Appositional angle closure in eyes with narrow angles: comparison between the fellow eyes of acute angle-closure glaucoma and normotensive cases

Abstract

Purpose: To identify topologic features of eyes with acute primary angle-closure glaucoma before an attack as compared with those features in normotensive cases, assuming that untreated fellow eyes of acute primary angle-closure glaucoma are candidates for an acute attack.

Methods: A total of 50 eyes (12 fellow eyes of acute primary angle-closure glaucoma and 38 normotensive cases with a closure-possible narrow angle) were prospectively examined by ultrasound biomicroscopy under dark-room conditions. All eyes were examined before surgical or laser intervention and had normal pupillary reaction without any topical drugs. Four predetermined angle locations per eye were examined. Parameters regarding the chamber angle configuration were measured and compared between the two groups.

Results: Appositional angle closures were observed in 27 locations in fellow eyes and in 48 locations in normotensive eyes with a closure-possible narrow angle. The incidence was statistically different between the two groups (69.2% in the fellow eyes and 48% in the normotensive eyes). Appositional angle closures beginning at the entrance of the angle were more frequently detected in the fellow eye group. The distance between the iris root and the bottom of the angle was significantly different between the two groups.

Conclusion: The fellow eyes of acute primary angle-closure glaucoma have different topologic features from normotensive narrow-angled eyes and a higher incidence of appositional closure that may predispose these eyes to an imminent acute attack.