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Results for “primary angle-closure glaucoma”

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At least 19 recordsLinked to original sources
PubMed1976

Primary angle-closure glaucoma. Oculometry, epidemiology, and genetics in a high risk population.

The ocular dimensions in patients suffering from primary angle-closure glaucoma (a.c.g.) have been studied in several clinical series, chiefly in Caucasians. The epidemiology and aetiology of a.c.g. are less well known although genetic factors seem to be involved. Eskimos have recently been shown to constitute a high risk population with respect to a.c.g. Consequently, a series of oculometric, epidemiologic, and genetic studies among Greenland Eskimos was undertaken. Besides the immediate purpose, prevention of blindness in this population, the survey had important general aspects and the following main results were obtained: 1a) Ocular dimensions, as well as clinical symptoms, in Eskimo a.c.g. patients correspond closely to those of a.c.g. reports from other ethnic groups and 1b) ocular dimensions of the anterior segment in the general Eskimo population deviate conspicuously towards the low level characteristic of all samples of a.c.g. patients. 2) A.c.g. prevalence rates were estimated at 1.6% in males and 5.1% in females of the general population aged 40 years or more. The epidemiology of a.c.g. seems to reflect closely the variations of axial anterior chamber depth (ACD) according to race (Eskimo, Caucasian), sex and age. Empirical a.c.g. risk estimates, depending on the ACD value, were obtained in elderly females. 3) A relatively shallow chamber was found in 1st and 2nd degree relatives of a.c.g. patients, in close agreement with an earlier study in Caucasians (Törnquist 1953). However, also in the general Eskimo population a pronounced familial resemblance with respect to ACD and corneal diameter was found. Thus the family studies indicate that the size of the anterior chamber shows a mainly genetic determination, which probably constitutes the genetic basis of a.c.g. as well. With this background a hypothesis is discussed, which interprets the small anterior chambers in Eskimos as a result of genetic adaptation to arctic environment. Corneal protection may have been the significant advantage and the a.c.g. load in elderly persons a relatively less important cost.

Adolescent↗
PubMed1979

Management of acute primary angle-closure glaucoma: a long-term follow-up of the results of peripheral iridectomy used as an initial procedure.

For the past 12 years peripheral iridectomy has been used as the initial surgical procedure after an acute attack of angle-closure glaucoma. The operation has been performed 2 to 5 days after the pressure has been controlled medically and has been followed routinely by prophylactic peripheral iridectomy in the fellow eye. Peripheral iridectomy for primary acute angle-closure glaucoma controlled the condition without any need for further medical or surgical therapy in 72% of cases. Careful and frequent follow-up within the first 4 postoperative months is essential to prevent further field loss, which can occur very rapidly if the pressure is not adequately controlled. If the pressure remains uncontrolled, further surgery should not be delayed. It was impossible to decide which patients would eventually need trabeculectomy when they first attended in the acute attack. Peripheral iridectomy as a prophylactic procedure was entirely effective in preventing an acute angle-closure attack in the fellow eye.

Acute Disease↗
PubMed1977

Cycloscopy of angle-closure glaucoma.

Cycloscopy was performed in eyes with primary angle-closure glaucoma and non-glaucomatous wide-angle. In all eyes of primary angle-closure glaucoma, the ciliary processes were accessible through the small pupil by cycloscopy with minimal or no indentation. In fellow eyes of the previously acute-attack eyes, the ciliary processes were visualized through the small pupil without indentation. On the contrary, in primary angle-closure glaucoma eyes the significant shallow chamber depth was seen in 66%, and the positive prone-position test in 41%. The results obtained seem to suggest that morphological changes of the ciliary processes might be causally related to the manifestation of primary angle-closure glaucoma, and that cycloscopy is a reliable diagnostic method.

Acute Disease↗
PubMed1978

The long-term effects of iridectomy for primary acute angle-closure glaucoma.

Forty-nine eyes were treated with iridectomy for primary acute angle-closure glaucoma. Forty asymptomatic, normotensive fellow eyes were similarly treated. The duration of follow-up after surgery was 52.3 +/- 3.6 months. Thirty-seven (76%) of the eyes with acute attacks were cured by iridectomy alone and required no medical therapy. Twelve eyes (24%) developed increased intraocular pressure following iridectomy, but only one eye (2%) required filtering surgery. Eighty-eight percent of the asymptomatic, normotensive fellow eyes required no subsequent therapy, and none developed visual field defects. Visual acuity was unchanged in 22 of 49 (45%) of the acutely involved eyes and decreased more than six lines in 11 (22%) eyes. In the 40 fellow eyes, visual acuity was unchanged in 63% and decreased more than six lines in only one (2%) eye.

Aged↗
PubMed2026

Incidence patterns and genetic validation of primary glaucoma subtypes among 1 million adults in China and the UK.

