Article Text

Ten-year incidence of primary angle closure in elderly Chinese: the Liwan Eye Study
  1. Lanhua Wang1,
  2. Wenyong Huang1,
  3. Shengsong Huang1,
  4. Jian Zhang1,
  5. Xinxing Guo1,
  6. David S Friedman2,
  7. Paul J Foster3,
  8. Mingguang He1,4
  1. 1 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  2. 2 Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  3. 3 NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
  4. 4 Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
  1. Correspondence to Professor Mingguang He, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China; mingguanghe{at}


Purpose To determine the 10-year incidence of all forms of primary angle closure (PAC) in phakic eyes and its risk factors in an urban Chinese population aged 50 years and older.

Methods Survivors of 1405 baseline participants were invited to attend the 10-year follow-up visit in the Liwan Eye Study. Participants with established baseline angle closure, including primary angle closure suspects (PACS), PAC and primary angle closure glaucoma (PACG), or those who underwent bilateral cataract surgery during the 10-year period, as well as those who did not tolerate gonioscopic examinations, were excluded from this analysis. Incident PAC was present when those with open angles at baseline developed angle closure in any form in either eye during the 10-year period.

Results Among 791 participants who returned during the 10-year follow-up visit, 620 (78.4%) provided data on PAC incidence. The 10-year cumulative incidence of any forms of PAC was 20.5% (127/620, 95% CI 17.4% to 24.9%), including 16.9%, 2.4% and 1.1% with incident PACS, PAC and PACG in either eye, respectively. In multiple logistic regression, significant risk factors for incident angle closure were greater baseline lens thickness (OR=1.82 per mm, p=0.003), shallower anterior chamber depth (OR=3.18 per mm decreased, p=0.010) and narrower angle width (OR=1.63 per decreased angle width, p<0.0001).

Conclusions Approximately one in five people aged 50 years and older developed some form of angle closure over a 10-year period. Small ocular dimensions and hyperopia at baseline were associated with the development of angle closure.

  • incidence
  • primary angle closure suspect
  • primary angle closure
  • primary angle closure glaucoma

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  • Funding This study was supported by the Fundamental Research Funds of the State Key Laboratory in Ophthalmology, National Natural Science Foundation of China (81420108008 and 81570843 H1204), and the Science and Technology Planning Project of Guangdong Province, China (2013B20400003). The sponsor or funding organisation had no role in the design or conduct of this research. MH receives support from the University of Melbourne at Research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian State Government. PJF receives research funding from the NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology.

  • Competing interests None declared.

  • Ethics approval Ethical approval was obtained from the Zhongshan University Ethics Review Board and the Research Governance Committee of Moorfields Eye Hospital in London, England.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Obtained.

  • Contributors Conception and design of the study: MH, DSF, PJF; analysis and interpretation: LW, WH, JZ; writing of the article: LW, XG; critical revision of the article: MH, DSF, PJF; data collection: LW, WH, SH.

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