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.