BACKGROUND/AIMS: Primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) are distinct diseases, yet many glaucoma cases in population-based datasets lack subtype specification. We assessed incidence patterns of glaucoma subtypes in China and the UK and used genetic evidence to infer the likely subtype composition of cases recorded as unspecified glaucoma. METHODS: Incident primary glaucoma was identified from linked inpatient records in the prospective China Kadoorie Biobank (CKB; n=512 504) and UK Biobank (UKB; n=492 329) studies. Cohort-specific phenotyping algorithms defined POAG, PACG and unspecified glaucoma. Adjusted incidence rates were estimated by direct standardisation. To support subtype inference, polygenic risk scores (PRSs) were constructed using ancestry-specific genome-wide association studies, including a new East Asian PACG meta-analysis, and tested for association with glaucoma phenotypes using multivariable logistic regression. RESULTS: Over 12 years of follow-up, 1658 primary glaucoma cases were identified in CKB and 7643 in UKB. Most (>68%) cases lacked subtype specification. Incidence increased with age and was twofold higher among women for PACG in both cohorts and for unspecified glaucoma in CKB. In UKB, POAG incidence was fivefold higher among Black than White participants, with a similar but attenuated pattern for unspecified glaucoma. PRS analyses indicated that unspecified glaucoma closely aligned with PACG in CKB but was more heterogeneous in UKB. CONCLUSION: Healthcare-recorded incidence patterns for POAG and PACG were consistent with established demographic risk factors, whereas unspecified glaucoma showed differences in subtype composition between populations. Integrating epidemiological and genetic evidence improves interpretation of glaucoma phenotypes when detailed clinical information is unavailable.

Epidemiology↗
PubMed1978

Angle-closure glaucoma secondary to posterior scleritis.

This paper reports 3 patients who presented with angle-closure glaucoma secondary to posterior scleritis. Differentiation from primary angle-closure glaucoma is important, as medical treatment is markedly different while surgical treatment is not required.

Adult↗
PubMed2026

Genome-wide discovery reveals 30 loci for choroidal thickness and uncovers potential causal links with angle-closure glaucoma.

The choroid is critical for maintaining vision and implicated in several ocular diseases, being the sole source of nutrients and waste removal for the outer retina. Genetic discovery can help elucidate the pathways through which choroidal features influence disease risk. Our meta-analysis of genome-wide association studies (n= 78,682 participants) identified 30 genomic regions, including 20 novel loci, associated with choroidal thickness. Findings suggest inflammatory and vascular processes drive choroidal thickness, with overlapping mechanisms shared with refractive error. Genome-wide independently significant SNPs accounted for 18.7% of the genetic variance in choroidal thickness. Mendelian randomisation analyses showed a causal effect of age-related macular degeneration on choroidal thickness, and suggest a bidirectional causal effect between choroidal thickness and primary angle-closure glaucoma. These findings provide insight into the shared genetic architecture and biological pathways linking choroidal thickness and related diseases.

Canadian Longitudinal Study on Aging↗
PubMed1977

Variation and heritability of ocular dimensions. A population study among adult Greenland Eskimos.

Adult Greenland Eskimos from Umanaq town (age 15+) and villages (age 40+) were examined. Optical pachymetry, ultrasonic oculometry, corneal diameter and curvature measurements, and subjective refraction were performed in 5-600 persons. Frequent occurrence of primary angle-closure glaucoma motivated the survey. Age-, sex- and family-variations were studied by linear regression analyses. Conspicuous age effect was found with respect to increase of lens thickness and forward displacement of the lens with age. Almost no age influence was found with respect to increase of lens thickness and forward displacement of the lens with age. Almost no age influence was found with respect to corneoscleral size, i. e. axial length, corneal size and corneal radius of curvature. Conspicuous heritability (h2=0.6-0.8) was found in corneoscleral size parameters as well as lens position, while refractive error showed a much smaller genetic influence.

Adolescent↗
PubMed1978

Argon laser iridotomy in the treatment of patients with primary angle-closure or pupillary block glaucoma: a clinicopathologic study.

A "pulsed" argon laser was successful in 48 of 64 (75%) attempted laser iridotomies. Scanning and transmission electron microscopy performed on specimens taken at varying intervals following laser treatment revealed progressive scarring of iris tissue. The complications appear minimal at this time, but longer follow-up is required before it can be stated that laser and surgical peripheral iridectomies are comparable. However, the laser's simplicity and ease of administration appear to warrant its continued use at this time.

Argon↗
PubMed1978

[Pathomechanism and therapy of angle-closure glaucoma (author's transl)].

Pathogenetically three types of primary angleclosure glaucoma can be differentiated. 1. Iridolenticular block; 2. Irido-trabecular block, 3. Cilioirido-lenticular block. The different types of angle-closure glaucoma are characterized by particular morphologic and functional criteria. Their therapy varies and should be oriented toward this classifikation.

Glaucoma↗
PubMed1979

Continuous wave argon laser iridectomy in angle-closure glaucoma.

