Aravind Eye Hospital, Pondicherry, India.
Wilmer Eye Institute, John Hopkins University, Baltimore, Maryland.
Ophthalmology. 2014 Nov;121(11):2091-7. doi: 10.1016/j.ophtha.2014.05.001. Epub 2014 Jun 25.
To compare the prevalence of angle closure among siblings of patients with open angles (OAs), suspect angle closure (PACS), and either primary angle closure (PAC) or PAC glaucoma (PACG).
Cross-sectional, clinical study.
A total of 303 South Indian sibling pairs, including 81 OA probands, 143 PACS probands, and 79 PAC/PACG probands.
Probands and siblings underwent a clinical examination, including gonioscopy by a masked grader, applanation tonometry, slit-lamp biomicroscopy, optic nerve evaluation, and A-scan ultrasonography. Probands and siblings were classified into 1 of 3 groups based on the phenotype of the more severely affected eye: OA, PACS, or PAC/PACG. Multivariable regression models were used to estimate the odds of prevalent angle closure in PACS or PAC/PACG siblings compared with OA siblings.
Prevalence and relative prevalence of angle closure and PAC/PACG among OA, PACS, and PAC/PACG siblings.
Mean sibling age was 49.7 ± 8.7 years, and 56.6% of siblings were females. Angle closure was more prevalent in both PACS siblings (35.0%) and PAC/PACG siblings (36.7%) compared with OA siblings (3.7%; P < 0.001). There was PAC/PACG present in 11.4% of PAC/PACG siblings compared with 4.9% of PACS siblings (P = 0.07) and 0% of OA siblings (P = 0.002). In multivariable models adjusting for sibling age and sex, the odds of angle closure was 13.6 times greater in angle closure (PACS or PAC/PACG) siblings compared with OA siblings (95% confidence interval [CI], 4.1-45.0; P < 0.001). Sibling angle-closure risk was also greater in female (odds ratio [OR], 2.3; 95% CI, 1.3-4.0; P = 0.005) and older siblings (OR, 1.5 per 10-year increment; 95% CI, 1.1-2.0; P = 0.02). Siblings of PAC/PACG probands had a 2.3-fold greater odds (95% CI, 0.8-6.5) of having PAC/PACG compared with siblings of PACS probands, although the association was not significant (P = 0.13).
In the South Indian population screened, siblings of angle-closure patients had a >1 in 3 risk of prevalent angle closure, whereas siblings of PAC/PACG patients had a >10% risk of prevalent PAC/PACG. Screening siblings of angle-closure patients is likely to be of high yield in finding undetected angle closure.
比较开角型青光眼（OA）患者、疑似闭角型青光眼（PACS）患者、原发性闭角型青光眼（PAC）或 PAC 青光眼（PACG）患者的兄弟姐妹中闭角型青光眼的患病率。
横断面、临床研究。
共纳入 303 对南印度同胞，包括 81 例 OA 先证者、143 例 PACS 先证者和 79 例 PAC/PACG 先证者。
先证者和同胞接受临床检查，包括由盲法分级员进行的房角镜检查、压平眼压测量、裂隙灯生物显微镜检查、视神经评估和 A 型超声检查。根据病情较重眼的表型，将先证者和同胞分为 3 组之一：OA、PACS 或 PAC/PACG。采用多变量回归模型来估计 PACS 或 PAC/PACG 同胞与 OA 同胞相比，患闭角型青光眼的比值比（OR）。
OA、PACS 和 PAC/PACG 兄弟姐妹中闭角型青光眼和 PAC/PACG 的患病率和相对患病率。
同胞的平均年龄为 49.7±8.7 岁，56.6%的同胞为女性。与 OA 同胞（3.7%；P＜0.001）相比，PACS 同胞（35.0%）和 PAC/PACG 同胞（36.7%）的闭角型青光眼更为常见。与 PACS 同胞（4.9%）相比，PAC/PACG 同胞中存在 PACG（11.4%；P=0.07）和 OA 同胞（0%；P=0.002）的比例更高。在调整同胞年龄和性别后，闭角型青光眼（PACS 或 PAC/PACG）同胞患闭角型青光眼的 OR 为 13.6（95%CI，4.1-45.0；P＜0.001）。女性（OR，2.3；95%CI，1.3-4.0；P=0.005）和年龄较大的同胞（OR，每增加 10 岁增加 1.5；95%CI，1.1-2.0；P=0.02）的同胞发生闭角型青光眼的风险也更高。与 PACS 先证者的同胞相比，PACG 先证者的同胞患 PACG 的 OR 为 2.3（95%CI，0.8-6.5），尽管该关联无统计学意义（P=0.13）。
在所筛查的南印度人群中，闭角型青光眼患者的同胞患闭角型青光眼的风险超过 1/3，而 PACG 患者的同胞患 PACG 的风险超过 10%。对闭角型青光眼患者的同胞进行筛查可能会发现未被发现的闭角型青光眼。
