Fang, Neoh Pei
(2017)
Evaluation of anterior segment biometry parameters in progress and non-progress primary angle closure glaucoma among Malays and Chinese.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background:
Primary angle closure glaucoma (PACG) is the second most common type of glaucoma in Asia,
and the main cause of glaucoma blindness. PACG is believed to progress faster among Asians.
Identification of patients at risk of progression is crucial to reduce the morbidity and disease
burden. Most knowledge of burden, risk factors and epidemiology about PACG has been
derived from high risk populations such as Chinese, Japanese and Indians populations. Both
Malay and Chinese comprise the majority population in Malaysia. Ethnic differences in PACG
progression may exist; Malays have been found to present with worst visual acuity and
progression compared to Chinese residing in Malaysia. Anterior segment biometry parameters
such as axial length have been associated with progression of PACG. As anterior segment
biometry has been found to be associated with progression, we aimed to investigate these
parameters in Malays and to.compare these parameters between the two major ethnicity in
Malaysia.
Objective:
The aim of this study were to compare anterior segment biometry parameters in
progress and non-progress PACG among Malays and Chinese.
Methods:
This was a cross-sectional study involving 75 patients (43 Malay PACG patients and 32
Chinese PACG patients) recruited from 1 glaucoma centre in Malaysia recruited between
November 2015 and December 2016. Ocular examination included axial length (AL) and
anterior chamber depth (ACD) measurement using a noncontact partial coherence
interferometer (IOL Master, Carl Zeiss, Germany). Anterior chamber angle (ACA), measuredby Anterior Segment-OCT (Cirrus, Carl Zeiss, Germany). Humphrey visual field (HVF) 24-2
analysis of the same eye was done and used to evaluate glaucoma progression. Patients were
categorized into two groups: those with progression and those without. Comparison of anterior
segment biometry parameters between Malay and Chinese PACG patients with and without
progression was analysed using independent T test and multivariate ANOVA analysis.
Results:
Chinese PACG patients had shorter AL (22.18mm±0.76) and narrower ACA (11.09°±1.31)
than Malay PACG patients. There was no significant difference between the ACD of Malay
and Chinese PACG patients. After adjustment for confounding factors., only ACA was
significantly difference. Among patients with progression, all the anterior segment biometry
parameters (AL, ACD, ACA) were significantly different between Malays and Chinese.
However, after controlling for confounding factors, there was no significant difference, In the
group without progression, no significant differences in anterior segment biometry parameters
were observed between the two ethnic groups. Malay PACG patients with progression had
narrower Anterior Chamber Angle (ACA) (11.96°±6.00) compared to non-progressing
patients. Axial Length (AL) and Anterior Chamber Depth (ACD) did not differ significantly
between Malay patients with and without progression.
Conclusion:
There was racial influence in ocular biometry measurement in PACG patients. Chinese has
significant narrower ACA compared to Malays. Serial AS-OCT monitoring is important in
management of PACG. Evaluating anterior segment biometry parameters is essential in
predicting risk of progression in Malay PACG. Further researches and larger studies need tobe conducted before we can further conclude the association of the anterior segment biometry
parameters with progression of PACG.
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