Nonprogressive glaucomatous cupping and visual field abnormalities in young Chinese males.
OBJECTIVE
To describe a series of young to middle-aged men of Chinese origin who presented with a constellation of ocular findings suggestive of glaucoma, that were found to be stable over a 7-year period.


METHODS
Retrospective case series.


METHODS
Sixteen 25- to 66-year-old male patients.


METHODS
Medical records of the participants, of Chinese origin and referred for glaucoma evaluation over a 7-year period, were reviewed. All patients underwent complete ophthalmic examinations, stereo imaging of the optic nerves, and automated perimetry. Fewer than 5% of all patients seen in this practice were of Chinese origin. The patients were observed for the duration of the study in a single glaucoma clinic.


METHODS
Visual field (VF) changes or progressive optic nerve cupping suggestive of glaucoma.


RESULTS
The patients had an average age of 38.9 years. Tilted discs were present in 75.0% (24/32) and peripapillary atrophy in 81.3% (26/32) of nerves. Cup-to-disc ratios ranged from 0.20 to 0.95 and averaged 0.56. The lowest intraocular pressure (IOP) in any patient at any time was 8 mmHg, whereas the highest was 29 (average range, 13.5-17.9). Intraocular pressure-lowering therapy had been used in 56.3% (9/16). There was a family history of presumed glaucoma in 25.0% (4/16) of patients. High myopia (>-6.00-diopter spherical equivalent [SE]) was present in 43.8% of eyes (14/32), and SEs ranged from -11.25 to +0.25. The most common VF defect was an arcuate defect, found in 31.3% (10/32) of patients. There were no females of Chinese origin with similar findings identified during this period. Neither optic nerve nor significant VF progression was found during the follow-up period, regardless of the use of IOP-lowering therapy.


CONCLUSIONS
These young Chinese patients previously diagnosed with glaucoma or considered glaucoma suspects had stable ocular findings for up to 7 years, irrespective of IOP-lowering therapy. Their condition was associated with myopia and tilted discs. Many were being treated with IOP-lowering therapy for glaucoma, a condition they may not have had. Further prospective epidemiologic study is needed to determine whether such a constellation of nonprogressive findings is more common in young Chinese males than in the general population.
Doshi
Amish
A
Department of Ophthalmology, Stanford University, Stanford, California 94305, USA. amishdoshi@yahoo.com
Kreidl
Ken O
KO
Lombardi
Lorinna
L
Sakamoto
Douglas K
DK
Singh
Kuldev
K
D000328:Adult; D000368:Aged; D001213:Asian; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications; D009900:Optic Nerve / Q000473:pathology*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology; D058609:Visual Field Tests; D014794:Visual Fields