Abstract：
BACKGROUND: There is limited data regarding the morbidity and progression to primary angle closure glaucoma in those presenting with acute primary angle closure (APAC) in the UK. We aim to report on the vision and intraocular pressure (IOP) outcomes and treatment required after an APAC episode and to identify any risk factors that could predict worse outcomes.
METHODS: A retrospective observational case series review including 117 consecutive patients (121 eyes) attending Moorfields Eye Hospital, at a tertiary referral unit in the UK, with APAC was performed.
RESULTS: Most patients (73%) had visual acuities of ≥6/12, meeting the UK driving standard, at the final follow-up. Only 15% (17 eyes) had severe visual impairment, as defined by the WHO, in the affected eye, of which 6.6% (eight eyes) were due to glaucoma. The delayed presentation was linked to a higher need for further medical treatment (OR=2.83, 95% CI 1.09 to 7.40, p=0.03). Patients who underwent phacoemulsification were at lower risk of having blindness in the affected eye (OR 0.18, 95% CI 0.05 to 0.69, p=0.01), having elevated IOP (OR 0.10, 95% CI 0.01 to 0.75, p=0.02) or requiring further medical treatment (OR 0.34, 95% CI 0.12 to 0.99, p=0.04). Older age (OR 1.26, 95% CI 1.08 to 1.48, p<0.01) was associated with worse visual outcomes.
CONCLUSIONS: APAC causes low long-term visual and treatment morbidity in this largely Caucasian patient group in the UK. Phacoemulsification as a treatment may enhance visual outcomes and reduce the need for further IOP-lowering treatment.
METHODS: A retrospective observational case series review including 117 consecutive patients (121 eyes) attending Moorfields Eye Hospital, at a tertiary referral unit in the UK, with APAC was performed.
RESULTS: Most patients (73%) had visual acuities of ≥6/12, meeting the UK driving standard, at the final follow-up. Only 15% (17 eyes) had severe visual impairment, as defined by the WHO, in the affected eye, of which 6.6% (eight eyes) were due to glaucoma. The delayed presentation was linked to a higher need for further medical treatment (OR=2.83, 95% CI 1.09 to 7.40, p=0.03). Patients who underwent phacoemulsification were at lower risk of having blindness in the affected eye (OR 0.18, 95% CI 0.05 to 0.69, p=0.01), having elevated IOP (OR 0.10, 95% CI 0.01 to 0.75, p=0.02) or requiring further medical treatment (OR 0.34, 95% CI 0.12 to 0.99, p=0.04). Older age (OR 1.26, 95% CI 1.08 to 1.48, p<0.01) was associated with worse visual outcomes.
CONCLUSIONS: APAC causes low long-term visual and treatment morbidity in this largely Caucasian patient group in the UK. Phacoemulsification as a treatment may enhance visual outcomes and reduce the need for further IOP-lowering treatment.
摘要：
背景：在英国，关于原发性闭角型青光眼急性闭角型（APAC）患者的发病率和进展的数据有限。我们的目标是报告APAC发作后的视力和眼内压（IOP）结局以及所需的治疗，并确定可能预测不良结局的任何风险因素。
方法：回顾性观察性病例系列回顾，包括在Moorfields眼科医院就诊的117名连续患者（121只眼），在英国的一个三级转诊单位，与亚太地区进行了合作。
结果：大多数患者（73％）的视力≥6/12，符合英国驾驶标准，在最后的后续行动中。只有15％（17只眼）有严重的视力障碍，根据世界卫生组织的定义，在受影响的眼睛中，其中6.6％（八眼）是由于青光眼。延迟就诊与需要进一步药物治疗有关（OR=2.83，95％CI1.09至7.40，p=0.03）。接受白内障超声乳化术的患者患眼失明的风险较低(OR0.18,95%CI0.05至0.69,p=0.01)。IOP升高(OR0.10,95%CI0.01~0.75,p=0.02)或需要进一步药物治疗(OR0.34,95%CI0.12~0.99,p=0.04)。年龄较大（OR1.26，95％CI1.08至1.48，p<0.01）与视力不良相关。
结论：APAC在英国这个以白种人为主的患者组中导致较低的长期视力和治疗发病率。作为一种治疗方法，超声乳化术可以提高视力，并减少进一步降低IOP治疗的需要。
方法：回顾性观察性病例系列回顾，包括在Moorfields眼科医院就诊的117名连续患者（121只眼），在英国的一个三级转诊单位，与亚太地区进行了合作。
结果：大多数患者（73％）的视力≥6/12，符合英国驾驶标准，在最后的后续行动中。只有15％（17只眼）有严重的视力障碍，根据世界卫生组织的定义，在受影响的眼睛中，其中6.6％（八眼）是由于青光眼。延迟就诊与需要进一步药物治疗有关（OR=2.83，95％CI1.09至7.40，p=0.03）。接受白内障超声乳化术的患者患眼失明的风险较低(OR0.18,95%CI0.05至0.69,p=0.01)。IOP升高(OR0.10,95%CI0.01~0.75,p=0.02)或需要进一步药物治疗(OR0.34,95%CI0.12~0.99,p=0.04)。年龄较大（OR1.26，95％CI1.08至1.48，p<0.01）与视力不良相关。
结论：APAC在英国这个以白种人为主的患者组中导致较低的长期视力和治疗发病率。作为一种治疗方法，超声乳化术可以提高视力，并减少进一步降低IOP治疗的需要。
