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Angle closure in the Andhra Pradesh Eye Disease Study.
Ophthalmology 2010; 117(9):1729-35O

Abstract

OBJECTIVE

To estimate the prevalence and associated risk factors for primary angle-closure glaucoma (PACG), primary angle closure (PAC), and primary angle-closure suspects (PACS) in the Indian state of Andhra Pradesh.

DESIGN

A population-based, cross-sectional study using a stratified, random, cluster, and systematic sampling strategy.

PARTICIPANTS

Between 1996 and 2000, participants aged > or =40 years from 94 clusters in 1 urban and 3 rural areas were included.

METHODS

Trained professionals performed a detailed eye examination, including visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated fundus evaluation after ruling out risk of angle closure. Humphrey threshold 24-2 visual fields (VFs) were performed when indicated by disc criteria or if intraocular pressure (IOP) was > or =22 mmHg.

MAIN OUTCOME MEASURES

Angle closure was diagnosed and categorized using International Society of Geographical and Epidemiological Ophthalmology criteria.

RESULTS

Primary angle-closure glaucoma was present in 35 of 3724 subjects aged > or =40 years, an age- and gender-adjusted prevalence of 0.94% (95% confidence interval [CI], 0.63-1.24). Primary angle closure was present in 12 subjects (0.3%; 95% CI, 0.1-0.5), and PACS was present in 71 subjects (2%; 95% CI, 1.5-2.3). The prevalence of angle-closure disease (ACD=PACG+PAC) was 1.26% (95% CI, 0.90-1.62). Forty-one of 47 subjects (87.2%) with ACD were unaware of their disease. The prevalence of PACG increased from 0.56% (0.17-0.94) in the fourth decade to 2.5% (0.87-4.12) in the seventh decade. Seven (20%) of the 35 subjects with PACG were blind (visual acuity <3/60). Intraocular pressure increase (odds ratio [OR] 1.16; 95% CI, 1.11-1.22; P<0.001), diabetes mellitus (OR 3.18l; 95% CI, 1.34-7.58; P=0.001), and female gender (OR 2.07; 95% CI, 1.09-3.93; P=0.025) were significantly associated with angle-closure disease. No significant association was found with systemic hypertension (P=0.24) and hyperopia (P=0.05).

CONCLUSIONS

The prevalence of PACG in this population was 0.94%. Increasing age, increasing IOP, diabetes mellitus, and female gender were significantly associated with angle-closure disease. Blindness due to PACG was 20%.

Authors+Show Affiliations

L.V Prasad Eye Institute, Kallam Anji Reddy campus, L.V Prasad Marg, Banjara Hills, Hyderabad, India. siddharth142@sify.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20466426

Citation

Senthil, Sirisha, et al. "Angle Closure in the Andhra Pradesh Eye Disease Study." Ophthalmology, vol. 117, no. 9, 2010, pp. 1729-35.
Senthil S, Garudadri C, Khanna RC, et al. Angle closure in the Andhra Pradesh Eye Disease Study. Ophthalmology. 2010;117(9):1729-35.
Senthil, S., Garudadri, C., Khanna, R. C., & Sannapaneni, K. (2010). Angle closure in the Andhra Pradesh Eye Disease Study. Ophthalmology, 117(9), pp. 1729-35. doi:10.1016/j.ophtha.2010.01.021.
Senthil S, et al. Angle Closure in the Andhra Pradesh Eye Disease Study. Ophthalmology. 2010;117(9):1729-35. PubMed PMID: 20466426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Angle closure in the Andhra Pradesh Eye Disease Study. AU - Senthil,Sirisha, AU - Garudadri,Chandrasekhar, AU - Khanna,Rohit C, AU - Sannapaneni,Krishniah, Y1 - 2010/05/13/ PY - 2009/03/19/received PY - 2010/01/08/revised PY - 2010/01/08/accepted PY - 2010/5/15/entrez PY - 2010/5/15/pubmed PY - 2010/9/21/medline SP - 1729 EP - 35 JF - Ophthalmology JO - Ophthalmology VL - 117 IS - 9 N2 - OBJECTIVE: To estimate the prevalence and associated risk factors for primary angle-closure glaucoma (PACG), primary angle closure (PAC), and primary angle-closure suspects (PACS) in the Indian state of Andhra Pradesh. DESIGN: A population-based, cross-sectional study using a stratified, random, cluster, and systematic sampling strategy. PARTICIPANTS: Between 1996 and 2000, participants aged > or =40 years from 94 clusters in 1 urban and 3 rural areas were included. METHODS: Trained professionals performed a detailed eye examination, including visual acuity, refraction, slit-lamp biomicroscopy, applanation tonometry, gonioscopy, and dilated fundus evaluation after ruling out risk of angle closure. Humphrey threshold 24-2 visual fields (VFs) were performed when indicated by disc criteria or if intraocular pressure (IOP) was > or =22 mmHg. MAIN OUTCOME MEASURES: Angle closure was diagnosed and categorized using International Society of Geographical and Epidemiological Ophthalmology criteria. RESULTS: Primary angle-closure glaucoma was present in 35 of 3724 subjects aged > or =40 years, an age- and gender-adjusted prevalence of 0.94% (95% confidence interval [CI], 0.63-1.24). Primary angle closure was present in 12 subjects (0.3%; 95% CI, 0.1-0.5), and PACS was present in 71 subjects (2%; 95% CI, 1.5-2.3). The prevalence of angle-closure disease (ACD=PACG+PAC) was 1.26% (95% CI, 0.90-1.62). Forty-one of 47 subjects (87.2%) with ACD were unaware of their disease. The prevalence of PACG increased from 0.56% (0.17-0.94) in the fourth decade to 2.5% (0.87-4.12) in the seventh decade. Seven (20%) of the 35 subjects with PACG were blind (visual acuity <3/60). Intraocular pressure increase (odds ratio [OR] 1.16; 95% CI, 1.11-1.22; P<0.001), diabetes mellitus (OR 3.18l; 95% CI, 1.34-7.58; P=0.001), and female gender (OR 2.07; 95% CI, 1.09-3.93; P=0.025) were significantly associated with angle-closure disease. No significant association was found with systemic hypertension (P=0.24) and hyperopia (P=0.05). CONCLUSIONS: The prevalence of PACG in this population was 0.94%. Increasing age, increasing IOP, diabetes mellitus, and female gender were significantly associated with angle-closure disease. Blindness due to PACG was 20%. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/20466426/Angle_closure_in_the_Andhra_Pradesh_Eye_Disease_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(10)00048-5 DB - PRIME DP - Unbound Medicine ER -