Nonprogressive Glaucomatous Cupping and Visual Field Abnormalities in Young Chinese Males

Amish Doshi, Ken O. Kreidl, Lorinna Lombardi, Douglas K. Sakamoto, Kuldev Singh

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)472-479
Number of pages8
JournalOphthalmology
Volume114
Issue number3
DOIs
StatePublished - Mar 2007
Externally publishedYes

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Visual Fields
Glaucoma
Intraocular Pressure
Optic Nerve
Myopia
Ocular Hypertension
Visual Field Tests
Therapeutics
Atrophy
Medical Records
Epidemiologic Studies
Outcome Assessment (Health Care)
Prospective Studies
Population

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Nonprogressive Glaucomatous Cupping and Visual Field Abnormalities in Young Chinese Males. / Doshi, Amish; Kreidl, Ken O.; Lombardi, Lorinna; Sakamoto, Douglas K.; Singh, Kuldev.

In: Ophthalmology, Vol. 114, No. 3, 03.2007, p. 472-479.

Research output: Contribution to journalArticle

Doshi, Amish ; Kreidl, Ken O. ; Lombardi, Lorinna ; Sakamoto, Douglas K. ; Singh, Kuldev. / Nonprogressive Glaucomatous Cupping and Visual Field Abnormalities in Young Chinese Males. In: Ophthalmology. 2007 ; Vol. 114, No. 3. pp. 472-479.
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abstract = "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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AU - Doshi, Amish

AU - Kreidl, Ken O.

AU - Lombardi, Lorinna

AU - Sakamoto, Douglas K.

AU - Singh, Kuldev

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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.

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