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L. S. Lim, F. Rensch, T. Aung, K. Y. C. Lee, R. Husain, G. Gazzard, S. K. L. Seah, J. B. Jonas; Peripapillary Atrophy After Acute Primary Angle-Closure. Invest. Ophthalmol. Vis. Sci. 2007;48(13):871.
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To determine the changes in peripapillary atrophy in eyes after acute primary angle-closure (APAC).
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.
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.
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.
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