Attack Of Primary Angle-closure Glaucoma Research Articles

The surge of acute angle-closure glaucoma during the outbreak of Omicron in a tertiary hospital in Shanghai.

Since December 2022, China has eliminated the compulsory nucleic acid screening, which led to a new pandemic of Omicron. We observed a surge of primary angle-closure glaucoma (PACG) at a largest tertiary hospital in Shanghai. We evaluated the potential relationship between the infection of Omicron and the occurrence of PACG. In this retrospective cross-sectional study, we identified 41 patients diagnosed with PACG from 523 individuals registered in ophthalmic emergency from December 2022 to January 2023. We compared the proportion of PACG patients in all the patients registered at the ophthalmic emergency department in the corresponding period (December and January) from 2018 to 2023. The proportion of PACG patients rose to 6.74% and 9.13%, nearly a five-fold increase compared to the previous 1.90%. The proportion of PACG patients throughout 2022 also increased in the recent 2 months. All PACG patients in our center from Dec. 21st 2022 to Jan. 27th 2023 had positive nucleic acid tests at their initial visits. The peak of glaucoma came around Dec. 27th 2022, while the peak of the internal medicine emergency came around Jan. 5th 2023. The behavior pattern of the infected people and anxiety mood would induce the PACG attack. Some ophthalmic advice should be added to the Chinese treatment guidelines for COVID-19. Also, a shallow anterior chamber and narrow angle need to be ruled out when necessary. Further studies on larger populations are needed to explore the relationship between PACG and Covid.

Технические трудности выполнения миниинвазивной хирургии катаракты при утолщенном хрусталике в глазах с короткой переднезадней осью

Purpose. To study the technical features of cataract phacoemulsification in in eye with short axial length. Material and methods. 18 eyes with an increased risk of primary angle-closure glaucoma (PACG) (18 patients, age: 46–80 years). In 14 eyes – clear lens; 4 eyes – initial cataract. Phacoemulsification for prophylaxis of development of PACG is carried out. Features of surgical technique and complication are revealed. The term of observation was 12–36 months. Results. Improvement of anatomic parameters of eye globe and visual functions is reached; PACG did not develop at anybody in remote period of observation. Conclusion. High performance and safety phacoemulsification of transparent crystalline lens for prophylaxis of risk of development of an acute attack of PACG in eyes with the short axial lengths is proved. Keywords: hyperopia, angle-closure glaucoma, phacoemulsification, complications.

Eye massage combined with laser treatment for acute attack of primary angle-closure glaucoma

Objective To observe the efficacy of eye massage combined with laser treatment for the acute attack of primary angle-closure glaucoma. Methods The data of 102 eyes of 102 patients with acute attack of primary angle-closure glaucoma from Aug. 2016 to May 2018 were analyzed retrospectively. Eye massage was performed on the basis of systemic and topical medication to reduce intraocular pressure.All cases received the combined surgery of multi-wavelength laser peripheral iridoplasty and YAG laser iridotomy. Results After treatment, the intraocular pressure decreased in 100 patients, with average (28.59±6.84) mmHg(1 mmHg=0.133 kPa). No serious complication occurred. Two cases of ineffective underwent traditional trabeculectomy. Conclusion Eye massage combined with laser treatment for the treatment of primary angle-closure glaucoma on the basis of drug treatment in acute attack is effective. Key words: Eye massage; Laser; Glaucoma, angle-closure, primary

The Seasonality of Acute Attack of Primary Angle-Closure Glaucoma in Beijing, China

In this study, the seasonality of acute attack of primary angle-closure glaucoma (PACG) was analysed. This retrospective case series included 283 patients (200 women, 83 men; mean age, 68.2 ± 10.3 years; range, 37–96 years) with acute attack of PACG from a university-based clinic over 4 years. Patients’ age and sex, and the date and season of onset of PACG attack, were analysed. Descriptive analysis and von Mises distribution were used for statistical analysis. The highest incidence of acute attack of PACG was observed in those aged 60–69 years (34.6%). Descriptive analysis showed that the incidence was greater in June and July for men, November for women, and November for the entire sample. An angular plot (using von Mises distribution) of the individual dates of onset revealed the estimated peak onset on September 11, November 8, and October 28 for men, women, and both, respectively. Integration of the results from the two analyses revealed the incidence to be higher in the summer and winter for men, and in the winter for women and for the entire sample. More females than males were affected. Monthly and seasonal variations in onset were observed, which might be related to weather changes.

Decision-making Impairments in Primary Angle-closure Glaucoma Patients.

Background:Primary angle-closure glaucoma (PACG) is a common eye disease and a common cause of blindness. Inappropriate medical decisions severely affect the prognosis. This study investigated decision-making under risk in PACG patients.Methods:Thirty patients with first acute attack of PACG before surgery and thirty healthy controls were included in the study. Decision-making under risk was evaluated with the game of dice task (GDT). The results of Eysenck Personality Questionnaire (EPQ) and GDT between PACG patients and healthy controls were compared.Results:Risky decisions in PACG patients were more than those in healthy controls as measured by mean score of GDT (12.47 ± 5.72 vs. 4.33 ± 3.30, P < 0.001). Higher neuroticism score in EPQ was found in PACG patients compared to healthy controls (14.97 ± 3.93 vs. 9.90 ± 4.49, P < 0.001). Neuroticism scores in EPQ were associated with decision-making performance (r = 0.417, P = 0.001).Conclusions:Neuroticism positively correlated with risky decisions. Decision-making might be influenced by neuroticism. Future studies will show whether therapy compliance will be improved by emotional management and psychological intervention in PACG patients.

