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W. Andreatta, M. Nessim, P. Shah; Long-Term Outcome After Acute Primary Angle Closure. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2758.
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To identify the long-term visual outcome of eyes who suffered an acute attack of primary angle closure, and to determine the causes of poor vision.
Retrospective case-series of 134 consecutive eyes who presented with acute primary angle closure (APAC) to a supra-regional tertiary referral unit in the United Kingdom over a period of 60 months. We looked at the best-corrected visual acuity (BCVA) in the affected eye at presentation, 6 months after the acute event and at the final follow up. Causes of poor vision were recorded as well as socio-demographic variables and surgical interventions.
134 eyes of 123 subjects were assessed, 97 (72.4%) were females and 37 (27.6%) males. The majority were Caucasians (77.6%), followed by Asians (14.2%), African-Caribbeans (2.2%) and other ethnicities (6%). The mean age was 67.3 ± 11.9 years. 52 eyes (38.8%) had cataract surgery, 21 (15.7%) required filtration surgery, and 5 (3.7%) had cyclodiode laser. A poor BCVA of ≤ 6/18 was recorded in 101 (75.4%) eyes at presentation, in 33 (24.6%) eyes at the six months appointment and in 34 (25.4%) eyes at the final follow up. At presentation only 18 (13.4%) eyes had a good BCVA of ≥6/12 compared to 85 (63.4%) eyes at the six month follow up and 90 (67.2%) eyes at the final follow up. The mean final follow up period was 2.6 ± 1.5 years. Reasons for poor vision at the final follow up were cataract in 10 (29.4%) eyes, glaucomatous optic neuropathy in 8 (23.5%), age-related macular degeneration in 3 (8.8%), amblyopia in 3 (8.8%) and other pathologies in the remaining 10 (29.4%) eyes.
More than two third of the eyes treated for APAC regained good central vision. Poor long-term visual acuity was mainly due to non-operated cataract and glaucomatous optic neuropathy. Individuals who suffered an APAC attack would benefit from cataract surgery and regular follow ups to monitor glaucoma progression.
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