Sihota R, Agarwal H C
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi.
Indian J Ophthalmol. 1998 Mar;46(1):25-9.
A prospective study of 500 consecutive patients of primary angle closure glaucoma was undertaken to study the clinical profile of the three subtypes: acute, subacute, and chronic. A record of age and sex distributions, symptomatology, the best corrected visual acuity, gonioscopy, visual fields, methods of control of intraocular pressure, and status of the second eye was maintained. Statistical analysis of these parameters and the subtypes of angle closure glaucoma was carried out using the chi-square test. Angle closure glaucoma constituted 45.9% of all primary adult glaucomas seen. 24.8% of these had acute angle closure glaucoma, 31.2% subacute, and 44% chronic glaucoma. Angle closure glaucoma occurred maximally in the sixth decade and females constituted 51.4% of those affected. The difference in symptoms among the subtypes was significant (p < 0.001). More than 80% of the chronic eyes had no significant symptoms. Visual field defects specific for glaucoma were seen in only 15.1% of chronic glaucoma eyes. Bilaterality was commonest in subacute angle closure glaucoma (95.5%) and least in acute angle closure 35.5%. Nd YAG iridotomy alone or with topical medication controlled the intraocular pressure in 48.3% of acute angle closure glaucoma, 78.8% of subacutes, and 30% of chronic eyes. Statistically, each parameter reviewed was significantly different among the subtypes. There are considerable differences as well as an overlap of clinical features in the subtypes of angle closure glaucoma, which suggest some anatomical differences or dissimilar pathogenic mechanisms in these eyes.
对500例连续性原发性闭角型青光眼患者进行了前瞻性研究，以探讨三种亚型（急性、亚急性和慢性）的临床特征。记录了年龄和性别分布、症状、最佳矫正视力、前房角镜检查、视野、眼压控制方法以及对侧眼的情况。使用卡方检验对这些参数以及闭角型青光眼的亚型进行了统计分析。闭角型青光眼占所有成人原发性青光眼的45.9%。其中，24.8%为急性闭角型青光眼，31.2%为亚急性闭角型青光眼，44%为慢性闭角型青光眼。闭角型青光眼在60岁左右发病率最高，女性占患者总数的51.4%。各亚型之间症状差异有统计学意义（p<0.001）。超过80%的慢性闭角型青光眼患者无明显症状。仅15.1%的慢性闭角型青光眼患者出现了青光眼特有的视野缺损。双侧发病在亚急性闭角型青光眼中最为常见（95.5%），在急性闭角型青光眼中最少见（35.5%）。单独使用Nd:YAG激光虹膜切开术或联合局部用药可使48.3%的急性闭角型青光眼、78.8%的亚急性闭角型青光眼和30%的慢性闭角型青光眼患者的眼压得到控制。统计学分析表明，各亚型之间所检查的每个参数均有显著差异。闭角型青光眼各亚型之间存在显著差异，同时临床特征也有重叠，这提示这些眼睛存在一些解剖学差异或不同的致病机制。