The clinic characteristics of ocular hypertension in the unoperated opposite eye after vitrectomy

Objective To observe the clinic characteristics of ocular hypertension in the unoperated opposite eye after vitrectomy. Methods The clinical data of 5 cases with ocular hypertension in the unoperated opposite eye after vitrectomy were analyzed retrospectively. Ultrasonic biomicroscopy, axial lengths, intraocular pressure and diopter were observed. Results The causes of 5 patients were intraocular foreign body, vitreous haemorrhage, retinal detachment, and idiopathic macular hole (IMH). Three patients received 16% C3F8 intravitreal tamponade and two patients received silicone oil tamponade. All five patients kept the prone position for more than a week after the operation, and then, the intraocular pressure of unoperated opposite eye of four patients was from 48 to 55 mmHg and they had short axial lengths and hypermetropia. Some of these 4 patients had ciliochoroidal detachment which was considered as the acute attack of primary angle-closure glaucoma. The intraocular pressure of the unoperated opposite eye of one patient was 25 mmHg, and this patient also had ciliochoroidal detachment which was considered as temporary increase of intraocular pressure. Conclusion The patient with high risk factors of primary angle-closure glaucoma might have the risk of an acute attack of primary angle-closure glaucoma in the unoperated opposite eye when keeping prone position for long time after vitrectomy. Key words: Vitrectomy; Ocular hypertension; Unoperated opposite eye; Position, prone

Reproducibility and tolerability of iCare rebound tonometer and its agreement evaluation with Goldmann applanation tonometry

Background Laser peripheral iridotomy(LPI) is used as the primary therapy for the eyes at risk of angle closure.But there are still 28% eyes with primary angle closure suspect occur angle closure within 2 years after LPI.It is necessary to explore the associated factors of the efficacy of LPI.Objective The aim of this study was to explore the changes of intraocular pressure(IOP) and anterior chamber angle in the fellow eyes of patients with unilateral acute attack of primary angle closure glaucoma (PACG) and analyze the relevant factors influencing the successful rate of LPI.Methods Eighty-seven fellow eyes received LPI from 87 patients with unilateral acute attack of PACG were included in this study and retrospectively analyzed.The IOP and gonioscopy were performed before and 1 week,3,6,9,12 months after LPI.Successful signs of LPI were defined as an IOP 6-21mmHg without any anti-glaucoma medication,none of glaucomatous neuropathy and the coincident visual field loss,and no need of additional glaucomatous medication or surgery.This study was approved by Ethic Committee of the First Hospital of Xinxiang Medical College,and written informed consent was obtained from each patient.Results Seventy-nine eyes of 79 cases finished the medical visit throughout the follow-up duration with the age 61.4±0.4 years and 33(41.8%) males and 46(58.2%) females.The mean IOP was lowed in various time points after LPI in comparison with before operation with the general difference among different time visiting groups(F=4.056,P＜0.01).Shaffer grade was increased in superior,temporal and nasal quadrants and significant differences were found between 1 week group,3 months group or 6 months group and before operation group (P＜0.05).LPI lessened the range of appositional angle closure (AAC) in postoperative 1 week group and 3 months group compared with pre-operative group (P＜0.05),but no statistically significant reduce was seen in range of AAC from 6 months through 12 months after LPI in comparison with pre-operation (P＞0.05).LPI was determined as successful in 61 cases (77.2%) during one-year fellow-up period.Several variables,such as preoperative IOP,Shaffer grade of each quadrant,mean Shaffer grade and the extent of AAC,were significantly different between LPI success and failure group(P＜0.01).Cox stepwise regression analysis found that the success rate was significantly associated with the extent of AAC (Wald=48.150,RR=1.963,P＜0.01) rather than pre-IOP,Shaffer grade of each quadrant,mean Shaffer grade,age and gender (P＞0.05).Conclusion LPI can widen the anterior chamber angle and low IOP in the fellow eyes of PACG attack eyes.The success rate of LPI is associated with the extent of pre-AAC,suggesting that it is necessary for LPI in consideration of the extent of pre-AAC. Key words: Primary angle closure glaucoma/fellow eye; Laser peripheral iridotomy; Intraocular pressure; Anterior chamber angle; Appositional angle closure

Immediate argon laser peripheral iridoplasty as treatment for acute attack of primary angle-closure glaucoma: a preliminary study

This study aimed to examine the intraocular pressure (IOP)-lowering effects and safety of immediate argon laser peripheral iridoplasty (ALPI) as a first-line treatment for acute primary angle-closure glaucoma (PACG). A prospective cohort study. Ten consecutive patients with their first attack of PACG, with IOP of 40 mmHg or greater, were recruited into the study. On presentation, each patient received topical pilocarpine (4%) and timolol (0.5%) and immediate ALPI as primary treatment. The IOPs at 15, 30, and 60 minutes after ALPI were documented by applanation tonometry. When the corneal edema had settled, laser peripheral iridotomy was performed as a definitive treatment. The IOP, corneal edema, and complications from ALPI were measured. The mean IOP of this group of patients was reduced from 59.5+/-10.4 mmHg to 28.7+/-14.9 mmHg at 15 minutes, 21.7+/-13.1 mmHg at 30 minutes, and 16.0+/-9.4 mmHg at 60 minutes after ALPI. No complications from the laser procedure were encountered during the study period. In nine of the ten patients, the corneal edema cleared up 1 hour after ALPI. In the remaining patient, the cornea cleared up 2 hours after ALPI. From this preliminary study, immediate ALPI, without adjunctive systemic antiglaucoma treatment, appeared to be very effective in controlling the IOP and returning corneal clarity in acute PACG. Its safety also appeared reassuring and did not have the risks associated with conventional systemic therapies.

The treatment of acute attack of primary angle-closure glaucoma by pilocarpine ocusert system.

The treatment of acute attack of primary angle-closure glaucoma by pilocarpine ocusert system.