Top-Ten of the Fourth Angle-Closure Glaucoma Club Meeting

October 29-30, 2005, Taipei, Taiwan

Por-tying Hung

• Since PACG is in large part due to the anatomic make-up of the eye, it is possible that genes that control ocular growth, as well as genes coding for collagen and extracellular matrix tissue, may be associated with the development of PACG.
  Professor Wang identified variations in genes coding for MMP9 using SNP-based genotyping in a case-control study of acute primary angle-closure patients. MMP9 may play a role controlling the development of anterior segment structures.
• Anterior segment optical coherence tomography (AS-OCT) can obtain high-resolution images of the angle and allows qualitative and quantitative angle analysis. The technique produces high-quality images permitting a dynamic, cross-sectional view of the irido-trabecular angle. Superior performance in detection of angle-closure when compared with gonioscope was reported.
• Investigators from the Tajimi Eye Study (a population-based study of eye disease among 3,021 Japanese subjects of the age of 40 years and older) reported that the prevalence of PAC (including PACG and suspected PACG) was 1.3% and that of PAC excluding PACG suspected PACG was 0.5%. PACG was defined using standard definitions and required both optic nerve and visual field abnormalities in most cases. As in previous research, the prevalence of PAC significantly increased with age.
• Glaucoma is the leading cause of irreversible blindness. Angle-closure accounts for about half of all glaucoma cases, and a higher proportion of glaucoma blindness than POAG. Most cases of angle-closure are asymptomatic. The traditional (symptomatic) classification does not promote a clear understanding of mechanisms responsible for closure, nor the physical characteristics that indicate prognosis. An ideal classification system should identify both stage of disease and mechanism of closure. Further refinement of definitions of narrow angles and associated glaucoma was urged.
• In study of visual outcomes of the contralateral eyes, 76 persons presenting with a unilateral attack of acute primary angle closure (APAC) in Singapore, three eyes (3.8%) had glaucoma at the time of diagnosis of APAC, and an additional four (5.1%) developed PACG during a mean follow-up of six years. Cataract was common in fellow eyes. All fellow eyes had laser iridotomy at the time of the attack, and most did well with low eye pressure and no glaucoma in long-term follow-up.
• Nd:YAG laser iridotomy is effective in increasing angle width and controlling intraocular pressure in the early stage of primary angle-closure in Mongols. However, once extensive synechiae or glaucomatous optic neuropathy associated with angle closure have occurred, iridotomy also is less effective in achieving IOP control. (By D. Uranchimeg, Mongolia.)
• The biometric evaluation of 77 subjects with convex iris configuration (CIC) and 38 plateau iris configuration showed significant thicker lens and smaller vitreous length in CIC.
• Incidence of zonular weakness was significantly higher in cases of primary angle-closure glaucoma.
• Although PACG is a big health problem in China, community-based screening does not appear cost-effective at this time. Screening should be combined with efforts to detect other preventable blinding eye diseases (such as cataract and refractive error). Reasonable screening intervals need to be determined.
• Complex biochemical changes which compromise the function of the extracellular matrix can occur in the inflamed eye. Following angle-closure, the trabecular meshwork function may remain impaired as a consequence of inflammatory processes, regardless of whether peripheral anterior synechiae develop or not.
   

Issue 7-3

Table of Contents Editor's Selection

Change Issue

24-1 (2024) 23-4 (2023) 23-3 (2023) 23-2 (2023) 23-1 (2022) 22-4 (2022) 22-3 (2022) 22-2 (2021) 22-1 (2021) 21-4 (2021) 21-3 (2021) 21-2 (2021) 21-1 (2020) 20-4 (2020) 20-3 (2020) 20-2 (2019) 20-1 (2019) 19-4 (2019) 19-3 (2018) 19-2 (2018) 19-1 (2018) 18-4 (2017) 18-3 (2017) 18-2 (2017) 18-1 (2017) 17-4 (2016) 17-3 (2016) 17-2 (2016) 17-1 (2016) 16-4 (2015) 16-3 (2015) 16-2 (2015) 16-1 (2014) 15-4 (2014) 15-3 (2014) 15-2 (2013) 15-1 (2013) 14-4 (2013) 14-3 (2013) 14-2 (2013) 14-1 (2012) 13-4 (2012) 13-3 (2011) 13-2 (2011) 13-1 (2011) 12-4 (2011) 12-3 (2010) 12-2 (2010) 12-1 (2010) 11-4 (2010) 11-3 (2009) 11-2 (2009) 11-1 (2009) 10-4 (2009) 10-3 (2008) 10-2 (2008) 10-1 (2008) 9-4 (2008) 9-3 (2007) 9-2 (2007) 9-1 (2007) 8-4 (2007) 8-3 (2006) 8-2 (2006) 8-1 (2006) 7-3 (2006) 7-2 (2005) 7-1 (2005) 6-3 (2005) 6-2 (2004) 6-1 (2004) 5-3 (2004) 5-2 (2003) 5-1 (2003) 4-3 (2003) 4-2 (2002) 4-1 (2002) 3-3 (2002) 3-2 (2001) 3-1 (2001) 2-3 (2001) 2-2 (2000) 2-1 (2000) 1-3 (2000) 1-2 (1999) 1-1 (1999)

---

advertisement