Acute Primary Angle Closure Attack Does Not Cause an Increased Cup-to-Disc Ratio

作者：Chew Shenton S L; Vasudevan Sushil; Patel Hussain Y; Gurria Lulu U; Kerr Nathan M; Gamble Greg; Crowston Jonathan G; Danesh Meyer Helen V^*

来源：Ophthalmology, 2011, 118(2): 254-259.

DOI：10.1016/j.ophtha.2010.06.026

Purpose: To determine if an increased cup-to-disc ratio (CDR) and retinal nerve fiber layer (RNFL) loss occur after acute primary angle closure (APAC).
Design: Prospective, observational case series.
Participants: Twenty participants with unilateral APAC provided 20 affected eyes and 20 fellow eyes (controls) for analysis.
Methods: After initial presentation, participants attended 3 further assessments over a 12-month period (visit 2, within 2 weeks; visit 3, 2-3 months; and visit 4, 6-12 months), in which they underwent the following investigations: Heidelberg Retinal Tomography (Heidelberg Engineering, Dossenheim, Germany), optical coherence tomography of the RNFL and macula, and automated perimetry.
Main Outcome Measures: Cup-to-disc ratio, optic cup area, neuroretinal rim area, RNFL thickness, macular thickness, and volume.
Results: There was no change from visits 2 to 4 in CDR (0.46 +/- 0.17 vs. 0.47 +/- 0.20; P = 0.94), neuroretinal rim area (1.64 +/- 0.55 vs. 1.64 +/- 0.57; P = 0.96), or other optic nerve head parameters analyzed in eyes with APAC. The mean overall RNFL thickness decreased from 106.6 +/- 17.9 mu m to 92.9 +/- 18.3 mu m between visits 2 and 3 (P < 0.01) in affected eyes. The superior quadrant RNFL thickness decreased from 134.8 +/- 25.9 mu m to 113 +/- 25.7 mu m (P < 0.01), and the inferior quadrant RNFL thickness decreased from 139.1 +/- 28.4 mu m to 115.6 +/- 24.9 mu m (P < 0.01). There was no significant change in macular thickness or volume.
Conclusions: This study demonstrated that an increase in CDR does not occur after APAC that is treated promptly, although RNFL loss does occur.

• 出版日期2011-2