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Bang and Lee: Correlation between Seasons, Climatic Factors and Acute Angle Closure Attack Incidence
Original Article

Journal of the Korean Ophthalmological Society 2019; 60(12): 1238-1243.

Published online: 17 December 2019

DOI: https://doi.org/10.3341/jkos.2019.60.12.1238

Correlation between Seasons, Climatic Factors and Acute Angle Closure Attack Incidence

So Ra Bang, MD, Tae Eun Lee, MD, PhD

Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea.

Address reprint requests to Tae Eun Lee, MD, PhD. Department of Ophthalmology, Chonbuk National University Hospital, #20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea. Tel: 82-63-250-1965, Fax: 82-63-250-1960, lte814@jbnu.ac.kr

Received 28 June 2019       Revised 25 July 2019       Accepted 6 December 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate seasonal variations in the incidence of acute primary angle closure (PAC) attack and to identify climatic factors associated with the frequency of angle closure attack.

Methods

A retrospective analysis of proven cases of acute PAC attack from hospital records over a 10-year period from January 2009 to December 2018 at a tertiary hospital. The study was performed to identify and analyze sex, age on diagnosis, onset timing of symptoms. And then, compared the seasonal occurrence rates and analyzed the correlation between climatic factors and occurrence frequency.

Results

A total of 227 patients of 227 eyes were diagnosed as acute PAC attack. There were 57 men and 170 women, mean age was 67.0 ± 9.1 years and the highest rate was in the 60s (38.3%). There was a statistically significant increase of acute angle closure attack incidence in women in winter (p = 0.002). In the case of climate factors, there was a negative correlation with the average temperature and the sunshine time (r = −0.657, p = 0.030; r = −0.583, p = 0.046, respectively). There was no significant correlation with the average humidity and the rate of sunshine (r = −0.288, p = 0.364; r = 0.021, p = 0.948, respectively).

Conclusions

Acute PAC glaucoma occurred more frequently in winter. Especially in women, it seems to be more affected by seasonal changes. Acute PAC attack incidence was associated with mean temperature, sum of hours of sunshine.

Keywords: Angle closure glaucoma, Climate change, Seasonal variation

Figures and Tables

Figure 1

Cumulative monthly incidence of acute angle closure attack over the 10 years. The highest angle closure attack incidence was in December (n = 25, 11%), followed by February and March (n = 24, 10.6%, respectively). According to sex, male (light gray bar) showed highest incidence in March (n = 11, 19.3%), female (dark gray bar) in February (n = 22, 12.9%).

jkos-60-1238-g001
Figure 2

Seasonal cumulative incidence of acute angle closure attack over the 10 years. There was a statistically significant increase of acute angle closure attack incidence in winter (top graph, n = 71, 31.2%, p = 0.019). Other seasons not showed statistically significant difference of incidence. There was no difference in the incidence according to season in males (center graph). In female, there was significant higher acute angle closure attack incidence in winter (bottom graph, p = 0.002).

jkos-60-1238-g002
Figure 3

Correlation of acute angle closure attack incidence with each monthly climatic factor. Mean temperature and sunshine hours were significantly correlated with acute angle closure attack incidence (left upper and lower). Humidity and sunshine rate were not significantly correlated with acute angle closure attack incidence (right upper and lower).

jkos-60-1238-g003
Table 1

Demographics of patients

jkos-60-1238-i001

Values are presented as mean ± standard deviation or number (%).

M = male; F = female; IOP = intraocular pressure; CT = corneal thickness.

Table 2

Age distribution of acute angle closure attack by sex

jkos-60-1238-i002

Values are presented as number (%).

Table 3

Distribution of intraocular pressure at first visit by month and season

jkos-60-1238-i003

Values are presented as mean ± standard deviation (range).

IOP = intraocular pressure.

*One-way ANOVA.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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