12th Consensus Meeting: Angle Closure and Angle Closure Glaucoma
Honolulu, HI, USA, June 26, 2025
Leadership
- WGA Consensus Initiative Chair
Robert N. Weinreb (USA) - WGA Consensus 12 Co-Chairs
Benjamin Xu (USA), David Friedman (USA), Paul Foster (UK), Tin Aung (Singapore), Xiulan Zhang (China) - Section Leaders
Ching-Yu Cheng (Singapore), Christopher Leung (Hong Kong), Clement Tham (Hong Kong), Do Tan (Vietnam), Gus Gazzard (UK), Kyung Rim Sung (Korea), Lisandro Sakata (Brazil), Mani Baskaran (India), Mingguang He (Hong Kong), Monisha Nongpiur (Singapore), Ningli Wang (China), Ronnie George (India), Sasan Moghimi (USA), Shan Lin (USA), Tanuj Dada (India), Vijaya Lingham (India)
Introduction
In the 19 years since the last World Glaucoma Association (WGA) consensus meeting on angle closure glaucoma (published in 2006), our understanding of this visually devastating disease has been significantly transformed by a series of landmark studies.
Population-based epidemiological research has shed new light on the global burden of primary angle closure glaucoma (PACG) and its associated ocular morbidity. Insights into disease pathogenesis have deepened, particularly regarding racial anatomical differences and dynamic iris-related mechanisms.
Anterior segment optical coherence tomography (AS-OCT) is emerging as a potential new standard for detecting and risk-stratifying angle closure, superseding gonioscopy, the long-standing clinical standard. The integration of artificial intelligence (AI) with AS-OCT has further enhanced its utility and accessibility for widespread clinical use.
At the same time, evidence-based care for angle closure disease has improved, driven by pivotal trials such as EAGLE and ZAP. These studies support a broader spectrum of treatment strategies, including clear lens extraction (CLE), goniosynechiolysis (GSL), and minimally invasive glaucoma surgeries (MIGS), and a reconsideration of which patients should be treated.
Given the depth and breadth of these advances, it is an ideal time is to synthesize current knowledge for the global glaucoma community and identify critical knowledge gaps to guide research over the next two decades.
As with all the previous WGA consensuses, the Angle Closure and Angle Closure Glaucoma Consensus is based on the published literature and expert experience. Although consensus does not replace and is not a surrogate for scientific investigation, it does provide considerable value, especially when the desired evidence is lacking. The goal of this consensus is to establish what we ‘know’ and what we need to ‘know’. It is expected that this consensus report will serve as a benchmark for our current knowledge and that it will be revised and improved with the emergence of new evidence.
Sections
Section 1: Epidemiology
Section 2: Pathophysiology and Risk Factors
Section 3: Diagnosis and Evaluation
Section 4: Medical and Laser Management
Section 5: Surgical Management
Section 6: Acute Primary Angle Closure
