Abstract
Purpose :
One episode of acute primary angle-closure might cause irreversible ocular damage. In this prospective study we investigate the relationship between changes in retinal nerve fiber layer (RNFL) thickness and visual field defects after unilateral acute primary angle closure (APAC) in Brazilians.
Methods :
Patients with unilateral APAC were eligible. The exclusion criteria were: (1) previous APAC in the affected or fellow eye; (2) co-existing ocular pathologies; (3) secondary angle closure; (4) previous intraocular surgery; (5) impossibility to follow-up. Patients were submitted to an ophthalmic examination, RNFL imaging using spectral-domain optical coherence tomography (SD-OCT), ultrasound biometric assessment, central corneal thickness and automated perimetry by means of Interzeag Octopus 1-2-3 (Haag-Streit AG, Koeniz, Switzerland). APAC eyes were compared with the fellow eyes as controls. Patients were followed up at 1 and 12 months after the APAC episode. For statistical analysis, we used the Spearman correlation coefficient. All analyses were conducted at 0.05 significance level (P<0.05).
Results :
Fifty-two subjects were assessed, but thirty-two were excluded. The mean age was 62.8±3.5 years. Fifteen patients (75%) were women and five patients (25%) were men. The RNFL thinning was significantly detected in the affected eye in comparison with fellow eye, at 12 months after APAC, in peripapillary RNFL sectors (global, superotemporal, temporal, inferotemporal, nasal) and macular sectors (inner superior, inner inferior, inner nasal, outer nasal and inner temporal). Visual field showed a mean defect with a statistically significant correlation with the global RNFL thinning at 1 month (rho=-0.603; P=0.0073) and 12 months (rho=-0.582; P=0.0082).
Conclusions :
One single APAC episode causes RNFL thickness thinning which is statistically correlated with visual field defect. The visual field defects depend on the severity of RNFL damage.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.