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Article: Visual symptoms and retinal straylight after laser peripheral iridotomy: the Zhongshan angle-closure prevention trial
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TitleVisual symptoms and retinal straylight after laser peripheral iridotomy: the Zhongshan angle-closure prevention trial
 
AuthorsCongdon, N3
Yan, X3
Friedman, DS4
Foster, PJ5
van den Berg, TJTP1
Peng, M4
Gangwani, R2
He, M3
 
Issue Date2012
 
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophtha
 
CitationOphthalmology, 2012, v. 119 n. 7, p. 1375-1382 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ophtha.2012.01.015
 
AbstractOBJECTIVE: To assess the impact of laser peripheral iridotomy (LPI) on forward-scatter of light and subjective visual symptoms and to identify LPI parameters influencing these phenomena. DESIGN: Cohort study derived from a randomized trial, using an external control group. PARTICIPANTS: Chinese subjects initially aged 50 or older and 70 years or younger with bilateral narrow angles undergoing LPI in 1 eye selected at random, and age- and gender-matched controls. METHODS: Eighteen months after laser, LPI-treated subjects underwent digital iris photography and photogrammetry to characterize the size and location of the LPI, Lens Opacity Classification System III cataract grading, and measurement of retinal straylight (C-Quant; OCULUS, Wetzlar, Germany) in the treated and untreated eyes and completed a visual symptoms questionnaire. Controls answered the questionnaire and underwent straylight measurement and (in a random one-sixth sample) cataract grading. MAIN OUTCOME MEASURES: Retinal straylight levels and subjective visual symptoms. RESULTS: Among 230 LPI-treated subjects (121 [58.8%] with LPI totally covered by the lid, 43 [19.8%] with LPI partly covered by the lid, 53 [24.4%] with LPI uncovered by the lid), 217 (94.3%) completed all testing, as did 250 (93.3%) of 268 controls. Age, gender, and prevalence of visual symptoms did not differ between treated subjects and controls, although nuclear (P<0.01) and cortical (P = 0.03) cataract were less common among controls. Neither presenting visual acuity nor straylight score differed between the treated and untreated eyes among all treated persons, nor among those (n = 96) with LPI partially or totally uncovered. Prevalence of subjective glare did not differ significantly between participants with totally covered LPI (6.61%; 95% confidence interval [CI], 3.39%-12.5%), partially covered LPI (11.6%; 95% CI, 5.07%-24.5%), or totally uncovered LPI (9.43%; 95% CI, 4.10%-10.3%). In regression models, only worse cortical cataract grade (P = 0.01) was associated significantly with straylight score, and no predictors were associated with subjective glare. None of the LPI size or location parameters were associated with straylight or subjective symptoms. CONCLUSIONS: These results suggests that LPI is safe regarding measures of straylight and visual symptoms. This randomized design provides strong evidence that treatment programs for narrow angles would be unlikely to result in important medium-term visual disability.
 
ISSN0161-6420
2013 Impact Factor: 6.170
 
DOIhttp://dx.doi.org/10.1016/j.ophtha.2012.01.015
 
DC FieldValue
dc.contributor.authorCongdon, N
 
dc.contributor.authorYan, X
 
dc.contributor.authorFriedman, DS
 
dc.contributor.authorFoster, PJ
 
dc.contributor.authorvan den Berg, TJTP
 
dc.contributor.authorPeng, M
 
dc.contributor.authorGangwani, R
 
dc.contributor.authorHe, M
 
dc.date.accessioned2012-10-18T09:00:35Z
 
dc.date.available2012-10-18T09:00:35Z
 
dc.date.issued2012
 
dc.description.abstractOBJECTIVE: To assess the impact of laser peripheral iridotomy (LPI) on forward-scatter of light and subjective visual symptoms and to identify LPI parameters influencing these phenomena. DESIGN: Cohort study derived from a randomized trial, using an external control group. PARTICIPANTS: Chinese subjects initially aged 50 or older and 70 years or younger with bilateral narrow angles undergoing LPI in 1 eye selected at random, and age- and gender-matched controls. METHODS: Eighteen months after laser, LPI-treated subjects underwent digital iris photography and photogrammetry to characterize the size and location of the LPI, Lens Opacity Classification System III cataract grading, and measurement of retinal straylight (C-Quant; OCULUS, Wetzlar, Germany) in the treated and untreated eyes and completed a visual symptoms questionnaire. Controls answered the questionnaire and underwent straylight measurement and (in a random one-sixth sample) cataract grading. MAIN OUTCOME MEASURES: Retinal straylight levels and subjective visual symptoms. RESULTS: Among 230 LPI-treated subjects (121 [58.8%] with LPI totally covered by the lid, 43 [19.8%] with LPI partly covered by the lid, 53 [24.4%] with LPI uncovered by the lid), 217 (94.3%) completed all testing, as did 250 (93.3%) of 268 controls. Age, gender, and prevalence of visual symptoms did not differ between treated subjects and controls, although nuclear (P<0.01) and cortical (P = 0.03) cataract were less common among controls. Neither presenting visual acuity nor straylight score differed between the treated and untreated eyes among all treated persons, nor among those (n = 96) with LPI partially or totally uncovered. Prevalence of subjective glare did not differ significantly between participants with totally covered LPI (6.61%; 95% confidence interval [CI], 3.39%-12.5%), partially covered LPI (11.6%; 95% CI, 5.07%-24.5%), or totally uncovered LPI (9.43%; 95% CI, 4.10%-10.3%). In regression models, only worse cortical cataract grade (P = 0.01) was associated significantly with straylight score, and no predictors were associated with subjective glare. None of the LPI size or location parameters were associated with straylight or subjective symptoms. CONCLUSIONS: These results suggests that LPI is safe regarding measures of straylight and visual symptoms. This randomized design provides strong evidence that treatment programs for narrow angles would be unlikely to result in important medium-term visual disability.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationOphthalmology, 2012, v. 119 n. 7, p. 1375-1382 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ophtha.2012.01.015
 
