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Published on: May 25, 2020
Comparative Evaluation of Functional Aqueous Humor Outflow in Primary Open Angle Glaucoma Versus Primary Angle
Nitika Beri1, Anuja Patil2, Akshita Sharma1
1Department of Ophthalmology, University College of Medical Sciences and GTB Hospital, Delhi, India.
Journal of Glaucoma
|June 24, 2026
Summary
Primary open-angle glaucoma (POAG) patients exhibit significantly higher aqueous humor outflow (AHO) compared to primary angle-closure glaucoma (PACG) patients. This difference was observed using Aqueous Angiography, with reduced AHO in PACG correlating with increased disease severity.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Anatomy and Physiology
Background:
- Primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) are distinct forms of glaucoma.
- Understanding aqueous humor outflow (AHO) pathways is crucial for glaucoma management.
- Previous studies suggest differences in AHO between POAG and PACG, but quantitative comparisons are limited.
Purpose of the Study:
- To quantitatively compare circumferential, perilimbal aqueous humor outflow (AHO) pathways in patients with POAG and PACG.
- To utilize Aqueous Angiography (AA) for precise measurement of AHO.
- To investigate the relationship between disease severity and AHO in both glaucoma types.
Main Methods:
- Aqueous Angiography (AA) was performed on 32 patients (16 POAG, 16 PACG) undergoing cataract surgery.
- Indocyanine green dye was injected into the anterior chamber, and images were captured to assess angiographic signal intensity (ASI).
- ASI was analyzed sectorally, quadrantally, and overall to quantify AHO, with statistical analysis for correlations.
Main Results:
- Aqueous humor outflow was significantly lower in PACG patients (123.72) compared to POAG patients (188.32) (P=0.029).
- Multivariate analysis confirmed higher overall flow in POAG versus PACG (β=56.705, P=0.010).
- A decreasing trend in overall flow was observed with increasing disease severity in PACG (r=0.515, P=0.044).
Conclusions:
- Both POAG and PACG demonstrate segmental AHO patterns.
- PACG eyes exhibit lower functional AHO compared to POAG eyes.
- Increased disease severity in PACG is associated with reduced overall aqueous humor outflow.
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