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Clinical characteristics, rates of blindness, and geographic features of PACD in China

Published:January 21, 2021DOI:https://doi.org/10.1016/j.jcjo.2020.12.010

      Abstract

      Objective

      To analyze the rates of blindness with the demographics and clinical characteristics of patients with primary angle-closure disease (PACD) to provide a comprehensive epidemiologic reference in China.

      Methods

      A retrospective analysis was conducted in the Chinese Glaucoma Study Consortium database, which is a national multicenter glaucoma research alliance of 111 hospitals participating between December 21, 2015 and September 9, 2018. The diagnosis of PACD was made by qualified physicians through examination. Comparison of sex, age, family history, subtypes of PACD, and blindness were analyzed.

      Results

      A total of 5762 glaucoma patients were included, of which 4588 (79.6%) had PACD. Of PACD patients, 72.1% were female with the sex ratio (F/M) of 2.6, and the average age of patients was 63.8±9.3 years with the majority between 60 and 70 years. Additionally, 30% of these patients had low vision in one eye, 8.8% had low vision in both eyes, 1.7% had blindness in one eye, and 0.3% had blindness in both eyes. There were statistical differences with regards to age between male and female patients with PACD, with male patients being older on average. Primary angle-closure glaucoma was more commonly diagnosed in males (60%) compared to females (35.9%), whereas acute primary angle closure (APAC) was more commonly diagnosed in females (54.3%) compared to males (37.7%). The visual acuity in APAC patients was lower and the rate of low vision and blindness was higher than other subtypes.

      Conclusion

      PACD was the major type of glaucoma in Chinese hospitals. There were more female patients with PACD, mostly between 60 and 70 years old, with higher rates of APAC in women. APAC resulted in the worst visual outcomes of all PACD subtypes.

      Objectif

      Analyser le taux de cécité en fonction des paramètres démographiques et cliniques de patients présentant une fermeture primitive de l'angle (PACD, pour primary angle-closure disease) dans l'optique de proposer une référence épidémiologique complète en Chine.

      Méthodes

      Une analyse rétrospective a été réalisée à partir de la base de données du consortium chinois pour l’étude sur le glaucome (regroupement de centres de recherche sur le glaucome à l’échelle nationale comptant 111 hôpitaux) qui a pris part au projet entre décembre 2015 et septembre 2018. Le diagnostic de PACD reposait sur l'examen des sujets par des médecins dûment qualifiés. On a procédé à une comparaison des paramètres liés au sexe, à l’âge, aux antécédents familiaux, aux sous-types de PACD et à la cécité.

      Résultats

      Au total, 5762 patients atteints d'un glaucome ont été inclus; 4588 (79,6 %) d'entre eux présentaient une PACD, dont 72,1 % de femmes; le rapport femmes-hommes s’établissait à 2,6. L’âge moyen des patients était de 63,8 ± 9,3 ans, la majorité des sujets étant âgés de 60 à 70 ans. On notait une basse vision dans un œil chez 30 % des patients, et dans les 2 yeux chez 8,8 % d'entre eux, tandis que 1,7 % des sujets présentaient une cécité unilatérale et 0,3 % d'entre eux, une cécité bilatérale. On enregistre des différences statistiques quant à l’âge entre les hommes et les femmes présentant une PACD, les hommes étant en moyenne plus âgés. Le glaucome primitif à angle fermé était plus souvent diagnostiqué chez les hommes (60 %) que chez les femmes (35,9 %), tandis que la crise de fermeture de l'angle (CFA) a été observée chez plus de femmes (54,3 %) que d'hommes (37,7 %). Chez les patients qui ont présenté une CFA, l'acuité visuelle était plus faible et les taux de vision basse et de cécité, plus élevés.

      Conclusion

      La PACD est la principale forme de glaucome que l'on retrouve dans les hôpitaux chinois. On compte plus de femmes atteintes de PACD, et elles sont principalement âgées de 60 à 70 ans. Enfin, les taux de CFA – qui donne lieu aux pires résultats visuels de tous les sous-types de PACD – sont plus élevés chez les femmes.
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