Abstract
PurposeTo investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese.MethodsInpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts.ResultsA total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis.ConclusionsWe described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.
Highlights
Study populationGlaucoma, characterized by retinal ganglion cell degeneration with or without intraocular pressure elevation, is the leading cause of global irreversible blindness
angle-closure glaucoma (ACG) was defined as having glaucomatous optic neuropathy due to high intraocular pressure (IOP) caused by angle closure based on gonioscopy or ultrasound biomicroscopy (UBM)
Age is known to be strongly associated with primary angle-closure glaucoma (PACG)
Summary
Glaucoma, characterized by retinal ganglion cell degeneration with or without intraocular pressure elevation, is the leading cause of global irreversible blindness. It is estimated that the number of glaucoma patients aged over 40 years old was 60.5 million in 2010, and was predicted to increase to 79.6 million in 2020 and 111.8 million in 2040 [1, 2]. Primary open-angle glaucoma (POAG) is the most common type, the distribution of glaucoma types varies among races and areas. Asian accounts for 87% of worldwide primary angle-closure glaucoma (PACG) cases [1] and China has the biggest population of PACG in the world. In a population survey by Foster and Johnson [3], 1.7 million glaucoma adults suffered from bilateral blindness in China, among whom 91% were caused by PACG.
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