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Rafael Merula, Sebastiao Cronemberger, Erica A de Abreu Borges; Long-term outcomes for retinal nerve fiber layer after acute primary angle closure in Brazilians and risk factors for the severity of the retinal reduction . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4570.
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This study was performed to assess the long-term changes in peripapillary RNFL thickness and identify possible risk factors for the severity of this loss in Brazilians.
<br /> This will be a cross-sectional comparative study. Subjects with APAC attended at the Glaucoma Service of São Geraldo Hospital were invited to attend a clinic examination, which included an ophthalmic examination, RNFL imaging using spectral-domain optical coherence tomography (SD-OCT), ultrasound biometric assessment, and automated perimetry by means of Interzeag Octopus 1-2-3 (Haag-Streit AG, Koeniz, Switzerland). APAC eyes were compared with non affected fellow eyes.<br />
The 9 patients included had the APAC acute crisis more than a year ago, varying from 1 to 23 years (7.2±6.9 years). Mean age of 67.9 (±8.7) years, 67% women, 77.8% leukodermic, 100% bilateral iridectomy, average time between the beginning of the symptoms and the lowering of IOP of 58,8 (±105.5) hours. In affected APAC eyes, IOP at the moment of the crisis was 49.7 (±8.3) mmHg, CCT was 538 (±26.3) µm, axial length was 21.79 (±0.79) mm, MD was 12.2 (±8.9), CLV was 24.4 (±21.8), RNFL thickness was 74.5 (±43.1) µm, superior temporal (ST) RNFL thickness was 77.7 (±35.4) µm, temporal (T) RNFL thickness was 51.0 (±9.2) µm, inferior temporal (IT) RNFL thickness was 85.9 (±39.8) µm, superior nasal (SN) RNFL thickness was 74.3 (±38.0) µm, nasal (N) RNFL thickness was 57.5 (±19.6) µm, inferior nasal (IN) RNFL thickness was 67.4 (±32.5) µm. In fellow non affected APAC eyes, IOP at the moment of the crisis was 12.4 (±0.5) mmHg, CCT was 537 (±19.3) µm, axial length was 21.56 (±0.32) mm, MD was 3.15 (±2.9), CLV was 18.6 (±18.9), RNFL thickness was 102.0 (±3.6) µm, ST RNFL thickness was 132.7 (±21.8) µm, T RNFL thickness was 69.7 (±12.7) µm, IT RNFL thickness was 141.0 (±17.1) µm, SN RNFL thickness was 108.5 (±12.6) µm, N RNFL thickness was 76.3 (±20.1) µm, IN RNFL thickness was 121.5 (±44.6) µm.<br />
We know that our results are limited because of the small number of cases, however we intend to improve it with more patients. Apart from that, it was possible to notice that affected APAC eyes have important structural (RNFL loss) and function (visual field defects) damages many years after the crisis.<br />
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