The Genetic Study of Primary Angle-Closure Glaucoma

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• An occludable angle was defined as one in which less than 90° circumference of the pigmented trabecular meshwork was visible. Persons in whom primary angle-closure was suspected (PACS) had an occludable angle and no other abnormality. Primary angle closure (PAC) was diagnosed in persons with a normal visual field and optic disc but having an occludable angle and evidence of angle dysfunction. Dysfunctional features included elevated IOP (\>19 mm Hg) or a positive darkroom-prone provocation test, peripheral anterior synechiae, pigment smearing in superior drainage angle, sequelae of acute angle closure (iris whorling or glaukomflecken), or a clear history of symptomatic angle closure with evidence of a peripheral iridectomy. An IOP of 19 mm Hg was chosen by taking the mean +2 SDs from other data on Sino-Mongoloid people.
• Primary angle-closure glaucoma was diagnosed in subjects with an occludable drainage angle and glaucomatous optic neuropathy with compatible visual morbidity. Optic neuropathy was defined as a CDR of 0.7 or more, or asymmetry of 0.2 or more. In early to moderate cases (CDR of 0.7 or 0.8 or asymmetry of 0.2), a reproducible visual field defect was required to confirm the diagnosis. In advanced cases (CDR \>=0.9 or CDR asymmetry \>0.3), perimetric evidence of visual loss was not an absolute requirement. Primary angle-closure glaucoma was diagnosed if the disc was not visible, but iris stromal atrophy and whorling were seen in conjunction with a visual acuity less than 20/400.