A comparison of two approaches to managing acute primary angle closure in Asian eyes

Henrietta Ho,1 Paul T Chew,2 Chelvin Sng,1,2 Huiqi Huang,1 Tin Aung,1,2 Shamira A Perera1,21Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 2Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, SingaporePurpose: To revie...

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Autores principales: Ho H, Chew PT, Sng C, Huang H, Aung T, Perera SA
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Publicado: Dove Medical Press 2013
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Acceso en línea:https://doaj.org/article/22750343cab343689684057d5c96e84c
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spelling oai:doaj.org-article:22750343cab343689684057d5c96e84c2021-12-02T02:15:07ZA comparison of two approaches to managing acute primary angle closure in Asian eyes1177-54671177-5483https://doaj.org/article/22750343cab343689684057d5c96e84c2013-06-01T00:00:00Zhttp://www.dovepress.com/a-comparison-of-two-approaches-to-managing-acute-primary-angle-closure-a13393https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Henrietta Ho,1 Paul T Chew,2 Chelvin Sng,1,2 Huiqi Huang,1 Tin Aung,1,2 Shamira A Perera1,21Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 2Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, SingaporePurpose: To review the management regimes of acute primary angle closure (APAC) in two hospitals in Singapore, and to identify the incidence of and risk factors for progression to glaucomatous optic neuropathy.Methods: We conducted a retrospective review of 40 patients from National University Hospital (NUH) and 52 patients from Singapore National Eye Centre (SNEC) who were diagnosed with APAC. Patients were treated with similar protocols of intensive medical therapy until laser peripheral iridotomy could be performed. In the event of failed medical treatment, patients at NUH only underwent laser iridoplasty. The 1-year outcomes were reviewed.Results: The demographic features of patients and presenting intraocular pressures (IOP) were similar in both centers. More patients from NUH presented within 3 days of symptom onset, compared to those from SNEC (90.0% versus 71.2%, respectively) (P = 0.037). The mean ± standard deviation time to break the attack was 18.2 ± 32.9 hours at SNEC and 9.80 ± 10.6 hours at NUH (P = 0.11). The mean follow up duration was 18.8 ± 14.0 months. Nineteen patients (36.5%) from SNEC and six patients (22.5%) from NUH developed raised IOP (P = 0.032) within 1-year of the attack. Of these, glaucomatous optic neuropathy developed in thirteen patients (68.4%) from SNEC and all six patients (100%) from NUH. At final review, the mean IOP of the APAC eye was 14.8 ± 4.3 mmHg from SNEC and 13.4 ± 3.0 mmHg from NUH. There was no significant difference in final visual acuity or IOP between both groups.Conclusion: Treatment strategies in both centers were effective in aborting an APAC attack. The development of raised IOP appears to be associated with a longer period of attack suggesting that greater urgency in aborting APAC attacks may entail better long term outcomes.Keywords: acute primary angle closure, management, primary angle closure glaucomaHo HChew PTSng CHuang HAung TPerera SADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 1205-1210 (2013)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Ho H
Chew PT
Sng C
Huang H
Aung T
Perera SA
A comparison of two approaches to managing acute primary angle closure in Asian eyes
description Henrietta Ho,1 Paul T Chew,2 Chelvin Sng,1,2 Huiqi Huang,1 Tin Aung,1,2 Shamira A Perera1,21Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; 2Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, SingaporePurpose: To review the management regimes of acute primary angle closure (APAC) in two hospitals in Singapore, and to identify the incidence of and risk factors for progression to glaucomatous optic neuropathy.Methods: We conducted a retrospective review of 40 patients from National University Hospital (NUH) and 52 patients from Singapore National Eye Centre (SNEC) who were diagnosed with APAC. Patients were treated with similar protocols of intensive medical therapy until laser peripheral iridotomy could be performed. In the event of failed medical treatment, patients at NUH only underwent laser iridoplasty. The 1-year outcomes were reviewed.Results: The demographic features of patients and presenting intraocular pressures (IOP) were similar in both centers. More patients from NUH presented within 3 days of symptom onset, compared to those from SNEC (90.0% versus 71.2%, respectively) (P = 0.037). The mean ± standard deviation time to break the attack was 18.2 ± 32.9 hours at SNEC and 9.80 ± 10.6 hours at NUH (P = 0.11). The mean follow up duration was 18.8 ± 14.0 months. Nineteen patients (36.5%) from SNEC and six patients (22.5%) from NUH developed raised IOP (P = 0.032) within 1-year of the attack. Of these, glaucomatous optic neuropathy developed in thirteen patients (68.4%) from SNEC and all six patients (100%) from NUH. At final review, the mean IOP of the APAC eye was 14.8 ± 4.3 mmHg from SNEC and 13.4 ± 3.0 mmHg from NUH. There was no significant difference in final visual acuity or IOP between both groups.Conclusion: Treatment strategies in both centers were effective in aborting an APAC attack. The development of raised IOP appears to be associated with a longer period of attack suggesting that greater urgency in aborting APAC attacks may entail better long term outcomes.Keywords: acute primary angle closure, management, primary angle closure glaucoma
format article
author Ho H
Chew PT
Sng C
Huang H
Aung T
Perera SA
author_facet Ho H
Chew PT
Sng C
Huang H
Aung T
Perera SA
author_sort Ho H
title A comparison of two approaches to managing acute primary angle closure in Asian eyes
title_short A comparison of two approaches to managing acute primary angle closure in Asian eyes
title_full A comparison of two approaches to managing acute primary angle closure in Asian eyes
title_fullStr A comparison of two approaches to managing acute primary angle closure in Asian eyes
title_full_unstemmed A comparison of two approaches to managing acute primary angle closure in Asian eyes
title_sort comparison of two approaches to managing acute primary angle closure in asian eyes
publisher Dove Medical Press
publishDate 2013
url https://doaj.org/article/22750343cab343689684057d5c96e84c
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