Bruch's membrane opening - minimum rim width measurement after acute primary angle-closure.

Area of Science:

• Ophthalmology
• Glaucoma research
• Anatomy of the eye

Background:

• Acute primary angle-closure attack (APAC) is a medical emergency.
• Understanding the long-term structural changes post-APAC is crucial for patient management.
• Bruch's membrane opening - minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer thickness (RNFLT) are key indicators of optic nerve health.

Purpose of the Study:

• To evaluate the impact of APAC on BMO-MRW and RNFLT.
• To compare structural measurements between affected and unaffected eyes post-APAC.
• To investigate the correlation between intraocular pressure (IOP) and these structural parameters.

Main Methods:

• A cohort of nine patients with unilateral APAC was studied.
• BMO-MRW and RNFLT were measured using spectral-domain optical coherence tomography (SDOCT) three months after the APAC.
• Affected eyes were compared to contralateral, unaffected eyes.

Main Results:

• APAC eyes exhibited significantly reduced BMO-MRW (281.22 ± 56.88 μm) and RNFLT (78 ± 15.36 μm) compared to contralateral eyes (313.78 ± 43.48 μm and 95.78 ± 10.81 μm, respectively).
• A strong positive correlation was observed between RNFLT and BMO-MRW measurements (R = 0.7436, P = 0.013).
• Higher presenting IOP showed a strong negative correlation with both BMO-MRW (R = -0.7669, P = 0.009) and RNFLT (R = -0.7723, P = 0.008).

Conclusions:

• BMO-MRW and RNFLT are significantly diminished three months after an APAC.
• The severity of IOP elevation during the APAC may contribute to the reduction in BMO-MRW and RNFLT.
• These findings highlight potential structural damage following APAC that warrants further investigation.