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Long-term outcomes in asians after acute primary angle closure
Tin Aung1, David S Friedman, Paul T K Chew
1Glaucoma Department, Singapore National Eye Center, and National University of Singapore. tin11@pacific.net.sg
Ophthalmology
|August 4, 2004
Summary
Long-term follow-up of Asian eyes after acute primary angle closure (APAC) revealed significant vision loss. Nearly half of patients developed glaucomatous optic nerve damage, emphasizing the need for regular monitoring.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Asian Eye Health
Background:
- Acute primary angle closure (APAC) is a medical emergency.
- Long-term outcomes and risk factors for glaucomatous optic nerve damage following APAC in Asian populations are not well-defined.
Purpose of the Study:
- To assess the long-term visual outcomes in Asian individuals following an acute attack of primary angle closure (APAC).
- To identify presenting risk factors associated with the development of glaucomatous optic nerve damage (GON) after APAC.
Main Methods:
- A cross-sectional observational study involved 90 Asian individuals previously treated for APAC.
- Comprehensive eye examinations included visual acuity, visual field testing, and optic nerve head assessment.
- Glaucomatous optic neuropathy was evaluated clinically and photographically by a masked glaucoma specialist.
Main Results:
- After 4-10 years, 17.8% of subjects were blind in the affected eye, with glaucoma causing half of these cases.
- 47.8% of subjects exhibited glaucomatous optic neuropathy (GON), and 15.5% had markedly cupped optic discs.
- Cataracts contributed significantly to reduced vision (worse than 6/9) in 58% of eyes; no specific APAC risk factors for GON were identified.
Conclusions:
- A significant proportion of Asian individuals experience blindness and develop glaucomatous optic nerve damage years after an APAC episode.
- Reduced vision, often due to unoperated cataracts, is common.
- Regular ophthalmological follow-up is crucial for monitoring visual field changes and detecting glaucoma progression after APAC.