A Study on Changes in Plasma Cholinesterase in Patients with Acute Primary Angle Closure

Abstract Purpose To analyze the differences in plasma cholinesterase (pChE) among patients with acute primary angle closure (APAC), patients with chronic primary angle closure glaucoma (CPACG) and normal people scheduled for cataract surgery and to analyze the relationship between intraocular pressure (IOP) and pChE in order to explore the significance of pChE in the pathogenesis of glaucoma. Methods Retrospective case series. Nighty-four patients with APAC, 72 patients with CPACG and 95 normal controls were enrolled in this study. All patients excluding those with diseases that may affect pChE underwent routine blood biochemical examination. Pearson correlation analysis was used to further analyze the correlation of IOP with pChE. Results There was no significant difference in age or sex among the three groups. The difference in IOP among the APAC (43.8 ± 12.2 mmHg), CPACG (25.6 ± 7.4 mmHg) and normal groups (13.6 ± 1.8 mmHg) was significant (P = 0.000). There was a significant difference in pChE between patients with APAC (7450.89 ± 1748.49 IU/L) and normal subjects (7994.68 ± 1321.90 IU/L) (P = 0.000) and between patients with APAC and those with CPACG (7969.44 ± 1572.14 IU/L) (P = 0.000). There was no significant difference in pChE between CPACG patients and normal subjects (P = 0.932). There was a moderate negative correlation between IOP and pChE in APAC patients (r = -0.410, P = 0.000), while there was no significant correlation in CPACG patients (P = 0.228) or normal subjects (P = 0.341). Conclusion APAC patients with higher IOP had lower pChE, which may have been related to IOP-induced neuroinflammation. It may provide a new strategy for optic nerve protection in glaucoma patients.

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Blindness short after treatment of acute primary angle closure in China

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316259 ◽

2020 ◽

pp. bjophthalmol-2020-316259

Author(s):

Shuning Li ◽

Guangxian Tang ◽

Su Jie Fan ◽

Gang Zhai ◽

Jianhua Lv ◽

...

Keyword(s):

Risk Factors ◽

Time Window ◽

Case Series ◽

Critical Time ◽

Education Level ◽

Angle Closure ◽

Retrospective Case ◽

Acute Primary Angle Closure ◽

Factors Associated ◽

Primary Angle Closure

AimsTo study the risk factors associated with blindness after treatment of acute primary angle closure (APAC), and to identify the critical time window to decrease rate of blindness.MethodsIn this multicentre retrospective case series, 1030 consecutive subjects (1164 eyes) with APAC in China were recruited. The rates of blindness were analysed up to 3 months after treatment of APAC. A logistic regression was used to identify the risk factors associated with blindness, including age, gender, distance to hospital, rural or urban settings, treatment method, education level, time from symptom to treatment (TST, hours) and presenting intraocular pressure (IOP). The critical time window associated with a blindness rate of ≤1% was calculated based on a cubic function by fitting TST to the rate of blindness at each time point.ResultsThe rate of blindness after APAC was 12.54% after treatment. In multivariate regression, education level, TST and presenting IOP were risk factors for blindness (p=0.022, 0.004 and 0.001, respectively). The critical time window associated with a blindness rate of ≤1% was 4.6 hours.Conclusions and relevanceEducation level, TST and presenting IOP were risk factors for blindness after APAC. Timely medical treatment is key in reducing blindness after APAC.

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Uveal effusion following acute primary angle-closure: a retrospective case series

International Journal of Ophthalmology ◽

10.18240/ijo.2017.03.13 ◽

2017 ◽

Keyword(s):

Case Series ◽

Angle Closure ◽

Retrospective Case ◽

Acute Primary Angle Closure ◽

Primary Angle Closure ◽

Retrospective Case Series ◽

Uveal Effusion

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Outcomes of combined gonioscopy-assisted transluminal trabeculotomy and goniosynechialysis in primary angle closure: a retrospective case series

International Ophthalmology ◽

10.1007/s10792-020-01676-y ◽

2021 ◽

Author(s):

Tanate Chira-adisai ◽

Kazuhiko Mori ◽

Akane Kobayashi ◽

Morio Ueno ◽

Yoko Ikeda ◽

...

Keyword(s):

Case Series ◽

Angle Closure ◽

Retrospective Case ◽

Primary Angle Closure ◽

Retrospective Case Series

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Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography

Scientific Reports ◽

10.1038/s41598-020-73223-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Kangcheng Liu ◽

Huizhuo Xu ◽

Haibo Jiang ◽

Hua Wang ◽

Pingbao Wang ◽

...

