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Screening for primary angle closure in Mongolia: a randomised controlled trial to determine whether screening and prophylactic treatment will reduce the incidence of primary angle closure glaucoma in an east Asian population
  1. W P Nolan1,
  2. J Baasanhu2,
  3. A Undraa2,
  4. D Uranchimeg2,
  5. S Ganzorig2,
  6. G J Johnson1
  1. 1Department of Epidemiology and International Eye Health, Institute of Ophthalmology, London, UK
  2. 2Department of Ophthalmology, Medical University Central Hospital, Ulaanbaatar, Mongolia
  1. Correspondence to: Winifred Nolan, Department of Epidemiology and International Eye Health, Institute of Ophthalmology, 11–43 Bath Street, London EC1V 9EL, UK; winnienolan{at}hotmail.com

Abstract

Aim: To describe the methods used and initial results of a prospective study designed to determine whether screening and prophylactic treatment will reduce the incidence of primary angle closure glaucoma (PACG) in Mongolia.

Methods: A total of 4725 individuals aged 50 years and above were recruited to the study and randomised to intervention or control groups. All subjects had non-mydriatic optic disc examination. The intervention arm had measurement of anterior chamber depth (ACD) by A-scan ultrasound and intraocular pressure (IOP) with Tonopen. Gonioscopy was performed on test positive cases (ACD <2.53 mm or IOP ≥24 mm Hg either eye). Those with occludable angles were offered laser iridotomy. Primary outcome will be incidence of PACG at 5 year follow up.

Results: Glaucoma was diagnosed in 128 (2.7%) subjects. Of the remaining 4597, 2293 were randomised to intervention. Intervention as allocated was received by 2280 (99.4%) individuals. 160 (23.4%) of 685 test positive cases had occludable angles, of which 156 were treated with iridotomy.

Conclusions: This trial is a further step in determining whether screening and prophylactic treatment for primary angle closure in east Asian populations will reduce the incidence of glaucoma.

  • screening
  • primary angle closure glaucoma

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