Comparison of symptomatic and asymptomatic, chronic, primary angle-closureglaucoma, open-angle glaucoma, and controls

Purpose: To determine the clinical features and anatomic parameters in asym ptomatic (creeping) and symptomatic, chronic, primary angle-closure glaucom a (PACG) as compared with open-angle glaucoma (OAG) and with control subjec ts with normal eyes. Methods: Forty consecutive patients with each of the following four types o f eyes were studied (N = 160): eyes with symptomatic PACG, eyes with asympt omatic PACG, eyes with GAG, and the eyes of age-, sex-, and refraction-matc hed control subjects. The refractive status, keratometry, pachymetry, corne al diameter, anterior chamber depth, lens thickness, axial length, and rela tive lens position were noted. The groups were compared using a paired t te st and analysis of variance. Results: Patients with asymptomatic chronic PACG were older than patients i n the symptomatic group, were more often men, and were more likely to have either diabetes mellitus or hypertension. Symptomatic chronic PACG eyes wer e mon hypermetropic. Asymptomatic eyes had more iridotrabecular synechiae a nd minimal pupillary ruff atrophy as compared with the symptomatic eyes tha t had largely iridocorneal synechiae and large areas where the ruff was abs ent. All other clinical and anatomic parameters were statistically similar in the two groups, but differed significantly from OAG and control eyes. Conclusions: The ocular parameters of asymptomatic or creeping angle closur e eyes show that these are significantly different from eyes having POAG. A symptomatic and symptomatic chronic PACG eyes are structurally similar. Ope n-angle glaucoma eyes and normal eyes were comparable, but differed from bo th the chronic angle-closure glaucoma groups in having a larger corneal dia meter, deeper anterior chamber, thinner lens, and a longer axial length. Th e symptomatic chronic PACG eyes showed more evidence of ischemic damage to the iris, and this could account for the symptoms reported by these patient s.