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Changes in the optic disc after acute primary angle closure.

Sunny Y Shen1, Mani Baskaran, Allan C Y Fong

  • 1Singapore National Eye Centre, Singapore.

Ophthalmology
|June 6, 2006
PubMed
Summary
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Acute primary angle closure (APAC) can cause optic disc changes within 4 months. This study observed increased cup-to-disc ratio and neuroretinal rim area loss, particularly in specific sectors, after APAC treatment.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Optic Nerve Imaging

Background:

  • Acute primary angle closure (APAC) is a critical condition that can lead to optic nerve damage.
  • Understanding the early structural changes in the optic disc post-APAC is crucial for managing glaucoma risk.

Purpose of the Study:

  • To investigate optic disc morphology changes in the initial 4 months following an acute primary angle closure (APAC) episode.
  • To quantify alterations in cup-to-disc ratio (CDR) and neuroretinal rim area using advanced imaging techniques.

Main Methods:

  • A prospective observational study involving 47 Asian subjects treated for unilateral APAC with laser peripheral iridotomy (LPI).
  • Stereoscopic optic disc photography was performed at 2 and 16 weeks post-LPI.
  • Computer-assisted planimetry analyzed optic disc area, CDR, and neuroretinal rim area by masked graders.

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Main Results:

  • Between 2 and 16 weeks post-LPI, the mean CDR increased significantly (0.56 to 0.59, P<0.001).
  • A significant decrease in mean neuroretinal rim area was observed (1.74 mm² to 1.59 mm², P<0.001).
  • Preferential neuroretinal rim loss occurred in the superotemporal and inferotemporal regions; fellow eyes showed no significant changes.

Conclusions:

  • Optic disc morphology undergoes significant changes between 2 and 16 weeks after APAC.
  • The observed pattern of optic nerve damage resembles that seen in primary open-angle glaucoma and experimental models.
  • Early detection and monitoring of optic disc changes post-APAC are vital for glaucoma management.