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D.S. Friedman, P.T. K. Chew, G. Gazzard, H.A. Quigley, T. Aung; Long–Term Outcomes in Fellow Eyes After Acute Primary Angle Closure in the Contralateral Eye . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2348.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the natural history of the contralateral eye of persons suffering an acute attack of primary angle closure (APAC).
Ninety individuals with APAC attacks were examined 4 to 10 years after the episode, seventy–nine of whom had a uniocular attack. All subjects underwent a complete eye examination, including visual acuity, visual field testing, dilated eye examination, and optic nerve head photography. All visual fields and optic nerve photographs (when available) were evaluated by a masked, glaucoma specialist, who assessed whether the changes were compatible with glaucoma.
Subjects were predominantly Chinese (68 subjects [86%]). There were 54 females (68%), mean age was 68.5 +/– 8.9 years (SD), with a mean duration of 6.3 +/– 1.5 years from the time of the APAC episode to the study examination. The contralateral eyes of 7 subjects (8.9%) had definite or probable glaucoma, three of whom were felt to have glaucoma in that eye at the time of the attack. Three eyes had markedly cupped optic discs (cup–to–disc ratio 0.9). Thirteen eyes (16.9%) had best–corrected vision worse than 6/12, due to cataract in almost half the cases. Mean IOP of the study subjects was 15.7 + 4.7 mm Hg with 6 subjects (7.6%) having undergone trabeculectomy.
The contralateral eye was at low risk for developing glaucoma over follow up. Definite or probable glaucoma was present at the time of diagnosis in 3 (3.8%) fellow eyes and developed in an additional four (5.1%) with a mean follow–up of 6 years. Over 80% of this cohort retained good vision in the contralateral eye, in contrast to APAC affected eyes. Unoperated cataract accounted for the majority of the visual impairment in this group.
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