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Abstract #9844 Published in IGR 5-3
Angle closure in younger patients
Ritch R; Chang BM; Liebmann JMOphthalmology 2003; 110: 1880-1889
PURPOSE: Angle-closure glaucoma is rare in children and young adults; only scattered cases associated with specific clinical entities have been reported. The authors evaluated the findings in patients aged 40 or younger with angle closure in their database. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: The database was searched for patients aged 40 years or younger with angle closure. Data recorded included age at initial consultation, age at the time of diagnosis, gender, slit-lamp examination, gonioscopy, ultrasound biomicroscopy (from 1993 onward), clinical diagnosis, and therapy. Patients with prior incisional surgery were excluded, as were patients with anterior chamber proliferative mechanisms leading to angle closure. RESULTS: Sixty-seven patients (49 females, 18 males) met entry criteria. Mean age at the time of consultation was 34.4 ± 9.4 (standard deviation) years (range, 3-68 years). Diagnoses included plateau iris syndrome (35 patients); iridociliary cysts (eight patients); retinopathy of prematurity (seven); uveitis (five); isolated nanophthalmos (three); relative pupillary block (two); Weill-Marchesani syndrome (three); and one patient each with Marfan syndrome, miotic-induced angle closure, persistent hyperplastic primary vitreous, and idiopathic lens subluxation. CONCLUSIONS: The etiology of angle closure in young individuals differs from the older population and is typically associated with structural/developmental ocular anomalies rather than relative pupillary block. After laser iridotomy, these eyes should be monitored for recurrent angle closure and the need for additional laser or incisional surgical intervention.
Dr. R. Ritch, Department of Ophthalmology, the New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY 10003, USA
Classification:
9.3.3 Plateau iris syndrome (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.3.10 Other (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
