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Angle closure in younger patients.

Brian M Chang1, Jeffrey M Liebmann, Robert Ritch

  • 1Department of Ophthalmology, New York Eye and Ear Infirmary, New York, New York, USA.

Transactions of the American Ophthalmological Society
|January 28, 2003
PubMed
Summary
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Angle-closure glaucoma in individuals under 40 is rare and often linked to developmental eye issues, unlike in older adults. Early diagnosis and monitoring are crucial for managing this condition.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Pediatric Ophthalmology

Background:

  • Angle-closure glaucoma (ACG) is uncommon in pediatric and young adult populations.
  • Previous reports on ACG in younger individuals are typically isolated cases linked to specific clinical conditions.

Purpose of the Study:

  • To investigate the clinical characteristics and etiologies of angle closure in patients aged 40 years or younger.
  • To differentiate the causes of angle closure in young individuals from those typically seen in older populations.

Main Methods:

  • A retrospective database search was conducted for patients aged 40 or younger diagnosed with angle closure.
  • Data collected included patient demographics, examination findings (slit-lamp, gonioscopy, ultrasound biomicroscopy), diagnoses, and treatments.

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  • Exclusion criteria included prior incisional surgery and anterior proliferative mechanisms.

    • Main Results:

    • Sixty-seven patients (mean age 34.4 years) met the inclusion criteria.
    • The most frequent diagnoses were plateau iris syndrome (35 patients) and iridociliary cysts (8 patients).
    • Other identified causes included retinopathy of prematurity, uveitis, nanophthalmos, and various genetic syndromes.

    Conclusions:

    • The causes of angle closure in young individuals differ significantly from older adults, often involving structural or developmental ocular anomalies.
    • Relative pupillary block is a less common cause in this younger demographic.
    • Post-laser iridotomy, vigilant monitoring for recurrent angle closure and potential surgical intervention is recommended.