Changes In Visual Field And Retinal Nerve Fiber Layer Thickness Of Acute Angle-Closure Glaucoma

Purpose:Compare the visual fields of acute primary angle closure glaucoma patients'attacked eye and the RNFL thickness of attacked eye and unaffected fellow eye following an acute attack at different times during the follow-up, analyze the visual fields and the RNFL thickness changed regularity of acute PACG..Methods:1.Using Humphrey visual field analyzer, visual field were accessed in attacked eyes following an acute attack when intraocular pressure drops to normal and 30 days later. Analyze the visual fields changed regularity of acute PACG.2.Using HRT-â…¡,the average RNFL thickness and RNFL in nasal, superior nasal, inferior nasal, temporal, superior temporal, inferior temporal are assessed in both eyes at an acute attack after intraocular pressure drops to normal and 15 days later and 30 days later. The HRT-â…¡parameters are compared between the attacked eyes and the unaffected eyes at 3 different time points.Results:1. The visual field results of 24 attacked eyes of 24 acute PACG patients following an acute attack when intraocular pressure drops to normal are devided to five categories using the glaucoma hemifield test(GHT). 3 patients'result belong to within normal limits, 2 patients'result belong to borderline, 17 patients'result belong to outside normal limits, 2 patients'result belong to general reduction of sesitivity, none belongs to abnormal high sensitvity. 87%(21/24)of 24 acute PACG patients'attacked eyes'visual fields defect following an acute attack when intraocular pressure drop to normal. 13% attacked eyes'visual fields are normal, besides 17/24(71%) visual fields belong to outside normal limitis. Statisticing the points of pattern deviation of 24 acute PACG patients, the upper nasal quadrant are the most damaged. The pecentage is 45.7%. 30 days later, 22 acute PACG patients are inspected visual field again. The results are devided to five catagories using the GHT. 8 patients'result belong to within normal limits, 2 patients'result belong to borderline, 12 patients'result belong to outside normal limits. The perimetry of 7 patients following an acute attack are as follow: 5 results belong to outside normal limits, 2 belong to general reduction of sesitivity. The visual field damaged of the 7 patients are reverted to within normal limits 30 days later. 2. The differences of RNFL thickness of any position of unaffected fellow eyes at 3 differently time points were insignificant(P>0.05); The defferences of RNFL thickness in nasal, superior nasal of affected eyes at the time when intraocular pressure drops to normal and 15 days later were significant(P=0.02,0.01). The differences of average RNFL thickness and RNFL thickness in temporal, superior temporal, inferior temporal, inferior nasal of affected eyes at the time when intraocular pressure drops to normal and 15 days later were insignificant(P>0.05). The differences of attacked eyes at any position of RNFL thickness 15 days and 30 days were insignificant(P>0.05); The differences of RNFL thickness in nasal at the time when intraocular pressure drops to normal between attacked eyes and unaffected fellow eyes were significant(P<0.05). The differences of RNFL thickness at any position between attacked eyes and unaffected fellow eyes 15 days later were insignificant(P=0.09-0.84). The differences of RNFL thickness in superior nasal between attacked eyes and unaffected fellow eyes 30 days later were insignificant(P<0.05).Conclusions:1. The 87%(21/24) visual fields of the affected eyes of acute PACG patients following an acute attack when intraocular pressure drops to normal are damaged. The upper nasal quadrants are the most affected zone. Perimetric damaged following an acute attack is reversible.2. The RNFL thickness of acute PACG unaffected fellow eyes at 3 different times does not change with time. The RNFL thickness of acute PACG attacked eyes in nasal significant thicker than that of unaffected fellow eyes following an acute attack when intraocular pressure drops to normal. During 15 days to 30 days after attack, the RNFL thickness of attacked eyes decreases to normal level.