Peripapillary Atrophy After Acute Primary Angle-Closure

Abstract

Purpose:: To determine the changes in peripapillary atrophy in eyes after acute primary angle-closure (APAC).

Methods:: This was a prospective observational clinical study. The study included 40 eyes of 38 patients of predominantly Chinese ethnicity. The intraocular pressure at the time of presentation was 51.7 ± 12 mm Hg (median: 55 mm Hg; range: 30 -74 mm Hg), and the mean duration of the symptoms was 37.7 ± 69.4 hours (range 1 to 336 hours). A laser iridotomy was performed 3.2 ± 8.4 days (median: 1 day, range: 0 - 48 days) after the APAC episode leading to a normalization of the intraocular pressure. Color optic disc photographs taken at 2 weeks and at 16 weeks after the attack were morphometrically examined. Peripapillary atrophy was divided into alpha zone and beta zone.

Results:: Comparing the baseline measurements with the measurements performed 16 weeks after the APAC episode, the minimal width of alpha zone (0.013±0.056 arbitrary units versus 0.016±0.001 arbitrary units; p=0.23), the maximal width of alpha zone (1.11±1.31 arbitrary units versus 1.31±0.79 arbitrary units; p=0.02), the minimal width of beta zone (0.030±0.122 arbitrary units versus 0.033±0.166 arbitrary units; p=0.93), and maximal width of beta zone (0.62±0.94 versus 0.73±0.98 arbitrary units; p=0.42) did not vary significantly. The optic cup was significantly (P<0.0001) enlarged at the end of follow-up.

Conclusions:: Alpha zone and beta zone of peripapillary atrophy did not markedly enlarge in patients after APAC with a short term and marked elevation of intraocular pressure, despite an enlargement of the optic cup over 4 months of follow-up.

Keywords: optic disc • intraocular pressure • clinical (human) or epidemiologic studies: natural history