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Peripapillary Atrophy After Acute Primary Angle-Closure
  1. Kelvin Y Lee,
  2. Florian Rensch,
  3. Tin Aung (tin11{at}pacific.net.sg),
  4. Laurence S Lim,
  5. Rahat Husain,
  6. Gus Gazzard,
  7. Steve K Seah,
  8. Jost B Jonas
  1. Singapore National Eye Centre, Singapore
  2. Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Germany, Germany
  3. Singapore National Eye Centre, Singapore
  4. Singapore National Eye Centre, Singapore
  5. Singapore National Eye Centre, Singapore
  6. Singapore National Eye Centre, Singapore
  7. Singapore National Eye Centre, Singapore
  8. Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Germany, Germany

    Abstract

    Purpose: To determine the changes in peripapillary atrophy (PPA) in eyes after acute primary angle-closure (APAC)

    Methods: This was a prospective observational study of 40 eyes of 38 patients of predominantly Chinese ethnicity. The intraocular pressure (IOP) 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 performed 3.2 ± 8.4 days after the APAC episode leading to a normalization of IOP in all cases. Color optic disc photographs taken at 2 weeks and at 16 weeks after APAC were morphometrically examined. PPA was divided into alpha zone and beta zone.

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

    Conclusions: Alpha zone and beta zone of PPA did not markedly enlarge in patients after APAC, despite an enlargement of the optic cup during a follow-up of 4 months.

    • Intraocular pressure
    • Neuroretinal rim
    • Optic Disc
    • Peripapillary atrophy
    • Primary angle-closure glaucoma

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