Dysgenetic changes in the chamber angle in patients with glaucoma or in glaucoma suspects developed before the age of 40

Objective: The aim of this study is to determine percentage and degree of d ysgenetic changes in the chamber angle in glaucoma suspects and in patients who acquired glaucoma before the age of fourty and to compare the primary classification with the classification after reexamination. Patients and Methods: 200 eyes of 104 patients (59 males, 45 females, 0-40 yrs old (median 29) at time of detection) could be examined or reexaminded by gonioscopy and photography with the CGA-1 goniolens. The angles were doc umented by drawing and by goniophotography. The different features of dysge nesis served to establish a point-scale. Results: Out of 200 eyes in 24 eyes (12%) a slight, in 81 (40,5%) an inderm ediate and in 49 (24.5%) a severe goniodysgenesis was found. By reexaminati on the dysgenesis rate rose from 48 to 77%. Conclusions: The high frequency of dysgenetic changes in the chamber angle of glaucoma patients affected under the age of fourty suggests, that in thi s age group developmental glaucoma is predominant and has to be separated a s a special entity from POAG. Two questions arise: 1. Were these dysgenetic changes overlooked most of the time in the newer genetic studies of patien ts with GLC1A, or, if not, 2nd: Do glaucoma suspects and patients with open angle glaucomas before the age of 40 with and without dysgenetic changes b elong to groupes with different glaucoma genes, the "with" to genes IRID 1 and IRID 2 and the "without" to genes GLC1A to GLC1F?