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

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.