Changes in the optic disc after acute primary angle closure.
OBJECTIVE
To evaluate the changes in optic disc morphology in the first 4 months after an episode of acute primary angle closure (APAC) using stereoscopic optic disc photography and computer-assisted planimetry.


METHODS
Prospective observational case series.


METHODS
Forty-seven Asian subjects with unilateral APAC who were successfully treated with laser peripheral iridotomy (LPI).


METHODS
Cup-to-disc ratio (CDR) and optic cup and neuroretinal rim areas.


METHODS
Stereoscopic optic disc photographs were taken 2 and 16 weeks after LPI, and the images were analyzed by computer-assisted planimetry. The overall, quadrantic, and 30 degrees sector areas of the optic disc, CDR, and neuroretinal rim area were analyzed by 2 independent masked graders, and the mean of the readings was used to calculate changes in optic disc parameters.


RESULTS
The majority of the subjects were female (66%) and Chinese (90%), and the mean age was 67.6+/-11.2 years (range, 40-94). In APAC eyes from week 2 to week 16, the mean CDR increased from 0.56+/-0.05 to 0.59+/-0.03 (P<0.001), and the mean neuroretinal rim area decreased from 1.74+/-0.31 mm2 to 1.59+/-0.27 mm2 (P<0.001). Quadrantic and sector analysis showed preferential loss of neuroretinal rim area at the superotemporal and inferotemporal areas. There was no significant change in optic disc parameters in the fellow eyes over the study period.


CONCLUSIONS
This study demonstrated changes in optic disc morphology from week 2 to week 16 after an episode of APAC. The pattern of optic nerve damage demonstrated in our study was comparable with that seen in primary open-angle glaucoma and experimental glaucoma models.
Shen
Sunny Y
SY
Singapore National Eye Centre, Singapore.
Baskaran
Mani
M
Fong
Allan C Y
AC
Chan
Yiong-Huak
YH
Lim
Laurence S
LS
Husain
Rahat
R
Gazzard
Gus
G
Seah
Steve K L
SK
Aung
Tin
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D010781:Photography; D011446:Prospective Studies