dc.identifier.citeulike10472646
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.ophtha.2012.01.015
 
dc.identifier.epage1382
 
dc.identifier.hkuros212130
 
dc.identifier.issn0161-6420
2013 Impact Factor: 6.170
 
dc.identifier.issue7
 
dc.identifier.pmid22424576
 
dc.identifier.scopuseid_2-s2.0-84863328137
 
dc.identifier.spage1375
 
dc.identifier.urihttp://hdl.handle.net/10722/169511
 
dc.identifier.volume119
 
dc.languageeng
 
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ophtha
 
dc.publisher.placeUnited States
 
dc.relation.ispartofOphthalmology
 
dc.subject.meshGlaucoma, Angle-Closure - prevention and control
 
dc.subject.meshIridectomy
 
dc.subject.meshLaser Therapy
 
dc.subject.meshRetina - radiation effects
 
dc.subject.meshRetinal Diseases - etiology
 
dc.titleVisual symptoms and retinal straylight after laser peripheral iridotomy: the Zhongshan angle-closure prevention trial
 
dc.typeArticle
 
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<contributor.author>Yan, X</contributor.author>
<contributor.author>Friedman, DS</contributor.author>
<contributor.author>Foster, PJ</contributor.author>
<contributor.author>van den Berg, TJTP</contributor.author>
<contributor.author>Peng, M</contributor.author>
<contributor.author>Gangwani, R</contributor.author>
<contributor.author>He, M</contributor.author>
<date.accessioned>2012-10-18T09:00:35Z</date.accessioned>
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<description.abstract>OBJECTIVE: To assess the impact of laser peripheral iridotomy (LPI) on forward-scatter of light and subjective visual symptoms and to identify LPI parameters influencing these phenomena. DESIGN: Cohort study derived from a randomized trial, using an external control group. PARTICIPANTS: Chinese subjects initially aged 50 or older and 70 years or younger with bilateral narrow angles undergoing LPI in 1 eye selected at random, and age- and gender-matched controls. METHODS: Eighteen months after laser, LPI-treated subjects underwent digital iris photography and photogrammetry to characterize the size and location of the LPI, Lens Opacity Classification System III cataract grading, and measurement of retinal straylight (C-Quant; OCULUS, Wetzlar, Germany) in the treated and untreated eyes and completed a visual symptoms questionnaire. Controls answered the questionnaire and underwent straylight measurement and (in a random one-sixth sample) cataract grading. MAIN OUTCOME MEASURES: Retinal straylight levels and subjective visual symptoms. RESULTS: Among 230 LPI-treated subjects (121 [58.8%] with LPI totally covered by the lid, 43 [19.8%] with LPI partly covered by the lid, 53 [24.4%] with LPI uncovered by the lid), 217 (94.3%) completed all testing, as did 250 (93.3%) of 268 controls. Age, gender, and prevalence of visual symptoms did not differ between treated subjects and controls, although nuclear (P&lt;0.01) and cortical (P = 0.03) cataract were less common among controls. Neither presenting visual acuity nor straylight score differed between the treated and untreated eyes among all treated persons, nor among those (n = 96) with LPI partially or totally uncovered. Prevalence of subjective glare did not differ significantly between participants with totally covered LPI (6.61%; 95% confidence interval [CI], 3.39%-12.5%), partially covered LPI (11.6%; 95% CI, 5.07%-24.5%), or totally uncovered LPI (9.43%; 95% CI, 4.10%-10.3%). In regression models, only worse cortical cataract grade (P = 0.01) was associated significantly with straylight score, and no predictors were associated with subjective glare. None of the LPI size or location parameters were associated with straylight or subjective symptoms. CONCLUSIONS: These results suggests that LPI is safe regarding measures of straylight and visual symptoms. This randomized design provides strong evidence that treatment programs for narrow angles would be unlikely to result in important medium-term visual disability.</description.abstract>
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<subject.mesh>Glaucoma, Angle-Closure - prevention and control</subject.mesh>
<subject.mesh>Iridectomy</subject.mesh>
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<subject.mesh>Retinal Diseases - etiology</subject.mesh>
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Author Affiliations
  1. Netherlands Institute for Neuroscience NIN - KNAW
  2. The University of Hong Kong
  3. Zhongshan Ophthalmic Center
  4. The Wilmer Eye Institute at Johns Hopkins
  5. UCL Institute of Ophthalmology