Acute primary angle closure attack does not cause an increased cup-to-disc ratio.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Retinal Imaging Analysis

Background:

• Acute primary angle closure (APAC) is a critical ophthalmic emergency.
• Understanding the long-term structural changes post-APAC is crucial for patient management.

Purpose of the Study:

• To investigate optic nerve head and retinal nerve fiber layer (RNFL) changes following acute primary angle closure (APAC).
• To determine if cup-to-disc ratio (CDR) increases or RNFL loss occurs after APAC treatment.

Main Methods:

• Prospective observational case series involving 20 participants with unilateral APAC.
• Eyes were assessed at baseline, within 2 weeks, 2-3 months, and 6-12 months post-APAC.
• Evaluations included Heidelberg Retinal Tomography, OCT of RNFL and macula, and automated perimetry.

Main Results:

• No significant change in cup-to-disc ratio (CDR) or optic nerve head parameters was observed over 12 months.
• A significant decrease in mean overall RNFL thickness was detected between 2 weeks and 2-3 months post-APAC (P<0.01).
• Both superior and inferior RNFL quadrants showed significant thinning; macular thickness and volume remained unchanged.

Conclusions:

• Promptly treated APAC does not lead to an increased cup-to-disc ratio (CDR).
• Retinal nerve fiber layer (RNFL) loss is a significant finding after APAC, even with timely treatment.
• These findings highlight the importance of monitoring RNFL integrity post-APAC.