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The role of ethnicity in primary angle-closure glaucoma
Abstract
Primary angle-closure glaucoma is significantly more common than primary open-angle glaucoma in the East, whereas in Africa and Europe the reverse is true. In order to study the role of ethnic background in the frequency of primary angle-closure glaucoma in Cape Town and, in particular, in people of mixed ethnic background, the so-called 'coloureds', we retrospectively reviewed all patients with primary glaucoma who attended the glaucoma clinic at Groote Schuur Hospital during a 30-month period. Primary angle-closure glaucoma was diagnosed in 11 of 63 (17%) whites, 11 of 85 (13%) blacks and 114 of 244 (46,7%) coloureds with primary glaucoma; the difference is statistically highly significant (P < 0,001). The human leucocyte antigen frequencies in 97 coloured patients with primary angle-closure glaucoma were similar to those found in a control group of individuals with a similar ethnic background. This study highlights the fact that coloureds are more predisposed to primary angleclosure glaucoma than whites or blacks. Because of their strong historical and genetic ties with south-east Asia, this greater prevalence of primary angle-closure glaucoma might be explained by an Eastern influence on the ocular structures of the eye, as opposed to an African or European influence.