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Raghavan Lavanya, DO; Tien-Yin Wong, MBBS, PHD, FRCSEdin; David S. Friedman, MD; Han T. Aung, MBBS; Tamuno Alfred, MSc; Hong Gao, MD; Steve K. Seah, FRCS; Kenji Kashiwagi, MD; Paul J. Foster; Tin Aung, MBBS, PhD, FRCSEdin

Arch Ophthalmol. 2008;126(5):686-691.

Objectives  To investigate systemic and ocular risk factors for angle closure (AC) in older Singaporeans and to determine if these risk factors are different in men vs women and in Chinese vs non-Chinese persons.

Methods  A cross-sectional study of 2042 subjects with phakia 50 years or older recruited from a primary care clinic in Singapore. Subjects completed a detailed questionnaire and underwent refraction, biometry, and gonioscopy. Univariate and multivariate analyses were performed to determine risk factors for AC.

Results  The prevalence of AC among this study population was 19.3% (n = 395); 89.4% (n = 1826) of the study population were Chinese. In univariate analysis, patients with AC were older, female, and of Chinese descent and had shorter axial length, lower body mass index, higher intraocular pressure, and shallower anterior chamber depth. In multivariate analysis, female sex (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.06-1.92; P =.02), Chinese race/ethnicity (OR, 3.58; 95% CI, 2.03-6.29; P < .001), axial length (OR per millimeter increase, 0.69; 95% CI, 0.58-0.81; P<.001), and central anterior chamber depth of less than 2.80 mm vs at least 3.00 mm (OR, 42.5; 95% CI, 27.4-66.2; P<.001) were independently associated with AC.

Conclusions  In this community-based study of older Singaporeans, statistically significant independent predictors of AC were female sex, shorter axial length, shallower central anterior chamber depth, and Chinese race/ethnicity. Sex and racial/ethnic differences in the risk of AC were not fully explained by sex and racial/ethnic variations in axial length or anterior chamber depth.

Author Affiliations: Department of Glaucoma, Singapore National Eye Center and Singapore Eye Research Institute (Drs Lavanya, Wong, H. T. Aung, Seah, and T. Aung), Yong Loo Lin School of Medicine, National University of Singapore (Drs Wong and T. Aung), and Clinical Trials and Epidemiology Research Unit (Dr Alfred), Singapore; Centre for Eye Research Australia, University of Melbourne, Melbourne (Dr Wong); Wilmer Eye Institute and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Friedman); University of Yamanashi, Chuo Yamanashi, Japan (Dr Kashiwagi); and Institute of Ophthalmology and Moorfields Eye Hospital, London, England (Dr Foster).

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