Outcomes following acute primary angle closure in an Asian population.
BACKGROUND
Data regarding development of primary angle closure glaucoma (PACG) following acute primary angle closure (APAC) is conflicting. This study looks at outcomes after an APAC episode with a secondary aim to identify any risk factors that could predict progression to PACG.


METHODS
This is a retrospective review of the charts of consecutive patients who were diagnosed with APAC from December 2003 to June 2006. All were treated in a standard manner with initial intensive medical therapy or laser iridoplasty followed by early laser peripheral iridotomy within 24 h of presentation.


RESULTS
Forty-two eyes of 41 patients were analysed. The mean follow-up period was 27.3 +/- 16.2 months. Nine eyes (21.4%) developed an increase in intraocular pressure (IOP) within a mean of 11.9 months (median 5 months) after resolution of APAC. Eight eyes went on to have trabeculectomy or glaucoma drainage device. At final follow up, the mean IOP of attack eye was 13.3 +/- 2.92 mmHg. None of the eyes, including those that underwent surgery, required topical medication to control IOP. Thirty-eight eyes (90.5%) have BCVA of 6/6 to 6/12. The duration of symptoms before presentation (P = 0.00) and duration taken to abort the acute attack (P = 0.01) were found to be significantly associated with development of PACG.


CONCLUSIONS
The results of this study suggest that outcomes following successful treatment of APAC may not be as poor as described previously. Early aggressive management of the acute episode may have a role to play in preventing development of PACG after APAC.
Tan
Anna M
AM
Department of Ophthalmology, National University Health System, Singapore. amwttan@yahoo.com
Loon
Seng C
SC
Chew
Paul T K
PT
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044466:Asian People / Q000208:ethnology*; D002387:Cataract Extraction; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000208:ethnology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D032801:Iridectomy / Q000379:methods; D007498:Iris / Q000601:surgery; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology*
D000959:Antihypertensive Agents