Long-term outcomes after acute primary angle closure of Caucasian chronic angle closure glaucoma patients

Abstract

Importance: There is a lack of information about long-term results of chronic angle closure glaucoma following an acute primary angle closure attack in Caucasian patients.

Purpose: The aim of the study was to report morphological and functional long-term data of chronic angle closure eyes following a monolateral primary angle closure attack and to provide a comparison with their fellow eyes.

Design: Observational retrospective case series.

Participants: Fifty-seven consecutive patients (114 eyes) underwent long-term follow-up analysis.

Methods: Patients underwent ophthalmic assessment more than 5 years since the angle closure attack.

Main outcome measures: Intraocular pressure, best-corrected visual acuity, angle assessment, vertical C/D ratio and standard automated perimetry were the main outcome measures. Comparisons were made between angle closure attack eyes and fellow eyes and between phakic and pseudophakic eyes.

Results: Mean follow-up time was 5.86 ± 1.19 years. A significant greater damage in the angle closure eyes compared with fellow eyes in both structural (mean C/D 0.61 ± 0.16; P < 0.001) and functional (mean deviation: -7.98 ± 6.46 vs. -4.83 ± 4.95 dB; P < 0.001) terms was present. Mean IOP was 13.44 ± 2.78 and 13.89 ± 2.60 mmHg in angle closure and fellow eyes (P = 0.11). Thirty of 57 (53%) fellow eyes developed chronic angle closure (mean deviation: -7.74 ± 5.21 dB) even if prophylactic iridotomy was promptly performed.

Conclusion and relevance: Our study prompts ophthalmologists to closely follow patients after an APAC attack to prevent potential glaucoma damage in both APAC and fellow eye.

Keywords: APAC; PACG; glaucoma; long-term follow-up; outcome.