Primary angle-closure glaucoma most prevalent in Asian patients but growing worldwide
COPENHAGEN, Denmark — Primary angle-closure glaucoma is estimated to affect 30 million individuals worldwide, 87% of whom are in Asia, according to a speaker here.
In a keynote lecture at the European Glaucoma Society meeting, Paul Chew, MD, said that in China, 1.7 million individuals are bilaterally blind from glaucoma, 91% due to angle closure. Singapore has the highest reported incidence at 12.2 per 100,000 annually in people at least 30 years old. Japanese studies report a prevalence of 0.6%.
Primary angle-closure glaucoma (PACG) is a growing problem in Western countries as well.
“In Caucasians, it is now two- to fourfold more common than previously reported. In Europe it affects 1.6 million individuals, 0.4% of the population over the age of 40. A further 9% increase is predicted within the next decade,” Chew said.
Laser peripheral iridotomy, the conventional treatment for PACG, has shown a high rate of failure, up to 30% in some Asian studies. According to Chew, this is largely due to late presentation.
“Early aggressive management may allow Asian outcomes to be similar to European data,” he said.
Also, the treatment needs to be tailored to individual patients.
“Pupil block, angle crowding, plateau iris configuration and lens thickness are variably involved and variously combined in primary angle closure,” Chew said.
The use of anterior-segment optical coherence tomography can help determine the specific mechanism and assist clinicians in planning customized treatments.