Comparison of Glaucomatous Optic Nerve Damage in Primary Angle-Closure Glaucoma with and without Acute Attack

Abstract

Purpose:To compare the glaucomatous optic nerve damage in primary angle-closure glaucoma (PACG) with acute attack (acute PACG; AACG) and PACG without acute attack (chronic PACG; CACG). Methods: The study subjects were 84 normal individuals, 130 AACG patients, and 86 CACG patients. Color optic disc photographs were evaluated for the presence or absence of 10 qualitative signs to differentiate between normal and glaucomatous optic discs. Results: Abnormally shaped rim width (alteration of ISN'T rule), bared circumlinear vessel, vessel bayonetting, rim width narrower than the temporal sector, and zone beta (nasal and superotemporal sectors) were detected more frequently in the CACG group than in the AACG group (P<0.05). The most accurate qualitative sign was abnormally shaped rim width in both groups. The specificity and sensitivity of abnormally shaped rim width were 71.4% and 60.8% for AACG, and 71.4% and 81.4% for CACG, respectively. Conclusions:The optic disc damage is greater in CACG than in AACG.

Changes in retinal nerve fibre layer, optic nerve head morphology, and visual field after acute primary angle closure

“…19 In contrast, a longer duration of raised IOP during APAC may result in the formation of peripheral anterior synechiae, subsequent IOP elevation despite a patent peripheral iridotomy, and optic disc cupping. 1,2,6,9 Our finding that peripapillary RNFL loss following APAC was associated with pale discs and visual field loss has not been previously reported. Previous studies have shown that an episode of APAC is associated with RNFL loss, detectable by both scanning laser polarimetry and OCT, [3][4][5] but the functional consequence of this is unclear.…”

“…Many studies report a poor long-term visual outcome after APAC, with high rates of blindness and glaucomatous optic neuropathy. 1,2 Retinal nerve fibre layer (RNFL) loss, [3][4][5] optic nerve head (ONH) damage, 6,7 and visual field defects [8][9][10] have been described following APAC. However, the severity of these sequelae is not well established, and little is known about the correlation between them.…”

An inducible rodent glaucoma model that exhibits gradual sustained increase in intraocular pressure with distinct inner retina and optic nerve inflammation

“…www.nature.com/scientificreports/ in gOHT. Interestingly, the extent and pattern of optic nerve head damage were different in primary angle eyes with and without angle closure attacks 91 . However, the gOHT model is not without limitations.…”

Sociodemographic factors and utilization of eye care services: is there an association with patients presenting to a tertiary referral hospital in acute angle‐closure?

“…However, given that not all patients presenting with AAC will experience premonitory symptoms and that individuals with asymptomatic angle closure are more likely to be affected by severe loss of visual function from glaucomatous optic neuropathy from severe visual impairment, the importance of routine anterior chamber angle assessment as part of the basic eye examination cannot be overstated 33–37 …”

“…31,32 However, given that not all patients presenting with AAC will experience premonitory symptoms and that individuals with asymptomatic angle closure are more likely to be affected by severe loss of visual function from glaucomatous optic neuropathy from severe visual impairment, the importance of routine anterior chamber angle assessment as part of the basic eye examination cannot be overstated. [33][34][35][36][37] A reliance on the use of self-reported responses to the study questionnaire renders the data prone to recall bias and is a potential limitation of this study. Keeffe et al 27 reported that men, those who spoke Greek or Italian, and those without private health insurance, were significantly more likely to have not used eye cares services.…”