Global Search

Search articles, concepts, and chapters

OphthalmologySeptember 201042 citations

Angle closure in the Andhra Pradesh Eye Disease Study.

Senthil Sirisha, Garudadri Chandrasekhar, Khanna Rohit C, Sannapaneni Krishniah


AI Summary

This study found primary angle-closure glaucoma prevalence was 0.94% in Andhra Pradesh, increasing with age, IOP, diabetes, and in females. Most cases were undiagnosed, highlighting the need for screening.

Abstract

Objective

To estimate the prevalence and associated risk factors for primary angle-closure glaucoma (PACG), primary angle closure (PAC), and primary angle-closure suspects (PACS) in the Indian state of Andhra Pradesh.

Design

A population-based, cross-sectional study using a stratified, random, cluster, and systematic sampling strategy.

Participants

Between 1996 and 2000, participants aged > or =40 years from 94 clusters in 1 urban and 3 rural areas were included.

Methods

Trained professionals performed a detailed eye examination, including visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated fundus evaluation after ruling out risk of angle closure. Humphrey threshold 24-2 visual fields (VFs) were performed when indicated by disc criteria or if intraocular pressure (IOP) was > or =22 mmHg.

Main outcome measures

Angle closure was diagnosed and categorized using International Society of Geographical and Epidemiological Ophthalmology criteria.

Results

Primary angle-closure glaucoma was present in 35 of 3724 subjects aged > or =40 years, an age- and gender-adjusted prevalence of 0.94% (95% confidence interval [CI], 0.63-1.24). Primary angle closure was present in 12 subjects (0.3%; 95% CI, 0.1-0.5), and PACS was present in 71 subjects (2%; 95% CI, 1.5-2.3). The prevalence of angle-closure disease (ACD=PACG+PAC) was 1.26% (95% CI, 0.90-1.62). Forty-one of 47 subjects (87.2%) with ACD were unaware of their disease. The prevalence of PACG increased from 0.56% (0.17-0.94) in the fourth decade to 2.5% (0.87-4.12) in the seventh decade. Seven (20%) of the 35 subjects with PACG were blind (visual acuity <3/60). Intraocular pressure increase (odds ratio [OR] 1.16; 95% CI, 1.11-1.22; P<0.001), diabetes mellitus (OR 3.18l; 95% CI, 1.34-7.58; P=0.001), and female gender (OR 2.07; 95% CI, 1.09-3.93; P=0.025) were significantly associated with angle-closure disease. No significant association was found with systemic hypertension (P=0.24) and hyperopia (P=0.05).

Conclusions

The prevalence of PACG in this population was 0.94%. Increasing age, increasing IOP, diabetes mellitus, and female gender were significantly associated with angle-closure disease. Blindness due to PACG was 20%.


MeSH Terms

AdultAge DistributionAgedCross-Sectional StudiesFemaleGlaucoma, Angle-ClosureGonioscopyHumansIndiaIntraocular PressureMaleMiddle AgedPrevalenceRisk FactorsRural PopulationSex DistributionUrban Population

Is this article assigned to the wrong chapter(s)? Let us know.