure in mean axial length (22.07±0.72 vs. 22.61±0.97, P=0.028), anterior chamber depth (ACD) (2.45±0.33 vs. 2.89±0.32, P<0.001), and lens thickness (4.97±0.3 vs. 4.62±0.4, P=0.002). Degree of hyperopia was marginally significant (3.13±2.3 vs. 2.45±1.5, P=0.09). In a logistic regression model, only ACD remained statistically significantly different (P=0.016). We tested the ability of ACD to distinguish eyes with angle closure. The area under the receiver operating characteristic curve was 0.824; using a cutoff ACD value of 2.65 mm, sensitivity was 0.786 with a specificity of 0.812. CONCLUSIONS: Clinically significant angle closure, mandating close follow-up or preventive procedures, may be more common in Caucasians than currently thought. We recommend that gonioscopy should be included in the routine ophthalmic examination of all adults with hyperopia.

Original languageEnglish
Pages (from-to)337-341
Number of pages5
JournalJournal of Glaucoma
Volume21
Issue number5
DOIs
StatePublished - Jun 2012
Externally publishedYes

Keywords

  • Caucasians
  • angle closure
  • glaucoma

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