Clinical Course and Outcome of Primary Acute Angle-Closure Glaucoma in Singapore

Abstract

Purpose: Data is lacking with regard to the factors which may predict the outcome of an acute glaucoma eye to treatment and its long-term prognosis. This study was carried out to identify such factors, in particular among Singaporeans. Methods: Fifty-seven eyes were included in this retrospective analysis and factors analysed included age and sex; the duration of onset of symptoms to the time they presented to hospital; state of pupil and presenting intraocular pressure (IOP); whether attack is terminated by medical treatment alone or a second procedure (eg laser, trabeculectomy) was required; final outcome with respect to the development of chronic angle closure glaucoma and state of pupil at last follow-up. Results: Patients with 24 to 72 hours' delay in presentation had a relative risk of 2.78 (CI= 1.03-7.46) in developing chronic glaucoma. Those who required the addition of a laser procedure to control the initial presenting IOP while those who proceeded to a trabeculectomy had relative risks of 3.63 (CI=1.49-8.89) and 4.83 (CI=1.18-19.7) respectively in developing chronic glaucoma when compared to patients who did not require any secondary treatment. Conclusion: Delay in presentation, and unresponsiveness to medical treatment in termination of the acute attack in an acute angle closure glaucoma patient carry a significant risk of chronic glaucoma.