Dysgenetische Kammerwinkelveränderungen bei Patienten mit Glaukom oder Verdacht auf Glaukom aufgetreten vor dem 40. Lebensjahr

Objective: The aim of this study is to determine percentage and degree of dysgenetic changes in the chamber angle in glaucoma suspects and in patients who acquired glaucoma before the age of fourty and to compare the primary classification with the classification after reexamination. Patients and Methods: 200 eyes of 104 patients (59 males, 45 females, 0-40 yrs old (median 29) at time of detection) could be examined or reexaminded by gonioscopy and photography with the CGA-1 goniolens. The angles were documented by drawing and by goniophotography. The different features of dysgenesis served to establish a point-scale. Results: Out of 200 eyes in 24 eyes (12%) a slight, in 81 (40,5%) an indermediate and in 49 (24.5%) a severe goniodysgenesis was found. By reexamination the dysgenesis rate rose from 48 to 77%. Conclusions: The high frequency of dysgenetic changes in the chamber angle of glaucoma patients affected under the age of fourty suggests, that in this age group developmental glaucoma is predominant and has to be separated as a special entity from POAG. Two questions arise: 1. Were these dysgenetic changes overlooked most of the time in the newer genetic studies of patients with GLC1A, or, if not, 2nd: Do glaucoma suspects and patients with open angle glaucomas before the age of 40 with and without dysgenetic changes belong to groupes with different glaucoma genes, the with to genes IRID 1 and IRID 2 and the without to genes GLC1A to GLC1F?