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Abstract #16924 Published in IGR 9-1
Nonprogressive glaucomatous cupping and visual field abnormalities in young Chinese males
Doshi A; Kreidl KO; Lombardi L; Sakamoto DK; Singh KOphthalmology 2007; 114: 472-479
See also comment(s) by Tec Kuan Paul Chew & Jovina See & Maria Cecilia Aquino •
OBJECTIVE: To describe a series of young to middle-aged men of Chinese origin who presented with a constellation of ocular findings suggestive of glaucoma, that were found to be stable over a 7-year period. DESIGN: Retrospective case series. PARTICIPANTS: Sixteen 25- to 66-year-old male patients. METHODS: Medical records of the participants, of Chinese origin and referred for glaucoma evaluation over a 7-year period, were reviewed. All patients underwent complete ophthalmic examinations, stereo imaging of the optic nerves, and automated perimetry. Fewer than 5% of all patients seen in this practice were of Chinese origin. The patients were observed for the duration of the study in a single glaucoma clinic. MAIN OUTCOME MEASURES: Visual field (VF) changes or progressive optic nerve cupping suggestive of glaucoma. RESULTS: The patients had an average age of 38.9 years. Tilted discs were present in 75.0% (24/32) and peripapillary atrophy in 81.3% (26/32) of nerves. Cup-to-disc ratios ranged from 0.20 to 0.95 and averaged 0.56. The lowest intraocular pressure (IOP) in any patient at any time was 8 mmHg, whereas the highest was 29 (average range, 13.5-17.9). Intraocular pressure-lowering therapy had been used in 56.3% (9/16). There was a family history of presumed glaucoma in 25.0% (4/16) of patients. High myopia ( > -6.00-diopter spherical equivalent [SE]) was present in 43.8% of eyes (14/32), and SEs ranged from -11.25 to +0.25. The most common VF defect was an arcuate defect, found in 31.3% (10/32) of patients. There were no females of Chinese origin with similar findings identified during this period. Neither optic nerve nor significant VF progression was found during the follow-up period, regardless of the use of IOP-lowering therapy. CONCLUSIONS: These young Chinese patients previously diagnosed with glaucoma or considered glaucoma suspects had stable ocular findings for up to 7 years, irrespective of IOP-lowering therapy. Their condition was associated with myopia and tilted discs. Many were being treated with IOP-lowering therapy for glaucoma, a condition they may not have had. Further prospective epidemiologic study is needed to determine whether such a constellation of nonprogressive findings is more common in young Chinese males than in the general population.
Dr. A. Doshi, Department of Ophthalmology, Stanford University, Stanford, CA 94305, USA. amishdoshi@yahoo.com
Classification:
6.20 Progression (Part of: 6 Clinical examination methods)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
