This article is more than 5 years old. Information may no longer be current.
New classification of primary angle-closure glaucoma could improve diagnosis, understanding of disease
Click Here to Manage Email Alerts
BERLIN — A new classification of primary angle-closure glaucoma that accounts for angle obstruction and optic neuropathy could help better define the disease for both clinicians and epidemiologists, a clinician said here.
"We need a revised classification of primary angle-closure glaucoma that focuses on the presence of structural and functional consequences of angle closure," Ching Lin Ho, MD, said.
Speaking at the World Ophthalmology Congress, Dr. Ho said clinicians should focus on raised IOP, peripheral anterior synechia and optic nerve damage caused by the disease.
Currently, the traditional primary angle-closure glaucoma (PACG) classification is acute or symptomatic PACG; chronic or asymptomatic PACG; and subacute or intermittent PACG, Dr. Ho said.
Instead, cases might be considered primary angle-closure suspects (narrow angles/primary angle-closure subjects), primary angle-closure and primary angle-closure glaucoma, she said.
For instance, primary angle-closure suspects or those with narrow angles would have factors including greater than 180°/270° of iridotrabecular contact. In addition to the same degree of iridotrabecular contact, PACG cases would have elevated IOP, glaucomatous optic neuropathy and visual field loss, she said.
For the audience packing the room for the South East Asia Glaucoma Interest Group’s Symposium on Angle-closure Glaucoma at the Berlin World Ophthalmology Congress, Dr. Ching Lin Ho’s presentation highlighted the relatively new ISGEO (International Society for Geographic and Epidemiological Ophthalmology) classification for this spectrum of diseases.
Primary angle-closure suspects have narrow angles with irido-trabecular contact, but without other evidence of pathology. When anterior segment pathology is associated with this underlying anatomical variation, such as peripheral anterior synechiae and/or raised IOP, the term “primary angle closure” is used, and if raised IOP leads to posterior segment pathology with glaucomatous optic neuropathy, usually with visual field loss, the patient has “primary angle-closure glaucoma.”
This classification has direct clinical relevance, helping clinicians manage patients appropriately over time.
– Ivan Goldberg, MB, BS, FRANZCO, FRACS
OSN Asia-Pacific Edition Editorial Board Member
Follow OSNSuperSite.com
on Twitter.