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Peripapillary atrophy after acute primary angle closure
  1. Kelvin Y C Lee1,*,
  2. Florian Rensch2,*,
  3. Tin Aung1,3,
  4. Laurence S Lim1,
  5. Rahat Husain1,4,
  6. Gus Gazzard1,4,
  7. Steve K L Seah1,
  8. Jost B Jonas2
  1. 1Singapore National Eye Centre, Singapore
  2. 2Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany
  3. 3Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  4. 4Institute of Ophthalmology, University College London, London, UK
  1. Correspondence to: Associate Professor Tin Aung Glaucoma Department, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751; tin11{at}pacific.net.sg

Abstract

Aim: To determine the changes in peripapillary atrophy after episodes of acute primary angle closure (APAC).

Methods: Prospective observational study of 40 eyes in 38 patients of predominantly Chinese ethnicity. The mean (SD) intraocular pressure at the time of presentation was 51.7 (12) mm Hg (median, 55 mm Hg) and the mean duration of the symptoms was 37.7 (69.4) hours. A laser iridotomy was undertaken 3.2 (8.4) days after the APAC episode, leading to normalisation of intraocular pressure in all cases. Colour optic disc photographs taken at 2 and 16 weeks after APAC were examined morphometrically. Peripapillary atrophy was divided into α and β zones.

Results: Comparing measurements at baseline with week 16, the minimum width of the α zone (0.013 (0.056) v 0.016 (0.001) arbitrary units; p = 0.23), the maximum width of the α zone (1.11 (1.31) v 1.31 (0.79) arbitrary units; p = 0.22), the minimum width of the β zone (0.030 (0.122) v 0.033 (0.166) arbitrary units; p = 0.93), and the maximum width of the β zone (0.62 (0.94) v 0.73 (0.98) arbitrary units; p = 0.42) did not vary significantly. The mean cup to disc ratio increased from 0.56 (0.05) to 0.62 (0.07) (p<0.0001) at the end of follow up.

Conclusions: The α and β zones of peripapillary atrophy did not enlarge markedly in patients after APAC, despite an enlargement of the optic cup during a follow up of four months.

  • APAC, acute primary angle closure
  • POAG, primary open angle glaucoma
  • peripapillary atrophy
  • optic disc
  • intraocular pressure
  • neuroretinal rim
  • glaucoma
  • APAC, acute primary angle closure
  • POAG, primary open angle glaucoma
  • peripapillary atrophy
  • optic disc
  • intraocular pressure
  • neuroretinal rim
  • glaucoma

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Footnotes

  • * KYCL and FR contributed equally and are joint first authors.

  • Published Online First 27 February 2007

  • Competing interests: None.

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