The Utility of Symptoms in Identification of Primary Angle-Closure in a High-Risk Population

• Published in: Ophthalmology (Rochester, Minn.) Vol. 115; no. 11; pp. 2024 - 2029
• Main Authors: Ong, Ee Lin, Baasanhu, Jamyanjav, MD, PhD, DCEH, Nolan, Winifred, MD, FRCOphth, Uranchimeg, Davatsuren, MSc, MD, Lee, Pak–Sang, MSc, MPhil, Alsbirk, Poul Helge, MD, DrMed, Johnson, Gordon J., MD, FRCSC, Foster, Paul J., PhD, FRCSEd
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2008; Elsevier
• Subjects: Adult; Anterior Chamber - pathology; Biological and medical sciences; False Positive Reactions; Glaucoma and intraocular pressure; Glaucoma, Angle-Closure - diagnosis; Glaucoma, Angle-Closure - epidemiology; Gonioscopy; Humans; Medical sciences; Miscellaneous; Mongolia - epidemiology; Ophthalmology; Predictive Value of Tests; Risk Factors; Rural Population - statistics & numerical data; Surveys and Questionnaires; Tonometry, Ocular; Urban Population - statistics & numerical data; Vision Disorders - diagnosis; Mongolia; High risk; Symptomatology; Eye disease; Primary; Identification; Ophthalmology; Angle closure glaucoma
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/j.ophtha.2008.06.023

Objective To examine the frequency of symptoms associated with primary angle closure in an East Asian population with high rates of disease. Design Population-based survey. Participants One thousand adults from rural and urban provinces of Mongolia were examined. Methods A standard questionnaire was used to determine a history of symptoms of angle closure. All participants underwent applanation tonometry, gonioscopy, and slit-lamp examination by the same observer. The frequency of symptoms was compared between normal subjects and those in 3 high-risk or affected groups: gonioscopically confirmed occludable angles, peripheral anterior synechiae (PAS) detected on gonioscopy, and anterior chamber depth of less than 2.5 mm. Main Outcome Measures The frequency of symptoms associated with primary angle closure. Results Symptoms of visual disturbance and ocular pain traditionally linked with angle closure were reported frequently by both normal and potentially affected people. Intermittent blurring of vision at night was the only common symptom of angle closure that was significantly more frequent in people with narrow angles and PAS ( P = 0.004, 48.4% vs. 31.0% narrow angles; P = 0.001, 54.3% vs. 30.6% PAS), but not in those with shallow anterior chambers ( P = 0.670, 38.3% vs. 30.9%). Conclusions Direct questioning about symptoms associated with angle closure identified high rates of positive responses in both affected and unaffected groups. Although the rate of symptoms tended to be higher in affected people, none of these symptoms were specific enough to be considered useful as a diagnostic criterion. Financial Disclosure(s) The authors have no proprietary or commercial interest in any materials discussed in this article.