Utilizing a continuous wave argon laser in a multiburn fashion, successful iridectomies were achieved in 42 of 45 phakic eyes with either acute or chronic angle-closure glaucoma. Five of the successful procedures required multiple sittings on different days or abandonment of the primary treatment site in favor of an alternate site to attain patency. Within the immediate postoperative period, ten eyes needed further treatment to eliminate moderate pigment proliferation at the perforation site. The procedure was performed on an outpatient basis under topical anesthesia, usually required less than one-half hour for completion, and resulted in only minimal complications. Therefore, CWAL iridectomy appears to present an alternative to surgical iridectomy for the definitive treatment of angle-closure glaucoma, although long-term evaluation of this modality of therapy is presently unavailable.

Adult↗
PubMed1979

Continuous wave argon laser iridectomy in angle-closure glaucoma.

By using a continuous wave argon laser in a multiburn fashion, successful iridectomies were achieved in 42 out of 45 phakic eyes with either acute or chronic angle-closure glaucoma. Five of the successful procedures required multiple sittings on different days or abandonment of the primary treatment site in favor of an alternate site, or both, to attain patency. Within the immediate postoperative period, ten eyes needed retreatment to eliminate moderate pigment proliferation at the perforation site. The procedure was performed on an outpatient basis under topical anesthesia, usually required less than one-half hour for completion, and resulted in only minimal complications. Therefore, continuous wave argon laser iridectomy appears to present a viable alternative to surgical iridectomy for the definitive treatment of angle-closure glaucoma, although long-term evaluation of this modality of therapy is presently unavailable.

Adult↗
PubMed2026

Migraine is not a risk factor for glaucoma: Evidence from a bidirectional Mendelian randomization study.

Numerous compelling observational studies have indicated that migraine is a risk factor for the development of glaucoma. Nevertheless, some studies have observed entirely opposite results. The objective of our research is to evaluate the potential relationship between migraine and glaucoma by employing a bidirectional Mendelian Randomization (MR) approach. This method enables us to rigorously assess the causal links between these 2 conditions, thereby addressing the discrepancies in existing literature. Independent genetic variants associated with glaucoma and migraine at the genome-wide significance level were selected as instrumental variables. All summary data were obtained from the genome-wide association study database. The primary method employed in the bidirectional MR analysis was the inverse variance weighted method, while sensitivity analyses utilized the leave-one-out method, MR-Egger method, and MR-Pleiotropy RESidual Sum and Outlier‌ method. When migraine and its subtypes (specifically migraine with aura and migraine without aura) were evaluated as exposure factors, we found no evidence of a causal relationship with glaucoma and its subtypes (namely angle-closure glaucoma and open-angle glaucoma). Subsequently, in the reverse MR analysis, when glaucoma and its subtypes (angle-closure glaucoma and open-angle glaucoma) were assessed as exposure factors, there was no substantial evidence to support a causal relationship with migraine or its subtypes (migraine with aura and migraine without aura). Furthermore, sensitivity analyses also reinforced the robustness of our bidirectional MR findings. Our bidirectional MR analysis mitigates the biases associated with traditional observational studies, highlighting that there is no direct causal relationship between migraine and the risk of glaucoma.

Humans↗
PubMed2023

The Use of ChatGPT to Assist in Diagnosing Glaucoma Based on Clinical Case Reports.

INTRODUCTION: The purpose of this study was to evaluate the capabilities of large language models such as Chat Generative Pretrained Transformer (ChatGPT) to diagnose glaucoma based on specific clinical case descriptions with comparison to the performance of senior ophthalmology resident trainees. METHODS: We selected 11 cases with primary and secondary glaucoma from a publicly accessible online database of case reports. A total of four cases had primary glaucoma including open-angle, juvenile, normal-tension, and angle-closure glaucoma, while seven cases had secondary glaucoma including pseudo-exfoliation, pigment dispersion glaucoma, glaucomatocyclitic crisis, aphakic, neovascular, aqueous misdirection, and inflammatory glaucoma. We input the text of each case detail into ChatGPT and asked for provisional and differential diagnoses. We then presented the details of 11 cases to three senior ophthalmology residents and recorded their provisional and differential diagnoses. We finally evaluated the responses based on the correct diagnoses and evaluated agreements. RESULTS: The provisional diagnosis based on ChatGPT was correct in eight out of 11 (72.7%) cases and three ophthalmology residents were correct in six (54.5%), eight (72.7%), and eight (72.7%) cases, respectively. The agreement between ChatGPT and the first, second, and third ophthalmology residents were 9, 7, and 7, respectively. CONCLUSIONS: The accuracy of ChatGPT in diagnosing patients with primary and secondary glaucoma, using specific case examples, was similar or better than senior ophthalmology residents. With further development, ChatGPT may have the potential to be used in clinical care settings, such as primary care offices, for triaging and in eye care clinical practices to provide objective and quick diagnoses of patients with glaucoma.

Artificial intelligence (AI)↗
PubMed1978

Lack of association of histocompatibility antigens with primary open-angle glaucoma.

Eighty-seven patients (35 with primary open-angle glaucoma, 20 with angle-closure glaucoma, and 32 controls) underwent HLA typing of peripheral lymphocytes. Sixteen specificities were detected at the A locus, 19 at the B locus, and four at the C locus. No significant differences were found between patients with either type of glaucoma and control patients.

Ethnicity↗