Long-term outcomes after acute primary angle closure of Caucasian chronic angle closure glaucoma patients.

IMPORTANCE

There is a lack of information about long-term results of chronic angle closure glaucoma following an acute primary angle closure attack in Caucasian patients.

PURPOSE

The aim of the study was to report morphological and functional long-term data of chronic angle closure eyes following a monolateral primary angle closure attack and to provide a comparison with their fellow eyes.

DESIGN

Observational retrospective case series.

PARTICIPANTS

Fifty-seven consecutive patients (114 eyes) underwent long-term follow-up analysis.

METHODS

Patients underwent ophthalmic assessment more than 5 years since the angle closure attack.

MAIN OUTCOME MEASURES

Intraocular pressure, best-corrected visual acuity, angle assessment, vertical C/D ratio and standard automated perimetry were the main outcome measures. Comparisons were made between angle closure attack eyes and fellow eyes and between phakic and pseudophakic eyes.

RESULTS

Mean follow-up time was 5.86 ± 1.19 years. A significant greater damage in the angle closure eyes compared with fellow eyes in both structural (mean C/D 0.61 ± 0.16; P < 0.001) and functional (mean deviation: -7.98 ± 6.46 vs. -4.83 ± 4.95 dB; P < 0.001) terms was present. Mean IOP was 13.44 ± 2.78 and 13.89 ± 2.60 mmHg in angle closure and fellow eyes (P = 0.11). Thirty of 57 (53%) fellow eyes developed chronic angle closure (mean deviation: -7.74 ± 5.21 dB) even if prophylactic iridotomy was promptly performed.

CONCLUSION AND RELEVANCE

Our study prompts ophthalmologists to closely follow patients after an APAC attack to prevent potential glaucoma damage in both APAC and fellow eye.