Evaluation of Intraocular Pressure (IOP) and optic disc in primary angle closure disease

Abstract

Background: Primary Angle Closure Disease is a common cause of Blindness. Objectives: Our study was to evaluate the Intraocular Pressure and Optic Disc in the Primary Angle Closure Disease. Materials and Methods: This was a tertiary hospital study in the Glaucoma clinic, Sarojini Devi Eye Hospital and Regional Institute of Ophthalmology (RIO), Osmania Medical College, Hyderabad over a period from August 2012 to August 2014. The study group was 50 Patients clinically diagnosed as a primary angle closure disease. Detailed history of the patient with the data of age, gender and clinical status were noted. Comprehensive ocular examination was done which includes Visual Acuity by Snellen’s Chart, Anterior Segment examination by Slit Lamp, Intraocular pressure measurement by Goldman’s applanation Tonometer, Angle of the anterior chamber (Gonioscopy) by 4 Mirror Goniolens (Sussmann and Posner) and Posterior segment examination by Slit lamp - biomicroscopy with + 90 D Lens and Indirect Ophthalmoscopy by + 20 D lens. Results: Age group distribution was 10(20.0%) in 40-50yrs, 27 (54.0%) in 51-60yrs, 12 (24.0%) in 61-70yrs and 1(2.0%) > 70yrs. 14 (28.0%) were males and 36 (72.0%) were females. It was acute in 13 (26.0%) with the presenting symptoms of pain, Redness and Colored Haloes and chronic with the presenting symptom of Defective Vision in 37 (74.0%). Angle of Anterior chamber was closed in 43 (86.0%) and Hazy View in 7 (14.0%). The Intra ocular pressure in mm Hg was 20-25 in 7 (14.0%), >25 – 30 in 27 (54.0%), >30 – 35 in 6(12.0%), >35 -40 in 5 (10.0%), >40 – 50 in 2 (4.0%) and >50 -60 in 2 (4.0%). Cup/ Disc ratio was <0.7-1 in 8 (16.0%), 0.7 – 1 in 12 (24.0 %), 0.8 – 1 in 11 (22.0 %), 0.9 – 1 in 4 (8.0%), total cupping in 8 (16.0%) and hazy view in 7 (14.0%). Polar notching was in 3(11.6%) and Disc Hemorrhage was in 3 (4.4%). Conclusions: Primary angle closure disease presented as a silent and chronic condition with Intraocular pressure of 25 - 30 mmHg and Optic cup: disc ratio of 0.7 – 1 to 0.8 -1 with a need for comprehensive ophthalmic examination in the early detection of the disease in the risk group to prevent angle closure disease related blindness in the community

Keywords

• primary angle closure disease
• intraocular pressure
• optic cup / disc ratio