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ReGAE 10: Long-term Visual Acuity Outcomes After Acute Primary Angle Closure

Andreatta, Walter MD, MSc*; Nessim, Maged FRCSEd, Ophth*; Nightingale, Peter PhD; Shah, Peter FRCOphth*,‡,§,∥

doi: 10.1097/IJG.0000000000000042
Original Studies

Purpose: The aim of this study was to identify the long-term visual acuity (VA) outcomes of eyes following an attack of acute primary angle closure in an urban UK population.

Patients and Methods: This was a retrospective observational case series of 134 consecutive eyes of 123 subjects presenting with acute primary angle closure to a supraregional tertiary referral unit in the United Kingdom over a period of 60 months. The VA in the affected eye was recorded at presentation 6 months after the acute event and at the final follow-up. In addition, causes of poor vision were documented as sociodemographic variables and surgical interventions. The main outcome measure was severe visual impairment (SVI). SVI was classified as VA<6/60 in the affected eye.

Results: A total of 134 eyes of 123 subjects were assessed, 89 (72%) female and 34 (28%) male patients. The majority of the individuals were White Caucasians (78%), followed by Indian and Pakistani (14%), African Caribbean (4%), and Chinese (2.4%). The mean age was 67.3±11.9 years.

During the period of follow-up, 44 (33%) eyes needed a cataract surgery, whereas 13 (10%) eyes underwent filtration surgery. Eight (6%) eyes had combined cataract and filtration surgery. The mean final follow-up period was 31.4±18.1 months. At this stage, 16 (12%) of the affected eyes had SVI. Glaucomatous optic neuropathy was responsible for SVI in 5/16 eyes, 1 eye had corneal decompensation, whereas 2/16 eyes were affected by central retinal vein occlusion. Other SVI causes were age-related macular degeneration (5/16) and cataract (3/16).

Conclusions: Sixteen (12%) eyes had SVI at the final follow-up. One third of SVI was secondary to GON.

*Birmingham & Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust

Wellcome Trust Clinical Research Facility, University of Birmingham

University Hospitals Birmingham NHS Foundation Trust, Birmingham

§Centre for Health and Social Care Improvement, University of Wolverhampton, Wolverhampton

National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK

Disclosure: The authors declare no conflict of interest.

Reprints: Walter Andreatta, MD, MSc, Birmingham and Midland Eye Centre, Dudley Road, Birmingham, B18 7QH, UK (e-mail:

Received February 14, 2013

Accepted January 10, 2014

© 2014 by Lippincott Williams & Wilkins.