Abstract
Irreversible damage to the optic nerve can follow the rapid increase of IOP during an Acute Primary Angle Closure (APAC). Despite the development of advanced imaging technology, there is still a lack of good longitudinal studies assessing patients after an acute attack. The aim of this study was to assess the progression of patients using different objective optic nerve head and retinal imaging parameters following APAC. Twenty patients with a single attack of APAC, were retrospectively assessed in this study. Patients were assessed with the Heidelberg Retinal Tomography (HRT3) and Scanning Laser Polarimeter (GDx-VCC) as well as Humphrey Visual Field (HVF) repeatedly up to eighteen months after the acute attack. Progression for each imaging modality was assessed with multiple parameters. All patients showed Retinal Nerve Fibre Layer (RNFL) and optic disc changes over time. At 18 months, 67% of patients showed progression in 4/5 GDx parameters, and 33% in all 5. HRT analysis similarly showed progression in 4/5 parameters in 70% of patients, and 30% in all 5. This study shows that structural progressive changes to RNFL and ONH occur following APAC confirming that APAC patients need long-term follow-up after the acute attack.
Highlights
Acute primary angle closure (APAC) is regarded as an ophthalmological emergency and if not promptly treated could lead to irreversible visual loss [1]
Despite the extensive use of Scanning laser ophthalmoscopy (HRT) and Scanning laser polarimeter (GDXVCC) for optic nerve assessment in diagnosis and follow up of primary open angle glaucoma, there is a paucity of clinical studies which have objectively assessed the progression of patients following APAC
Differences in HRT parameters after acute attack The following parameters were used in the HRT analysis in all 20 patients after APAC attack: rim area, rim volume, mean retinal nerve fibre layer (RNFL) thickness, Linear cup-disc ratio, and Glaucoma probability score
Summary
Acute primary angle closure (APAC) is regarded as an ophthalmological emergency and if not promptly treated could lead to irreversible visual loss [1]. It is characterized by a mechanical occlusion of the trabecular meshwork leading to a profound and sight threatening increase in intraocular pressure (IOP). Despite the extensive use of Scanning laser ophthalmoscopy (HRT) and Scanning laser polarimeter (GDXVCC) for optic nerve assessment in diagnosis and follow up of primary open angle glaucoma, there is a paucity of clinical studies which have objectively assessed the progression of patients following APAC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Clinical & Experimental Ophthalmology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
