Profile of angle closure in a tertiary care center in north India.
OBJECTIVE
To study the demographic and clinical profile of the types of primary angle closure patients presenting at a tertiary care center in North India.


METHODS
Clinic records of patients diagnosed as primary angle closure were reviewed. International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification scheme was used to categorize patients. Demographic and clinical data including prior management was collected and analyzed. Main Outcome measures were age, sex, symptomatology, best corrected visual acuity (BCVA), intraocular pressure (IOP), gonioscopy, optic disc assessment and visual field defects. Logistic regression model and receiver operating curve (ROC) were calculated for predictors of type of glaucoma.


RESULTS
Eight hundred and fourteen patients (1603 eyes; males: 380, females: 434) were diagnosed to have various subtypes of angle closure. Mean (+/-SD) age at presentation was significantly higher for males (57.57 +/- 11.62 years) as compared to females (53.64 +/- 10.67 years) ( P < 0001). Primary angle closure glaucoma (PACG) was most frequently diagnosed subtype (49.38%) followed by Primary angle closure (PAC) (39.68%) and Primary angle closure suspect (PACS) (10.93%) respectively. The three subtypes differed significantly among their mean IOP (on ANOVA, F = 14.04; P < 0001 using Greenhouse-Geisser correction). Univariate analysis was done to find significant predictors for the outcome of PACG. Logistic regression model and ROC containing the significant predictors yielded a very high AUC of 0.93 with strong discriminatory ability for PACG.


CONCLUSIONS
In our hospital-based study, the significant predictors for the outcome of PACG included male gender, diminution of vision, the presence of pain and worsening grades of BCVA. Nearly half of PACG presented with advanced disease. In spite of one-third of the patients being diagnosed as angle closure prior to referral, only 8.34% had iridotomy (laser or surgical) done.
Ichhpujani
Parul
P
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Pandav
Surinder S
SS
Ramasubramanian
Aparna
A
Kaushik
Sushmita
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged