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Abstract #73486 Published in IGR 18-4
Long term outcomes after acute primary angle closure of Caucasian chronic angle closure glaucoma (CACG) patients
Fea AM; Dallorto L; Lavia C; Pignata G; Rolle T; Aung TClinical and Experimental Ophthalmology 2018; 46: 232-239
IMPORTANCE: There is a lack of information about long term results of chronic angle closure glaucoma (CACG) following an acute primary angle closure (APAC) in Caucasian patients PURPOSE: To report morphological and functional long-term data of CACG eyes following a monolateral APAC attack and to provide a comparison with their fellow eyes DESIGN: Observational retrospective case series (Clinica Oculistica Universitaria, Ospedale Oftalmico, Turin) PARTICIPANTS: 57 consecutive patients (114 eyes) underwent long term follow-up analysis. METHODS: Patients underwent ophthalmic assessment more than 5 years since the APAC attack. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), number of antiglaucoma medications, best corrected visual acuity (BCVA), angle assessment with gonioscopy, Vertical Cup-To-Disc ratio (VCDR), Standard automated perimetry (SAP). Comparisons were made between APAC attack eyes and fellow eyes and between phakic and pseudophakic eyes as observed at follow up. RESULTS: Mean follow-up time was 5.86 ± 1.19 years. Outcomes showed a significant greater damage in the APAC eyes compared with fellow eyes both in structural (mean VCDR 0.61± 0.16; p<0.001) and functional (Mean Deviation (MD): -7.98 ± 6.46 vs -4.83 ± 4.95 dB; p<0.001) terms. Mean IOP was respectively 13.44 ± 2.78 and 13.89 ± 2.60 mmHg in APAC and fellow eyes (p=0.11). 30/57 (53%) fellow eyes developed CACG (mean MD -7.74 ± 5.21 dB) even if prophylactic iridotomy was promptly performed. CONCLUSION AND RELEVANCE: Our study prompts ophthalmologists to closely follow-up patients after an APAC attack to prevent potential glaucoma damage in both APAC and fellow eye.
Dipartimento di Scienze Chirurgiche, Universita' degli Studi di Torino, Italy.
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