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Br J OphthalmolAugust 202016 citations

Factors associated with blindness three months following treatment for acute primary angle glaucoma.

Li Shuning, Tang Guangxian, Fan Su Jie, Zhai Gang, Lv Jianhua, Zhang Hengli, Lu Wensheng, Jiang Jing, Lv Aiguo, Wang Ningli


AI Summary

This study found that education, treatment delay, and initial eye pressure are key risk factors for blindness after acute angle closure glaucoma, highlighting the critical importance of timely intervention within 4.6 hours.

Abstract

Aims

To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.

Methods

In this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of ≤1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point.

Results

The rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of ≤1% was 4.6 hours.

Conclusions and relevance: Education level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC.


MeSH Terms

Acute DiseaseAgedBlindnessChinaFemaleFollow-Up StudiesGlaucoma, Angle-ClosureHumansIncidenceIntraocular PressureIridectomyMalePostoperative ComplicationsRetrospective StudiesTime FactorsVisual Acuity

Key Concepts3

In a multicentre retrospective case series of 1030 consecutive subjects (1164 eyes) with acute primary angle closure (APAC) in China, the rate of blindness after treatment was 12.54% at 3 months.

PrognosisCase seriesMulticentre Retrospective Case Seriesn=1030 subjects (1164 eyes)Ch10Ch13

In a multicentre retrospective case series of 1030 consecutive subjects (1164 eyes) with acute primary angle closure (APAC) in China, multivariate regression identified education level (p=0.022), time from symptom to treatment (TST, p=0.004), and presenting intraocular pressure (IOP, p=0.001) as risk factors for blindness after APAC.

PrognosisCase seriesMulticentre Retrospective Case Seriesn=1030 subjects (1164 eyes)Ch10Ch13Ch28

In a multicentre retrospective case series of 1030 consecutive subjects (1164 eyes) with acute primary angle closure (APAC) in China, the critical time window associated with a blindness rate of ≤1% was calculated to be 4.6 hours based on a cubic function fitting time from symptom to treatment (TST) to the rate of blindness.

PrognosisCase seriesMulticentre Retrospective Case Seriesn=1030 subjects (1164 eyes)Ch13Ch28

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