exudates and Glaucoma--Angle-Closure

This study aims to determine the 5-year visual field progression and identify the prognostic factors for progression in Malay patients with primary glaucoma.. A retrospective cohort record review study was conducted among 222 patients (222 eyes) with primary glaucoma who were selected from a glaucoma research database of a tertiary center in Malaysia. The patients were Malays and diagnosed with primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG). Patients who were followed up regularly for at least 6 months between 1 January 2009 and 31 December 2014 and completed another 1-year follow-up after recruitment (between 1 January 2015 and 31 December 2015) were selected. Multiple prognostic factors that influence visual field progression were identified. Progression of visual field loss was based on the Advanced Glaucoma Intervention Study and Hodapp-Parrish-Anderson scores. Kaplan-Meier survival and Cox proportional hazard regression analyses were performed.. Sixty-three patients (28.4%) developed visual field progression after a mean (SD) follow-up of 6.9 (3.3) years. Those with POAG progressed faster (mean time, 10.6 years; 95% confidence interval [CI], 9.3, 11.9) than those with PACG (17.3 years; 95% CI, 14.8, 19.9) but not statistically significant. Disc hemorrhage and history of eye pain increased the risk of progression by 2.8-folds (95% CI, 1.6, 4.8) and 2.5-folds (1.4, 4.4), respectively.. The 5-year survival of the Malay primary glaucoma patients with visual field progression was similar with that of other Asian populations. However, aggressive management is required for those with disc hemorrhages and eye pain related to increased intraocular pressure.

Topics: Disease Progression; Eye Pain; Glaucoma; Glaucoma, Angle-Closure; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Malaysia; Prognosis; Retrospective Studies; Survival Analysis; Visual Field Tests; Visual Fields

The purpose of this study was to determine the association between cigarette smoking and the severity of primary angle closure glaucoma (PACG) in Malay patients residing in Malaysia.. A cross-sectional study was conducted involving 150 Malay PACG patients between April 2014 and August 2016. Ocular examination was performed including Humphrey visual field (HVF) 24-2 analysis assessment. On the basis of the 2 consecutive reliable HVFs, the severity of glaucoma was scored according to modified Advanced Glaucoma Intervention Study (AGIS) by 2 masked investigators and classified as mild, moderate, and severe. Those with retinal diseases, neurological diseases, memory problem, and myopia ≥4 diopters were excluded. Their smoking status and details were obtained by validated questionnaire from Singapore Malay Eye Study (SiMES). The duration of smoking, number of cigarettes per day, and pack/year was also documented. Multiple linear regression analysis was conducted.. There was a significant association between education level and severity of PACG (P=0.001). However, there was no significant association between cigarette smoking and severity of glaucoma (P=0.080). On the basis of multivariate analysis, a linear association was identified between cigarette smoked per day (adjusted b=0.73; 95% CI: 0.54, 1.45; P<0.001) and body mass index (adjusted b=0.32; 95% CI: 0.07, 1.35; P=0.032) with AGIS score.. There was no significant association between cigarette smoking and severity of PACG. Cigarette smoked per day among the smokers was associated with severity of PACG. However, because of the detrimental effect of smoking, cessation of smoking should be advocated to PACG patients.

Topics: Asian People; Cigarette Smoking; Cross-Sectional Studies; Female; Glaucoma, Angle-Closure; Gonioscopy; Humans; Intraocular Pressure; Malaysia; Middle Aged; Risk Factors; Severity of Illness Index; Surveys and Questionnaires; Visual Field Tests; Visual Fields

Patients with bleeding diatheses can present in a variety of clinical situations. When these patients manifest with ocular complications, their management can be challenging. We describe a case of acute angle closure glaucoma secondary to subretinal haemorrhage, with myelodysplasia as a predisposing factor.

Topics: Acute Disease; Aged, 80 and over; Female; Glaucoma, Angle-Closure; Humans; Malaysia; Neural Tube Defects

Thirty-seven consecutive patients (41 eyes) diagnosed with primary angle closure glaucoma (PACG) attending the Glaucoma Clinic in University Malaya Medical Centre, over a period of 6 months were categorized into acute, subacute and chronic PACG from their clinical presentation. Each case was subjected to automated refraction, A-scan biometry for anterior chamber depth, axial length and lens thickness, keratometry and corneal diameter measurement. Calculations for the relative lens position and the lens thickness: axial length index were performed. The data collected was analysed by the nonparametric test (Kruskal-Wallis), one way analysis of variance (ANOVA), chi-square test, Spearman's nonparametric correlations and regression analysis. For controls 15 eyes from 15 normal subjects matched for age, sex, refractive error and race were chosen and subjected to the same examinations. Chronic PACG was the predominant subtype (53.6% of patients and 58.5% of eyes). The ocular biometric measurements of acute PACG eyes deviated most from normals in having the shallowest anterior chamber depth, shortest axial length, smallest corneal diameter, steepest corneal radius, thickest and most anteriorly situated lens, and the greatest lens thickness: axial length index. The subacute subtype was closest to normal and chronic PACG subtype fell in between in most of the biometric characteristics. These findings were not statistically significant. All PACG eyes as a group however showed statistically significant shallower anterior chamber depth (p < 0.05), and a more anterior relative lens position (p < 0.05) compared to normals.

Topics: Academic Medical Centers; Aged; Anterior Chamber; Biometry; Eye; Female; Glaucoma, Angle-Closure; Humans; Malaysia; Male; Middle Aged

To estimate the rates of hospital admissions for primary angle closure glaucoma (PACG) in Chinese, Malays, and Indians in Singapore. A population-wide hospital discharge database in Singapore was used to identify all hospital admissions with a primary discharge diagnosis of PACG (International Classification of Disease-CM code: 365.2). The Singapore census was used for denominator data.. Between 1993 and 1997 there were 894 hospital admissions for PACG. The mean annual rate of PACG admissions was 11.1 per 100 000 (95% confidence interval (CI), 10.4, 11.8) among people aged 30 years and over. The annual rate was highest for Chinese (age and sex adjusted rate: 12.2 per 100 000), which was twice that of Malays (6.0 per 100 000) and Indians (6.3 per 100 000). Females had two times higher rates than males in all three races (age adjusted relative risk: 2.0, 95% CI: 1.7, 2.3).. Malay and Indian people had identical rates of hospital admissions for PACG, which were only half the rates compared with Chinese.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; China; Female; Glaucoma, Angle-Closure; Hospitalization; Humans; India; Malaysia; Male; Middle Aged; Sex Distribution; Singapore