Objectives. To determine if hyperopia is a risk factor for primary angle-closure glaucoma (PACG) in the Dutch population and to identify other biometrical parameters as risk factors for PACG including axial length (AL), anterior chamber depth (ACD), and values. Methods. The study population consisted of PACG patients that had undergone a laser peripheral iridotomy (LPI). The control group consisted of age- and gender-matched cataract patients. The main outcome was hyperopia (spherical equivalent ≥+0.5 dioptres) measured with IOL Master or autorefractor. Refractive error, ACD, AL, and values were tested with a Mann-Whitney test and by logistic regression. Results. 117 PACG patients and 234 controls were included (mean age = 80 years ± 3.6). The prevalence of hyperopia in patients and controls was 69.6% and 61.1%, respectively (Fisher’s test ). Mann-Whitney test showed no statistically significant relation with refractive error ( ) or values ( ). In contrast, ACD and AL were statistically significant ( ). Tested with logistic regression, only ACD was a significant predictor of PACG ( ). Conclusion. There was no statistically significant correlation between refractive error and PACG. ACD was strongly correlated, though, with PACG, whereas AL turned out to be a less significant risk factor. 1. Introduction Glaucoma is the most important cause of irreversible blindness in the world [1]. Primary angle-closure glaucoma (PACG) is highly prevalent in Asian countries. However, the Egna-Neumarkt Glaucoma Study stated that the burden of PACG in Europe has been underestimated previously [2]. The prevalence in this study was 0.6%, which accounts for about a quarter of all primary glaucoma cases. The most frequent type was chronic angle closure, which is more insidious and hence more often missed. Further damage of PACG can be easily prevented by performing a laser peripheral iridotomy (LPI) [3]. It is important to know more about the pathophysiology and risk factors for PACG to improve prevention. Several risk factors have been identified for PACG, including female gender, older age, and shallow anterior chamber depth (ACD) [2, 4–8]. Ophthalmologists in Europe commonly have the clinical impression that hyperopia is a risk factor for PACG. The relation between hyperopia and PACG was suggested as early as in 1970 [9]. Despite several studies, however, this relation has not been convincingly proven [4, 6–8]. A possible explanation for the mismatch between the clinical impression of such a relationship and the lack of evidence might be that most researches have been done
References
[1]
H. Quigley and A. T. Broman, “The number of people with glaucoma worldwide in 2010 and 2020,” British Journal of Ophthalmology, vol. 90, no. 3, pp. 262–267, 2006.
[2]
L. Bonomi, G. Marchini, M. Marraffa et al., “Epidemiology of angle-closure glaucoma: prevalence, clinical types, and association with peripheral anterior chamber depth in Egna-Neumarkt glaucoma study,” Ophthalmology, vol. 107, no. 5, pp. 998–1003, 2000.
[3]
W. P. Nolan, P. J. Foster, J. G. Devereux, D. Uranchimeg, G. J. Johnson, and J. Baasanhu, “YAG laser iridotomy treatment for primary angle closure in east Asian eyes,” British Journal of Ophthalmology, vol. 84, no. 11, pp. 1255–1259, 2000.
[4]
R. J. Casson, M. Baker, K. Edussuriya, T. Senaratne, D. Selva, and S. Sennanayake, “Prevalence and determinants of angle closure in central Sri Lanka: the Kandy Eye Study,” Ophthalmology, vol. 116, no. 8, pp. 1444–1449, 2009.
[5]
Y. Barkana, I. Dekel, Y. Goldich, Y. Morad, I. Avni, and D. Zadok, “Angle closure in caucasians-a pilot, general ophthalmology clinic-based study,” Journal of Glaucoma, vol. 21, pp. 337–341, 2012.
[6]
Y. Y. Kim, J. H. Lee, M. D. Ahn, and C. Kim, “Angle closure in the Namil study in central South Korea,” Archives of Ophthalmology, vol. 130, no. 9, pp. 1177–1183, 2012.
[7]
S. Senthil, C. Garudadri, R. C. Khanna, and K. Sannapaneni, “Angle closure in the Andhra Pradesh Eye Disease Study,” Ophthalmology, vol. 117, no. 9, pp. 1729–1735, 2010.
[8]
L. Vijaya, R. George, H. Arvind et al., “Prevalence of angle-closure disease in a rural southern Indian population,” Archives of Ophthalmology, vol. 124, no. 3, pp. 403–409, 2006.
[9]
R. F. Lowe, “Aetiology of the anatomical basis for primary angle-closure glaucoma. Biometrical comparisons between normal eyes and eyes with primary angle-closure glaucoma,” British Journal of Ophthalmology, vol. 54, no. 3, pp. 161–169, 1970.
[10]
D. Zhang, Y. Shi, B. Gong et al., “An association study of the COL1A1 gene and high myopia in a Han Chinese population,” Molecular Vision, vol. 17, pp. 3379–3383, 2011.
[11]
G. J. Johnson and P. J. Foster, “Can we prevent angle-closure glaucoma?” Eye, vol. 19, no. 10, pp. 1119–1124, 2005.
[12]
L. Vijaya, R. George, H. Arvind et al., “Prevalence of primary angle-closure disease in an urban south Indian population and comparison with a rural population. The Chennai Glaucoma Study,” Ophthalmology, vol. 115, no. 4, pp. 655–660, 2008.
[13]
L. Xu, W. F. Cao, Y. X. Wang, C. X. Chen, and J. B. Jonas, “Anterior chamber depth and chamber angle and their associations with ocular and general parameters: the Beijing Eye Study,” American Journal of Ophthalmology, vol. 145, no. 5, pp. 929–936, 2008.
[14]
W. T. Ng and W. Morgan, “Mechanisms and treatment of primary angle closure: a review,” Clinical & Experimental Ophthalmology, vol. 40, no. 4, pp. e218–e228, 2012.
[15]
G. Marchini, A. Pagliarusco, A. Toscano, R. Tosi, C. Brunelli, and L. Bonomi, “Ultrasound biomicroscopic and conventional ultrasonographic study of ocular dimensions in primary angle-closure glaucoma,” Ophthalmology, vol. 105, no. 11, pp. 2091–2098, 1998.
[16]
A. C. How, M. Baskaran, R. S. Kumar et al., “Changes in anterior segment morphology after laser peripheral iridotomy: an anterior segment optical coherence tomography study,” Ophthalmology, vol. 119, pp. 1383–1387, 2012.
[17]
P. J. Buckhurst, J. S. Wolffsohn, S. Shah, S. A. Naroo, L. N. Davies, and E. J. Berrow, “A new optical low coherence reflectometry device for ocular biometry in cataract patients,” British Journal of Ophthalmology, vol. 93, no. 7, pp. 949–953, 2009.
[18]
J. Zhao, Z. Chen, Z. Zhou, L. Ding, and X. Zhou, “Evaluation of the repeatability of the Lenstar and comparison with two other non-contact biometric devices in myopes,” Clinical & Experimental Optometry, vol. 96, no. 1, pp. 92–99, 2013.
[19]
N. Visser, T. T. Berendschot, F. Verbakel, J. de Brabander, and R. M. Nuijts, “Comparability and repeatability of corneal astigmatism measurements using different measurement technologies,” Journal of Cataract & Refractive Surgery, vol. 38, no. 10, pp. 1764–1770, 2012.
[20]
M. P. Holzer, M. Mamusa, and G. U. Auffarth, “Accuracy of a new partial coherence interferometry analyser for biometric measurements,” British Journal of Ophthalmology, vol. 93, no. 6, pp. 807–810, 2009.
