Synechial angle closure pattern in Chinese chronic primary angle-closure glaucoma patients

Area of Science:

• Ophthalmology
• Glaucoma Research
• Asian Eye Health

Background:

• Chronic primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness globally.
• Understanding the specific patterns of angle closure is crucial for timely intervention in PACG.
• Previous studies have indicated ethnic and geographic variations in PACG progression.

Purpose of the Study:

• To investigate the topographical pattern of synechial angle closure in Hong Kong Chinese patients diagnosed with chronic PACG.
• To identify potential early sites and progression pathways of synechial angle closure in this specific population.

Main Methods:

• A retrospective clinical study involving 84 eyes of Hong Kong Chinese patients with chronic PACG.
• Indentation gonioscopy was performed by a single examiner to assess the anterior angle quadrants (superior, nasal, inferior, temporal).

Main Results:

• High incidences of synechial angle closure were observed: superior (98%), temporal (94%), nasal (77%), and inferior (31%).
• The superior quadrant showed a significantly higher incidence compared to nasal (P=0.005) and inferior (P<0.001) quadrants.
• No significant difference was found between superior and temporal quadrants (P=0.07).

Conclusions:

• Synechial angle closure in this cohort is circumferential but asymmetric.
• The superior and temporal quadrants appear to be the earliest affected sites.
• A potential progression pathway involves initial closure at superior/temporal quadrants, extending nasally, and finally to the inferior quadrant.