title: Determinants and characteristics of angle-closure disease in an elderly Chinese population.
abstract: OBJECTIVE
  To determine factors associated with angle-closure disease, particularly in those with structural or functional damage to the eyes, in an elderly Chinese population.
  
  
  METHODS
  A total of 460 individuals aged over 72 years were recruited. The association of angle-closure diseases, including primary angle-closure suspect (PACS), primary angle-closure (PAC) and primary angle-closure glaucoma (PACG), with various systemic and ocular characteristics was evaluated using multivariate logistic regression analyses.
  
  
  RESULTS
  Of 374 phakic subjects, 199 (53.2%) had angle-closure disease, including 135 PACS, 46 PAC, and 18 PACG. The majority of those with untreated PACG (10/13, 76.9%) had presenting intraocular pressure (IOP) < 20 mmHg. Independent risk factors for angle-closure disease were lower Van Herick grading, shallower central anterior chamber depth (ACD), and higher post-mydriatic IOP (all p < 0.05). Central and peripheral ACD estimation correlated weakly, only 60.8% of angle-closure eyes had generalized narrowing of ACD as a Van Herick grading ≤ 2 and central ACD ≤ 2.83 mm. A criterion considering either central or peripheral ACD identified 91% of angle-closure eyes, including all PACG. A higher post-mydriatic IOP was associated with a diagnosis of PAC or PACG among angle-closure eyes (p = 0.002).
  
  
  CONCLUSIONS
  Both central and peripheral ACD should be evaluated and shallowing of either one should be an indication for gonioscopic examination to maximize detection of angle-closure disease in elderly Chinese persons. PAC and PACG were associated with higher post-mydriatic IOP than PACS, although subjects with PACG frequently presented with normal IOP.
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital , Taipei , Taiwan .
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Ko
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Liu
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hsu
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.forename: Tung-Mei
authors.initials: TM
authors.lastname: Kuang
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology; D044466:Asian People / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis* / Q000208:ethnology*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D058609:Visual Field Tests
keywords: Angle-closure glaucoma; anterior chamber depth; elderly; intraocular pressure; mydriasis