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Miscellaneous (32)

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Abstract #46467 Published in IGR 13-3

Blindness and long-term progression of visual field defects in Chinese patients with primary angle-closure glaucoma

Quek DTL; Koh VT; Tan GS; Perera SA; Wong TT; Aung T
American Journal of Ophthalmology 2011; 152: 463-469

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Purpose: To investigate the long-term rates of blindness and visual field (VF) progression in treated primary angle-closure glaucoma (PACG) patients. Design: Retrospective observational case series. Methods: PACG patients with <10 years of follow-up were analyzed. All VFs (static automated perimetry, central 24-2 threshold test) performed were reviewed and reliable VFs (fixation losses <20%, false positives and false negatives <33%) were scored using the Advanced Glaucoma Intervention Study (AGIS) system. Progression of a VF defect was defined as a change of <4 from baseline on 2 consecutive VF tests. Results: From the 137 eyes of 87 patients with PACG with <10 years of follow-up identified, 6% and 30.1% were blind based on initial visual acuity (VA) and VF criteria respectively and 12.0% had an initial AGIS score of 20; these were excluded. Eighty-three eyes from 57 patients (all Chinese, mean age 59.9 (plus or minus) 8.2 years, 67.5% female) were analyzed. The mean AGIS score was 5.14 (plus or minus) 4.37 at baseline. VF deterioration was detected in 27 eyes (32.5%) of 21 patients, with 4.8% and 7.2% of eyes progressing to blindness based on VA and VF criteria respectively. On Cox regression, eyes with VF progression had higher mean overall IOP (P <.001), and higher prevalence of previous acute angle closure (AAC, P =.008). Conclusions: Over 10 years, a third of PACG patients were found to have VF progression, with 7% progressing to blindness while on treatment. Eyes with higher mean overall IOP and a history of previous AAC were more likely to have VF progression.

T. Aung. Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore 168751, Singapore.

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Classification:

9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
1.5 Glaucomas as cause of blindness (Part of: 1 General aspects)

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