The following is a summary of “Long-term outcomes after acute primary angle closure: case series from Moorfields Eye Hospital, UK,” published in the May 2024 issue of Ophthalmology by Hamid et al.
A lack of evidence is seen regarding the progression and morbidity of primary angle closure glaucoma with the association of acute primary angle closure (APAC).
Researchers conducted a retrospective study reporting on vision and eye pressure outcomes after APAC, identifying necessary treatments and risk factors associated with worse outcomes.
They included 117 patients with 121 eyes and APAC, attending Moorfields Eye Hospital in the UK. The patients were tracked to understand vision and eye pressure outcomes, required treatment, and potential associated risks.
The results showed that most patients (73%) had visual acuities of ≥6/12 at the final follow-up, which was suitable for UK driving. Only 15% (17 eyes) had WHO-defined severe visual impairment, with 6.6% (eight eyes) due to glaucoma. Delayed presentation increased the need for further treatment (OR=2.83, 95% CI, 1.09 to 7.40, P=0.03). Patients undergoing phacoemulsification had a reduced risk of blindness (OR 0.18, 95%CI 0.05 to 0.69, P=0.01), elevated Intraocular pressure (IOP) (OR 0.010, 95% CI 0.01 to 0.75, P=0.02), and additional treatment (OR 0.34, 95% CI 0.12 to 0.99, P=0.04). Older age worsened visual outcomes (OR 1.26, 95% CI 1.08 to 1.48, P<0.01).
Investigators concluded that APAC led to low long-term visual and treatment morbidity in patients with Caucasians. Phacoemulsification can improve vision and reduce the need for additional IOP-lowering treatments.
Source: bjo.bmj.com/content/early/2024/05/13/bjo-2023-324748
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