Angle closure in younger patients.
OBJECTIVE
Angle-closure glaucoma is rare in children and young adults; only scattered cases associated with specific clinical entities have been reported. We evaluated the findings in patients aged 40 or younger with angle closure in our database.


METHODS
Retrospective noncomparative case series.


METHODS
Our database was searched for patients aged 40 years or younger with angle closure. Data recorded included age at initial consultation, age at the time of diagnosis, gender, slit-lamp examination, gonioscopy, ultrasound biomicroscopy (from 1993 onward), clinical diagnosis, and therapy. Patients with prior incisional surgery were excluded, as were patients with anterior chamber proliferative mechanisms leading to angle closure.


RESULTS
Sixty-seven patients (49 females, 18 males) met entry criteria. Mean age at the time of consultation was 34.4 +/- 9.4 (standard deviation) years (range, 3-68 years). Diagnoses included plateau iris syndrome (35 patients); iridociliary cysts (8 patients); retinopathy of prematurity (7 patients); uveitis (5 patients); isolated nanophthalmos (3 patients); relative pupillary block (2 patients); Weill-Marchesani syndrome (3 patients); and 1 patient each with Marfan syndrome, miotic-induced angle closure, persistent hyperplastic primary vitreous, and idiopathic lens subluxation.


CONCLUSIONS
The etiology of angle closure in young individuals differs from the older population and is typically associated with structural/developmental ocular anomalies rather than relative pupillary block. After laser iridotomy, these eyes should be monitored for recurrent angle closure and the need for additional laser or incisional surgical intervention.
Ritch
Robert
R
Department of Ophthalmology, the New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY 10003, USA.
Chang
Brian M
BM
Liebmann
Jeffrey M
JM
D000293:Adolescent; D000328:Adult; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005128:Eye Diseases / Q000150:complications; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007498:Iris / Q000000981:diagnostic imaging; D008297:Male; D012189:Retrospective Studies; D014463:Ultrasonography