Keyword(s):

Early Stage ◽

Normal Subjects ◽

Vessel Density ◽

Foveal Avascular Zone ◽

Angle Closure ◽

Acute Primary Angle Closure ◽

Primary Angle Closure ◽

Circularity Index ◽

Avascular Zone ◽

And Control

Abstract This study analyzed the optical coherence tomography angiography (OCTA) macular parameters in primary angle-closure glaucoma (PACG) patients after acute primary angle closure (APAC) episodes. Thirty-three patients with 33 APAC eyes and 33 primary angle closure suspect (PACS) eyes and 33 age-matched normal subjects (controls) were enrolled. Macular vessel density (VD) in central, inner, outer and full regions and foveal avascular zone (FAZ) parameters (area, perimeter and circularity index) were compared between APAC, PACS, and control eyes. For resolved APAC eyes, the VD in each macular region was significantly lower than that in control eyes, with less central and inner macular VD than PACS eyes. The central macular VD was significantly lower in PACS eyes than in controls. There was no difference in FAZ area and perimeter between APAC, PACS, and control eyes. FAZ circularity was highest in control eyes, followed by PACS eyes, and lowest in APAC eyes. The AUC, sensitivity and specificity of FAZ circularity were 0.944, 93.9% and 84.8%, respectively, in APAC eyes and 0.881, 84.8% and 81.8%, respectively, in PACS eyes. Therefore, FAZ circularity had the best discrimination capability for detecting both APAC and PACS eyes. Macular assessment with OCTA could provide an accurate early-stage diagnostic tool for PACG.

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Efficacy and Safety of Argon Laser Peripheral Iridoplasty and Systemic Medical Therapy in Asian Patients with Acute Primary Angle Closure: A Meta-Analysis of Randomized Controlled Trials

Journal of Ophthalmology ◽

10.1155/2019/7697416 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Wenting Cai ◽

Qiyang Lou ◽

Jiaqi Fan ◽

Donghui Yu ◽

Tianyi Shen ◽

...

Keyword(s):

Medical Therapy ◽

Meta Analysis ◽

Argon Laser ◽

Angle Closure ◽

Cochrane Library ◽

Percent Reduction ◽

Glaucoma Medication ◽

Acute Primary Angle Closure ◽

Primary Angle Closure ◽

Significant Difference

Purpose. The purpose of this meta-analysis was to assess the percent reduction in the intraocular pressure (IOP) after argon laser peripheral iridoplasty (ALPI) and systemic medical therapy in patients with acute primary angle closure (APAC). Methods. We searched a number of electronic databases, including MEDLINE, EMBASE, PubMed, and Cochrane Library. We searched the electronic databases from the inception of the databases to August 2018. The primary outcomes included the IOP reduction (IOPR), percent reduction in IOP (IOPR%) from baseline to the endpoint and peripheral anterior synechiae (PAS). The secondary outcomes included the cup-to-disc ratio (CDR), mean endothelial count, and percent of patients requiring topical glaucoma medication. Summary weighted mean difference (WMD), odds ratio (OR), and 95% confidence intervals (CIs) were calculated. Results. Four eligible studies including 183 eyes (92 in the ALPI group and 91 in the medical therapy group) were identified. When comparing ALPI to medical therapy, the WMDs of the IOPR% were 30.03 (95% CI: 21.33 to 38.72, p<0.00001) at 15 minutes, 27.39 (95% CI: 18.89 to 35.89, p<0.00001) at 30 minutes, 18.15 (95% CI: 10.63 to 25.68, p<0.00001) at 1 hour, and 12.91 (95% CI: 4.50 to 21.32, p=0.003) at 2 hours. There was no statistically significant difference between the two groups at 24 hours and at more than 6 months after therapy. Meanwhile, no significant difference was observed in the degree of PAS, CDR, mean endothelial count, and percent of patients requiring topical glaucoma medication after treatment between the two groups. Conclusions. Both ALPI and systemic medications were effective with regard to decreasing the IOP. ALPI was more effective in lowering the IOP within the first two hours. Therefore, ALPI may be a better choice for rapidly lowering the IOP in patients with APAC within a short period.

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Vessel Density and Structural Measurements in Primary Angle-Closure Suspect Glaucoma Using Optical Coherence Tomography Angiography

BioMed Research International ◽

10.1155/2020/7526185 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Yi Zha ◽

Juanjuan Chen ◽

Shuyu Liu ◽

Jinfei Zhuang ◽

Jianqiu Cai

Keyword(s):

Retinal Vessel ◽

Normal Subjects ◽

Vessel Density ◽

Angle Closure ◽

Control Group ◽

Fiber Layer ◽

Primary Angle Closure ◽

Rnfl Thickness ◽

Significant Difference ◽

Retinal Vessel Density

Purpose. To measure the macular retinal vessel density (VD) and peripapillary retinal nerve fiber layer (RNFL) in primary angle-closure suspects (PACS) by Angio-OCT to be compared with normal subjects. Methods. Primary angle-closure suspect patients and normal subjects were enrolled in this study. The demographic and clinical characteristics of all subjects, such as RNFL thickness, retinal vessel density, and ocular perfusion pressure, were compared. Results. No significant difference was found in both groups on age, sex distribution, intraocular pressure (IOP), and retinal vessel density. The PACS group exhibited significantly thicker RNFL thickness compared with the control group. The deep vessel density was negatively associated with age ( P = − 0.034 ), while IOP had negative association with ACD ( P = − 0.019 ). OPP was independently associated with RNFL ( B = 0.334 , P = 0.038 ) in the PACS group. Conclusions. OCTA showed significant thicker change on RNFL in the PACS group. Only OPP was independently associated with RNFL in the PACS group.

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