Purpose: To evaluate changes in lens opacity in the first year after prophylactic laser peripheral iridotomy (LPI) performed in fellow eyes of subjects with acute primary angle closure (APAC). Design: Prospective obse...Purpose: To evaluate changes in lens opacity in the first year after prophylactic laser peripheral iridotomy (LPI) performed in fellow eyes of subjects with acute primary angle closure (APAC). Design: Prospective observational case series. Participants: Sixty Asian subjects with unilateral APAC. Methods: All fellow eyes underwent prophylactic LPI within the first week of presentation, followed by 1 week of topical steroids. The degree of lens opacity was graded at the slit-lamp examination using the Lens Opacity Classification System III (LOCS III) with standard color photographs as the reference for grading of lens opacity. This was performed 2 weeks, 4 months, and 12 months after LPI. Progression in lens opacity was defined as an increase in LOCS III grade by 2 or more units in any lens region. Main Outcome Measures: Lens Opacity Classification Sytem III grades in nuclear, cortical, and posterior subcapsular (PSC) regions. Results: Most patients were Chinese (85% ) and female (63.3% ), with an average age of 61.5 ± 10.6 years. The mean baseline LOCS grades in the nuclear, cortical, and PSC regions were 3.58 ± 0.74, 0.57 ± 1.08, and 0.23 ± 0.72, respectively. With 12 months of follow-up, 14 of the 60 eyes (23.3% ; 95% confidence interval, 16.9- 29.7% ) showed signifi-cant progression in any lens region. Progression in the nuclear, cortical, and PSC regions was documented in 5% , 6.7% , and 16.7% of cases, respectively. By use of logistic regression, the following factors were not found to be significant for cataract progression in any lens region: age, race, gender, history of hypertension or diabetes, presence of peripheral anterior synechiae or angle width at baseline, and total laser energy delivered. Conclusions: In fellow eyes of APAC, prophylactic LPI is complicated by significant cataract progression, mainly in the posterior subcapsular region. These findings may have implications for the role of prophylactic LPI in the prevention of angle-closure blindness.展开更多
Purpose To evaluate the changes in re tinal nerve fiber layer(RNFL)thickness in the first 16weeks after acute primary angle closure(APAC)using scanning laser polarimetry(SLP)-Design Prospective,observational case seri...Purpose To evaluate the changes in re tinal nerve fiber layer(RNFL)thickness in the first 16weeks after acute primary angle closure(APAC)using scanning laser polarimetry(SLP)-Design Prospective,observational case series.Par-ticipants Thirty-seven Asian subje cts with APAC.Methods For all cases,APAC had resolved afte r treatment,and the study was conducted during the follo w-up period after the acute episode.Using the GDx Nerve Fi ber Analyzer(Laser Diagnostic Technologies,San Diego,CA),the RNFL was assessed in both eyes 2weeks after APAC,and again after16weeks.The SLP parameters were com pared between week 2and week 16within affected and fellow eyes.A multiple logistic regression analy sis was carried out to an-alyze factors likely to influence RN FL outcome.Main out-come measures Superior and inferior average RNFL thick-ness.Results The mean age of study su bjects was 60.1±10.3years(range,46-91years),and most subjects were female(68%)and Chinese(86%).In APAC eyes,the superior average RNFL thic kness decreased from63.8±13.6μm to 61.4±11.2μm(P=0.04)and the inferior average RNFL thickness decreased from 69.5±14.4μm to 66.3±12.6μm(P=0.005).There was also a decrease in inferior ratio(P=0.008)-and ellipse modulation(P=0.02).In the fellow eyes,there was no difference found between week 2and w eek 16for any of the SLP parameters studied.Logisti c regression analysis showed no significant association b etween developing a 10%reduction in either superior or i nferior RNFL thick-ness with age,gender,history of isc hemic risk factors,duration of symptoms during APAC,th e level of present-ing intraocular pressure(IOP),or the development of a rise in IOP between study visits.Con clusions After an episode of APAC,superior and inferior average RNFL thickness was found to decrease sign ificantly from week 2to week 16.展开更多
文摘Purpose: To evaluate changes in lens opacity in the first year after prophylactic laser peripheral iridotomy (LPI) performed in fellow eyes of subjects with acute primary angle closure (APAC). Design: Prospective observational case series. Participants: Sixty Asian subjects with unilateral APAC. Methods: All fellow eyes underwent prophylactic LPI within the first week of presentation, followed by 1 week of topical steroids. The degree of lens opacity was graded at the slit-lamp examination using the Lens Opacity Classification System III (LOCS III) with standard color photographs as the reference for grading of lens opacity. This was performed 2 weeks, 4 months, and 12 months after LPI. Progression in lens opacity was defined as an increase in LOCS III grade by 2 or more units in any lens region. Main Outcome Measures: Lens Opacity Classification Sytem III grades in nuclear, cortical, and posterior subcapsular (PSC) regions. Results: Most patients were Chinese (85% ) and female (63.3% ), with an average age of 61.5 ± 10.6 years. The mean baseline LOCS grades in the nuclear, cortical, and PSC regions were 3.58 ± 0.74, 0.57 ± 1.08, and 0.23 ± 0.72, respectively. With 12 months of follow-up, 14 of the 60 eyes (23.3% ; 95% confidence interval, 16.9- 29.7% ) showed signifi-cant progression in any lens region. Progression in the nuclear, cortical, and PSC regions was documented in 5% , 6.7% , and 16.7% of cases, respectively. By use of logistic regression, the following factors were not found to be significant for cataract progression in any lens region: age, race, gender, history of hypertension or diabetes, presence of peripheral anterior synechiae or angle width at baseline, and total laser energy delivered. Conclusions: In fellow eyes of APAC, prophylactic LPI is complicated by significant cataract progression, mainly in the posterior subcapsular region. These findings may have implications for the role of prophylactic LPI in the prevention of angle-closure blindness.
文摘Purpose To evaluate the changes in re tinal nerve fiber layer(RNFL)thickness in the first 16weeks after acute primary angle closure(APAC)using scanning laser polarimetry(SLP)-Design Prospective,observational case series.Par-ticipants Thirty-seven Asian subje cts with APAC.Methods For all cases,APAC had resolved afte r treatment,and the study was conducted during the follo w-up period after the acute episode.Using the GDx Nerve Fi ber Analyzer(Laser Diagnostic Technologies,San Diego,CA),the RNFL was assessed in both eyes 2weeks after APAC,and again after16weeks.The SLP parameters were com pared between week 2and week 16within affected and fellow eyes.A multiple logistic regression analy sis was carried out to an-alyze factors likely to influence RN FL outcome.Main out-come measures Superior and inferior average RNFL thick-ness.Results The mean age of study su bjects was 60.1±10.3years(range,46-91years),and most subjects were female(68%)and Chinese(86%).In APAC eyes,the superior average RNFL thic kness decreased from63.8±13.6μm to 61.4±11.2μm(P=0.04)and the inferior average RNFL thickness decreased from 69.5±14.4μm to 66.3±12.6μm(P=0.005).There was also a decrease in inferior ratio(P=0.008)-and ellipse modulation(P=0.02).In the fellow eyes,there was no difference found between week 2and w eek 16for any of the SLP parameters studied.Logisti c regression analysis showed no significant association b etween developing a 10%reduction in either superior or i nferior RNFL thick-ness with age,gender,history of isc hemic risk factors,duration of symptoms during APAC,th e level of present-ing intraocular pressure(IOP),or the development of a rise in IOP between study visits.Con clusions After an episode of APAC,superior and inferior average RNFL thickness was found to decrease sign ificantly from week 2to week 16.
