Prevalence and Risk Factors of Primary Angle Closure Disease in an Adult Chinese American Population: The Chinese American Eye Study: Prevalence of Primary Angle Closure Disease in Chinese Americans.

IF 4.1 1区医学 Q1 OPHTHALMOLOGY American Journal of Ophthalmology Pub Date : 2025-02-27 DOI:10.1016/j.ajo.2025.02.037

Benjamin Y Xu, Grace M Richter, Bruce S Burkemper, Dandan Wang, Xuejuan Jiang, Mina Torres, Roberta McKean-Cowdin, Nathan Dhablania, Rohit Varma

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Abstract

Objective: To assess the prevalence and risk factors of primary angle closure disease (PACD) among adult Chinese Americans.

Design: Cross-sectional population-based study.

Participants: 4,582 Chinese Americans 50 years and older from 15 census tracts in Monterey Park, CA.

Methods: Participants received complete eye exams, including gonioscopy, fundus photography, and standard automated perimetry. Primary angle closure suspect (PACS) was defined as non-visible posterior trabecular meshwork for ≥270 degrees on gonioscopy. Primary angle closure (PAC) was defined as PACS with peripheral anterior synechiae (PAS) and/or IOP≥21 mmHg without glaucomatous neuropathy (GON). PACG was defined as PACS or PAC with GON. Suspected PACG (sPACG) was defined as GON without PACS or PAC but with evidence of prior laser iridotomy or cataract surgery with residual PAS. Multivariable logistic regression models were developed to identify risk factors for PACS, PAC, and PACG.

Main outcome measures: Prevalence and risk factors of PACS, PAC, and PACG.

Results: Data from 4,310 CHES participants were included in the analysis. The prevalence of PACS, PAC, and PACG were 8.1% (95% CI: 7.3-9.0%; N=351), 3.1% (95% CI: 2.6-3.6%; N=132), and 1.1% (95% CI: 0.8-1.4%; N=46), respectively. Prevalence of PACG and sPACG combined was 1.8% (95% CI: 1.4-2.2%; N=76). Older age (OR=1.06 per year), positive family history of glaucoma (OR=3.21), higher IOP (OR=1.17 per mmHg), and shorter axial length (OR=1.67 per mm) were significant risk factors (p<0.003) for PACG on multivariable analysis. 75.0% of PACG cases were previously undiagnosed. There was one case of PACG with unilateral blindness and no cases with bilateral blindness.

Conclusion: PACG prevalence was not substantially lower among Chinese Americans compared to mainland Chinese. Older age, higher IOP, positive family history of glaucoma, and smaller AL conferred higher risk. While the majority of PACG cases were undetected, blindness was rare. Improved access to eye care and cataract surgery appears to mitigate severe visual morbidity associated with PACG.

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目的评估原发性闭角型角膜病（PACD）在成年美籍华人中的患病率和风险因素：横断面人群研究：来自加利福尼亚州蒙特利公园市 15 个人口普查区的 4582 名 50 岁及以上的美籍华人：参与者接受完整的眼部检查，包括眼底镜检查、眼底照相和标准自动视力测定。原发性角膜闭合疑似症（PACS）的定义是：在眼底镜检查中，小梁后网≥270度时不可见。原发性角膜闭合（PAC）的定义是：PACS伴有周围性前节膜（PAS）和/或眼压≥21 mmHg，但无青光眼性神经病变（GON）。PACG 被定义为 PACS 或 PAC 伴有 GON。疑似 PACG（sPACG）定义为无 PACS 或 PAC 的 GON，但有证据表明之前进行过激光虹膜切开术或白内障手术并残留 PAS。建立多变量逻辑回归模型以确定PACS、PAC和PACG的风险因素：主要结果测量：PACS、PAC 和 PACG 的患病率和风险因素：分析纳入了 4310 名 CHES 参与者的数据。PACS、PAC和PACG的患病率分别为8.1%（95% CI：7.3-9.0%；N=351）、3.1%（95% CI：2.6-3.6%；N=132）和1.1%（95% CI：0.8-1.4%；N=46）。PACG和sPACG的合计患病率为1.8%（95% CI：1.4-2.2%；N=76）。年龄较大（OR=1.06/年）、青光眼家族史阳性（OR=3.21）、眼压较高（OR=1.17/毫米汞柱）和轴向长度较短（OR=1.67/毫米）是重要的风险因素（P结论：与中国大陆人相比，美籍华人的 PACG 患病率并没有明显降低。年龄越大、眼压越高、青光眼家族史阳性以及眼压越小，患病风险越高。虽然大多数 PACG 病例未被发现，但失明的情况却很少见。改善眼科护理和白内障手术的可及性似乎可减轻与 PACG 相关的严重视觉发病率。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.