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Clinical science
Blindness short after treatment of acute primary angle closure in China
  1. Shuning Li1,
  2. Guangxian Tang2,
  3. Su Jie Fan3,
  4. Gang Zhai4,
  5. Jianhua Lv5,
  6. Hengli Zhang2,
  7. Wensheng Lu5,
  8. Jing Jiang4,
  9. Aiguo Lv3,
  10. Ningli Wang1,6,
  11. Kai Cao6,
  12. Jing Zhao1,
  13. Vivian Vu7,
  14. Dapeng Mu1,
  15. Xiaohua Pan1,
  16. Hui Feng1,
  17. Yen C Hsia7,
  18. Ying Han7
  1. 1Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
  2. 2Department of Ophthalmology, 1st Hospital of Shijiazhuang, Shijiazhuang, China
  3. 3Department of Ophthalmology, Handan 3rd Hospital, Handan, Hebei, China
  4. 4Department of Glaucoma, Fushun Eye Hospital, Fushun, China
  5. 5Department of Glaucoma, Hebei Eye Hospital, Xingtai, Hebei, China
  6. 6Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
  7. 7Ophthalmology, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Shuning Li, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China; lishuningqd{at}163.com

Abstract

Aims To study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.

Methods In this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of ≤1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point.

Results The rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of ≤1% was 4.6 hours.

Conclusions and relevance Education level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC.

  • glaucoma
  • angle

https://doi.org/10.1136/bjophthalmol-2020-316259

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    Footnotes

    • Presented at American Glaucoma Society Annual Meeting, 2019 World Glaucoma Congress Meeting, 2019.

    • Contributors SL: investigation design, conduct, interpretation and manuscript preparation, critical revision of the article. GT: data collection. SF: data collection. GZ: data collection. JL: data collection. HZ: data collection. JJ: data collection. WL: data collection. AL: data collection. NW: data collection. DM: data collection. XP: data collection. HF: data collection. KC: data analysis and manuscript preparation. JZ: manuscript preparation. VV: manuscript preparation. YCH: manuscript preparation and critical revision of the article. YH: data interpretation, manuscript preparation and critical revision of the article.

    • Funding The Capital Health Research and Development of Special (No. 2016-2-1081).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study protocol received approval from the institutional review board and ethics committee of each centre. This study complied with the Health Insurance Portability and Accountability Act regulations and adhered to the tenets of the Declaration of Helsinki.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request. Data could be available from the corresponding author by reasonable inquire.

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