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J. M. Aduan, K. Onn, S. Loon, P. Chew; Retrospective Study of Nerve Fiber Layer Parameters in Primary Angle Closure Glaucoma Patients in the National University Hospital Singapore. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2745.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the objective structure changes of the retinal nerve fiber layer (RNFL) in primary angle closure glaucoma (PACG) and to evaluate the quantitative assessment of RNFL thickness with optical coherence tomography (OCT).
Case notes of 59 patients who had unilateral PACG were reviewed of their Stratus OCT results. For all cases, PACG had resolved after treatment. OCT results taken 3 months after attack, and 6 months after remission with the RNFL assessed in both eyes. The OCT parameters were compared among normal controls, the unaffected fellow eyes, and the attacked eyes.
RNFL of the PACG eyes initially became thicker (average: 148.7+/-21.0 micron) within 3 months and thinner (average: 81.7+/-18.7 micron) at 6 months after acute strike compared with the fellow unaffected and normal eyes. Upon comparing the average and 4-quadrant RNFL thicknesses for the attacked eyes with those of the normal controls (P<0.001 to 0.001) and fellow eyes (P<0.001 to 0.002) using 1-way analysis both with at 3 months and 6 months after remission significant differences were demonstrated. Significant difference in the RNFL thickness among the 2 time points after intraocular pressure controlled in the acute strike group (P<0.001).
Using OCT, RNFL thickness was found to increase in eyes after an episode of PACG followed by a decrease in RNFL thickness over time (up to 6 mo). The pathologic retinal changes detected of patients involved in PACG can aid in better understanding and help in the assessment and management of these patients.
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