title: Evaluation of blotchy pigments in the anterior chamber angle as a sign of angle closure.
abstract: BACKGROUND
  Blotchy pigments in the anterior chamber (AC) angle are considered diagnostic of primary angle closure (PAC). But there are no reports either on the prevalence of blotchy pigments in AC angles or the validity of this sign.
  
  
  OBJECTIVE
  To determine the prevalence of blotchy pigments in AC angles and to evaluate their relationship with glaucomatous optic neuropathy (GON) in eyes with occludable angles.
  
  
  METHODS
  Cross-sectional, comparative study.
  
  
  METHODS
  Gonioscopy was performed in 1001 eyes of 526 subjects (245 eyes of 148 consecutive, occludable angle subjects and 756 eyes of 378 non-consecutive, open angle subjects), above 35 years of age. Quadrant-wise location of blotchy pigments was documented.
  
  
  METHODS
  Odds of blotchy pigments in occludable angles against that in open angles were evaluated. Relationship of GON with blotchy pigments in occludable angle eyes was evaluated using a multivariate model.
  
  
  RESULTS
  Prevalence of blotchy pigments in occludable angles was 28.6% (95% CI, 22.9-34.3) and in open angles was 4.7% (95% CI, 3.2-6.3). Blotchy pigments were more frequently seen in inferior (16%) and superior quadrants (15%) of occludable angles, and inferior quadrant of open angles (4%). Odds of superior quadrant blotchy pigments in occludable angles were 33 times that in open angles. GON was seen in 107 occludable angle eyes. Blotchy pigments were not significantly associated with GON (odds ratio = 0.5; P = 0.1).
  
  
  CONCLUSIONS
  Blotchy pigments were seen in 28.6% of occludable angle eyes and 4.7% of open angles eyes. Presence of blotchy pigments in the superior quadrant is more common in occludable angles. Presence of GON in occludable angle eyes was not associated with blotchy pigments.
authors.affiliation: VST Glaucoma Center, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Andhra Pradesh, India.
authors.forename: Harsha L
authors.initials: HL
authors.lastname: Rao
authors.forename: Sachin C
authors.initials: SC
authors.lastname: Mungale
authors.forename: Tukaram
authors.initials: T
authors.lastname: Kumbar
authors.forename: Rajul S
authors.initials: RS
authors.lastname: Parikh
authors.forename: Chandra S
authors.initials: CS
authors.lastname: Garudadri
mesh_terms: D000328:Adult; D000869:Anterior Eye Segment / Q000737:chemistry*; D003430:Cross-Sectional Studies; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D006068:Gonioscopy; D006801:Humans; D007194:India / Q000453:epidemiology; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012168:Retinal Pigments / Q000032:analysis*; D012189:Retrospective Studies
chemical_list: D012168:Retinal Pigments