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Appositional Angle Closure in Chinese Patients with Primary Angle Closure and Primary Angle Closure Glaucoma after Laser Peripheral Iridotomy 1. Yu-jie Yan Peking University Third Hospital, Peking University Eye Center, Beijing, PR China Purpose: to determine the prevalence of appositional angle closure (AAC) after laser peripheral iridotomy (LPI) in Chinese patients with primary angle closure (PAC) and primary angle closure glaucoma(PACG) and to evaluate the pathogenesis by investigating anatomic characteristics. Methods: In this cross-sectional observational study, consecutive patients with PAC and PACG after LPI underwent UBM in darkness. Darkroom provocative tests (DRPT) were performed for those with normal IOP. UBM imagine of each quadrant without peripheral anterior synechea (PAS) under gonioscopy was qualitatively assessed. Results: 134 eyes of 134 patients were enrolled. AAC was observed in at least 2 quadrants in 39 subjects (29.1%) and plateau iris was found in at least 2 quadrants in 13 subjects (9.7%). There were 459 quadrants of 134 patients without PAS, in which AAC existed in 143 quadrants (31.2%).Plateau iris accounted for 42.7% (61/143), anterior inserted iris alone for 16.1% (23/143), thick iris alone for 11.1% (16/143), and anterior inserted iris combined with thick iris for 20.3% (29/143). 115 subjects underwent DRPT. Positive rate of DRPT of eyes with AAC in 2 or more quadrants (27.8%, 20/72) was significantly higher than those in 0 or 1 quadrant (14.0%, 6/43) (p=0.018). No significant difference in DRPT positive rate was found between eyes with plateau iris in 0 or 1 quadrant (21.2%, 22/104) and those in 2 or more quadrants (36.4%,4/11) (p=0.251). Conclusion: About one third of PAC and PACG eyes of Chinese patients after LPI had AAC based on UBM findings. Plateau iris only accounted for less than half. Other factors such as thick peripheral iris and anterior inserted iris contribute more. DRPT results suggested AAC may have more functional meaning than plateau iris. |
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