Trends in the characteristics of acute primary angle closure in Korea over the past 10-years

PLoS One. 2019 Oct 9;14(10):e0223527. doi: 10.1371/journal.pone.0223527. eCollection 2019.

Abstract

Purpose: To investigate the changes in the demographic, clinical, and biometric characteristics of APAC patients in South Korea during the last decade.

Methods: Medical records of patients with APAC who visit the emergency department or the glaucoma clinic of Chonnam National University Hospital, a tertiary referral center in Gwangju, South Korea in 2007 and 2017 were analyzed. Demographics, clinical characteristics, and treatment modality were compared between the APAC patients in 2007 and 2017.

Results: The number of patients with APAC increased from 54 in 2007 to 68 in 2017. Female patients in their 60s were most common in both groups and there was no significant difference in IOP, cataract grade, gonioscopic grading, PAS, or optic nerve damage between the two groups at baseline visit (all P > 0.05). However, APAC eyes in 2017 had a shallower ACD (1.74 ± 0.28 mm vs 1.87 ± 0.35 mm; P = 0.024) and greater LV (1.05 ± 0.26 mm vs 0.93 ± 0.19 mm; P = 0.001) than those of APAC eyes in 2007. During one year follow-up, 25 patients (51.02%) received LPI only, and 18 patients (36.73%) required LE, and 6 patients (12.24%) required phacotrabeculectomy or sequential LE and trabeculectomy. However, in 2017, LPI alone was sufficient in 23 patients (38.33%), 29 patients (48.33%) required further LE, and 8 patients (13.33%) required phacotrabeculectomy or sequential LE and trabeculectomy for the treatment of APAC (P = 0.015).

Conclusions: Compared to older cases of APAC, recent cases received LE more frequently, which suggests an increasing trend of LE as a treatment option for APAC. In addition, recent cases had a greater LV and shallower ACD than older cases and these biometric differences may be one of the reasons for increasing rate of LE in this study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Glaucoma, Open-Angle / diagnosis*
  • Glaucoma, Open-Angle / epidemiology
  • Glaucoma, Open-Angle / therapy
  • Humans
  • Male
  • Middle Aged
  • Republic of Korea
  • Tertiary Care Centers / statistics & numerical data
  • Trabeculectomy / statistics & numerical data

Grants and funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (NRF-2015R1D1A1A01059630), and the Bio & Medical Technology Development Program of the NRF funded by the Korean government (MSIP-2017M3A9E8023019). The funding organizations had no role in the design or conduct of this research.