Profile of angle closure glaucoma in the Gangetic Delta

Purpose: To study the clinical profile of the types of primary angle closure patients in a rural and urban population in Eastern India. Materials and Methods: International Society of Geographical and Epidemiological Ophthalmology (ISGEO) classification scheme was used to categorize patients. Clinic records of patients diagnosed as primary angle closure were reviewed. Clinical data including prior management was collected and analyzed. Main Outcome measures were age, sex, best corrected visual acuity (BCVA), intraocular pressure (IOP), gonioscopy, optic disc assessment and Frequency Doubling Perimetry(FDT). Logistic regression model and receiver operating curve (ROC) were calculated for predictors of type of glaucoma. Results: 1904 eyes; males:982 , females: 922) were diagnosed to have various subtypes of angle closure. Mean (±SD) age at presentation was significantly higher for males (56.54 ± 11.51 years) as compared to females (52.76 ± 10.46 years) (P < 001). Primary angle closure glaucoma (PACG) was most frequently diagnosed subtype (45.24%) followed by Primary angle closure (PAC) (40.46%) and Primary angle closure suspect (PACS) (14.30%) respectively. The three subtypes differed significantly among their mean IOP (on ANOVA, F = 12.04; P < 001). ROC yielded a very high AUC of 0.96 with strong discriminatory ability for PACG. Conclusion: In our population based study, the significant predictors for the outcome of PACG included male gender, diminution of vision, the presence of pain and worsening grades of BCVA. Nearly half of PACG presented with advanced disease.