TY - JOUR
T1 - Nonprogressive Glaucomatous Cupping and Visual Field Abnormalities in Young Chinese Males
AU - Doshi, Amish
AU - Kreidl, Ken O.
AU - Lombardi, Lorinna
AU - Sakamoto, Douglas K.
AU - Singh, Kuldev
PY - 2007/3
Y1 - 2007/3
N2 - Objective: To describe a series of young to middle-aged men of Chinese origin who presented with a constellation of ocular findings suggestive of glaucoma, that were found to be stable over a 7-year period. Design: Retrospective case series. Participants: Sixteen 25- to 66-year-old male patients. Methods: Medical records of the participants, of Chinese origin and referred for glaucoma evaluation over a 7-year period, were reviewed. All patients underwent complete ophthalmic examinations, stereo imaging of the optic nerves, and automated perimetry. Fewer than 5% of all patients seen in this practice were of Chinese origin. The patients were observed for the duration of the study in a single glaucoma clinic. Main Outcome Measures: Visual field (VF) changes or progressive optic nerve cupping suggestive of glaucoma. Results: The patients had an average age of 38.9 years. Tilted discs were present in 75.0% (24/32) and peripapillary atrophy in 81.3% (26/32) of nerves. Cup-to-disc ratios ranged from 0.20 to 0.95 and averaged 0.56. The lowest intraocular pressure (IOP) in any patient at any time was 8 mmHg, whereas the highest was 29 (average range, 13.5-17.9). Intraocular pressure-lowering therapy had been used in 56.3% (9/16). There was a family history of presumed glaucoma in 25.0% (4/16) of patients. High myopia (>-6.00-diopter spherical equivalent [SE]) was present in 43.8% of eyes (14/32), and SEs ranged from -11.25 to +0.25. The most common VF defect was an arcuate defect, found in 31.3% (10/32) of patients. There were no females of Chinese origin with similar findings identified during this period. Neither optic nerve nor significant VF progression was found during the follow-up period, regardless of the use of IOP-lowering therapy. Conclusions: These young Chinese patients previously diagnosed with glaucoma or considered glaucoma suspects had stable ocular findings for up to 7 years, irrespective of IOP-lowering therapy. Their condition was associated with myopia and tilted discs. Many were being treated with IOP-lowering therapy for glaucoma, a condition they may not have had. Further prospective epidemiologic study is needed to determine whether such a constellation of nonprogressive findings is more common in young Chinese males than in the general population.
AB - Objective: To describe a series of young to middle-aged men of Chinese origin who presented with a constellation of ocular findings suggestive of glaucoma, that were found to be stable over a 7-year period. Design: Retrospective case series. Participants: Sixteen 25- to 66-year-old male patients. Methods: Medical records of the participants, of Chinese origin and referred for glaucoma evaluation over a 7-year period, were reviewed. All patients underwent complete ophthalmic examinations, stereo imaging of the optic nerves, and automated perimetry. Fewer than 5% of all patients seen in this practice were of Chinese origin. The patients were observed for the duration of the study in a single glaucoma clinic. Main Outcome Measures: Visual field (VF) changes or progressive optic nerve cupping suggestive of glaucoma. Results: The patients had an average age of 38.9 years. Tilted discs were present in 75.0% (24/32) and peripapillary atrophy in 81.3% (26/32) of nerves. Cup-to-disc ratios ranged from 0.20 to 0.95 and averaged 0.56. The lowest intraocular pressure (IOP) in any patient at any time was 8 mmHg, whereas the highest was 29 (average range, 13.5-17.9). Intraocular pressure-lowering therapy had been used in 56.3% (9/16). There was a family history of presumed glaucoma in 25.0% (4/16) of patients. High myopia (>-6.00-diopter spherical equivalent [SE]) was present in 43.8% of eyes (14/32), and SEs ranged from -11.25 to +0.25. The most common VF defect was an arcuate defect, found in 31.3% (10/32) of patients. There were no females of Chinese origin with similar findings identified during this period. Neither optic nerve nor significant VF progression was found during the follow-up period, regardless of the use of IOP-lowering therapy. Conclusions: These young Chinese patients previously diagnosed with glaucoma or considered glaucoma suspects had stable ocular findings for up to 7 years, irrespective of IOP-lowering therapy. Their condition was associated with myopia and tilted discs. Many were being treated with IOP-lowering therapy for glaucoma, a condition they may not have had. Further prospective epidemiologic study is needed to determine whether such a constellation of nonprogressive findings is more common in young Chinese males than in the general population.
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U2 - 10.1016/j.ophtha.2006.07.036
DO - 10.1016/j.ophtha.2006.07.036
M3 - Article
C2 - 17123617
AN - SCOPUS:33847138926
SN - 0161-6420
VL - 114
SP - 472
EP - 479
JO - Ophthalmology
JF - Ophthalmology
IS - 3
ER -