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Measurement of Retinal Nerve Fiber Layer in Primary Acute Angle Closure Glaucoma by Optical Coherence Tomography

. Dr. Sajida Parveen Shaikh, Dr. Shahnawaz Channa, Dr. Bibi Rafeen Talpur, Muhammad Sibghatullah Fahad, Dr. Imran Ali Pirzado & Dr. Shabeer Ahmed Bhutto


Abstract

Objective: To assess the accuracy of quantitative retinal nerve fiber layer (RNFL) thickness assessment using optical coherence tomography (OCT) in the detection of RNFL changes in primary acute angle closure glaucoma (PAACG).

Methods: A cross-sectional study enrolled 60 patients after remission with unilateral PAACG attacks and 60 normal controls with single eyes. Treatment had resolved PAACG in all cases.

 RNFLs of both eyes were assessed by Stratus OCT within two weeks and four months after PAACG. The parameters of OCT were compared within two weeks and four months after remission between normal controls, unaffected fellow eyes, and attacked eyes. Twenty PAACG patients underwent five measurements after intraocular pressure was controlled, within 2 weeks and at 1, 2, 3, and 4 months afterward. A comparison of the mean RNFL thickness among affected and fellow eyes was also conducted after remission at various times.

Results: A total of 60 eyes of 60 participants with unilateral PAACG and 60 eyes of 60 normal individuals participated in this study. The PAACG and normal groups both had 9 males and 51 females. Because of treatment, the mean intraocular pressure was 14.3±3.4 mm Hg. PSD and MD values for twenty PAACG patients (33.3%) were excluded from analyzes because of unreliable perimetry results. Statistically significant changes were to start in the average, temporal, superior, nasal, and inferior RNFL thicknesses of 60 acutely attacked eyes (within two weeks of remission), as equated to fellow eyes or normal eyes (P-value <0.001)

Conclusions: After PAACG episodes, RNFL thickness increased in the eyes immediately and decreased (up to 3 months) over time, according to OCT. Because of this detection, more understanding of pathologic retinal changes associated with PAACG can be gained, besides our ability to assess and manage these patients.

Keywords: Optical coherence tomography, acute angle closure glaucoma, retinal nerve fiber.

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