Undetected Angle Closure in Patients With Diagnosis of Open-Angle Glaucoma
Narrative Responses:
Purpose
To identify the proportion of patients referred by ophthalmologists to a tertiary glaucoma center with a diagnosis of open angle glaucoma that were found to have angle closure.
Methods
We conducted a retrospective chart review of patients referred by ophthalmologists to two glaucoma specialists in a tertiary glaucoma center over an 18-month span. Only referrals for primary open angle or pseudoexfoliative open angle glaucoma that specified angle status were included. Patients with previous cataract surgery were excluded. The data collected included glaucoma specialist’s angle assessment, diagnosis, and glaucoma severity. Those with 180 degrees or more Shaffer angle grading of 0 or slit were classified as angle closure.
Results
122 patients had referrals with a diagnosis of open angle glaucoma. Of these, 14 patients (11.5%) were found on examination by the glaucoma specialist to have angle closure. 28.5% of those with angle closure glaucoma had pseudoexfoliation syndrome as opposed to 13.8% of the open angle glaucoma group. There was no difference in demographic or ocular biometric parameters between groups.
Conclusion
Almost 1 in 8 patients referred by ophthalmologists to a tertiary glaucoma center with a diagnosis of open angle glaucoma were in fact found to have angle closure. Given the different treatment approaches for angle closure versus open angle glaucoma, this study suggests a need to strengthen angle evaluations.