Synechial angle closure pattern in Chinese chronic primary angle-closure glaucoma patients

Purpose: The aim of this retrospective clinical study is to investigate the pattern of synechial angle closure in a group of Hong Kong Chinese with chronic primary angle-closure glaucoma, Methods: The anterior angle of the upper, lower, medial, and lateral quadrants of 84 eyes from Hong Kong Chinese patients with chronic primary angle-closure glaucoma were assessed by the same examiner using indentation gonioscopy. Results: The incidences of synechial angle closure at the superior, nasal, inferior, and temporal quadrants were 98% (83/84), 77% (65/84), 31% (26/84), and 94%, (79/84), respectively. The Fisher exact test showed that the incidence of synechial angle closure at the superior quadrant was significantly higher than the nasal (P = 0.005) and inferior (P < 0.001) quadrants, but not the temporal quadrant (P = 0.07). Conclusion: Synechial angle closure is circumferential with asymmetry in these Chinese patients with chronic primary angle-closure glaucoma. The superior and temporal quadrants of the anterior angle may be the earliest sites of the synechial angle closure. The anterior angle may close synechially at the superior and temporal quadrants with gradual extension on the nasal quadrant, until the angle may close at the inferior quadrant.