Increasing age, higher IOP tied to primary angle-closure disease in Asians

The incidence of primary angle-closure disease (PACD) in a multi-ethnic Asian population is 3.50 percent over 6 years, a study has shown. Increasing age, higher intraocular pressure (IOP), and shallower anterior chamber contribute to the increased risk of incident PACT, while late posterior subcapsular cataract (PSC) is associated with a lower likelihood of developing PACD.

This population-based cohort study in Singapore was conducted among adults aged ≥40 years. The authors performed the baseline examination between 2004 and 2010 and the 6-year follow-up examination between 2011 and 2017.

A total of 6,762 participants attended the follow-up examination, of whom 5,298 at risk for primary angle-closure glaucoma (PACG) and 5,060 for PACD were included in the analyses.

The authors carried out standardized examinations, including slit-lamp biomicroscopy, indentation gonioscopy, IOP measurement, and static automated perimetry. PACD, in this study, included primary angle-closure suspect (PACS), primary angle-closure (PAC), and PACG.

At 6 years, the age-adjusted PACD incidence stood at 3.50 percent (95 percent confidence interval [CI], 2.94‒4.16). Multivariable analysis revealed the following factors to be associated with higher PACD chances: increasing age per decade (odds ratio [OR], 1.35, 95 percent CI, 1.15‒1.59), higher IOP (OR, 1.04, 95 percent CI, 1.00‒1.08), and shallower anterior chamber depth (OR, 1.11, 95 percent CI, 1.08‒1.14) at baseline. In contrast, late PSC (OR, 0.60, 95 percent CI, 0.48‒0.76) correlated with lower PACD odds.

The age-adjusted incidences at 6 years were 0.29 percent (95 percent CI, 0.14‒0.55) for PACG, 0.46 percent (95 percent CI, 0.29‒0.75) for PAC, and 2.54 percent (95 percent CI, 2.07‒3.12) for PACS.

“These findings can aid in future projections and formulation of healthcare policies for screening of at-risk individuals for timely intervention,” the authors said.