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A prospective longterm study of primary chronic angle closure glaucoma.
Ramanjit Sihota1, Aman Sood, Viney Gupta
1Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. rjsihota@hotmail.com
Acta Ophthalmologica Scandinavica
|March 27, 2004
Summary
This study shows that medical and surgical treatments effectively control intraocular pressure (IOP) and stabilize visual fields in chronic primary angle closure glaucoma (PACG) patients over six years, with 90% achieving good long-term outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Clinical Trials
Background:
- Chronic primary angle closure glaucoma (PACG) poses a significant challenge for long-term management.
- Effective control of intraocular pressure (IOP) is crucial to prevent further visual field deterioration.
Purpose of the Study:
- To prospectively evaluate the long-term outcomes of chronic PACG therapy.
- To assess the efficacy of medical and surgical interventions for IOP and visual field stabilization.
Main Methods:
- A 6-year prospective study of 70 chronic PACG patients with IOP > 21 mmHg despite iridotomy.
- Patients received medical therapy or trabeculectomy without antimetabolites.
- Key metrics included best-corrected visual acuity, IOP, cup:disc ratio, and visual fields.
Main Results:
- 65% of eyes achieved IOP control medically; 35% required surgery.
- Mean IOP significantly decreased from 25.4 mmHg at baseline to 15.6 mmHg at 6 years (p < 0.001).
- Visual field progression occurred in 10% of eyes, associated with larger baseline cup:disc ratios and higher IOP levels.
Conclusions:
- Medical and surgical therapies provide good long-term IOP control and visual field stability in 90% of chronic PACG patients over 6 years.
- Early identification of risk factors like larger cup:disc ratios may help predict progression.