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Purpose: To provide an updated analysis of the long-term outcomes of patients with acute primary angle closure (APAC) and to investigate the risk factors for visual field (VF) loss progression. Study Design: Retrospective, clinical cohort study Methods: One hundred and forty-six APAC patients with a minimum of 1-year follow-up were included. The presenting features and the treatment utilized were recorded. The visual and intraocular pressure (IOP) outcomes were analyzed. The main outcome measures were the proportion of blindness and IOP at the final visit. A subset of patients with sufficient VF results was divided into a stable and progressive group based on mean deviation (MD) loss rate. Univariate and multivariate logistic regression analyses were performed to identify predictors of progression. Results: Nine patients (6.2%) were blind, and 76.0% (111/146) had final decimal visual acuity greater than or equal to 0.5. All patients had normal final IOP, and 65.1% (95/146) were medication-free. 64.4% (94/146) underwent cataract surgery at a median 4 months after their APAC attack. The use of topical hypotensive medications (OR = 8.029, P = 0.012) was the only significant predictor of fast MD loss in the multivariate regression. Conclusions: The long-term outcomes of APAC in recent years have been more promising. All patients maintained normal IOP several years following their APAC attack, and fewer than half required hypotensive agents. The incidence of blindness was low. These findings suggest that current practice patterns in the management of APAC are beneficial. [ABSTRACT FROM AUTHOR]

Background/Aim. Impaired vision resulting from glaucoma can have deleterious effects on both physical and mental health. This study aims to examine the adverse im-pacts of primary open-angle glaucoma (POAG), primary angle closure glaucoma (PACG), and pseudoexfoliation glaucoma (PEG) on the quality of life (QoL) in Central Serbia. Methods. This research, designed as a cross-sectional study, included 102 patients treated for POAG, PACG, or PEG. The patients were divided into three groups (POAG, PACG, and PEG) based on the type of glaucoma they suffered from and were monitored for six months. The data on the QoL were obtained with the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Using the appropriate algorithm, the total NEI VFQ-25 scores were calculated for each group. Results. The questionnaire showed that scores for general vision were significantly lower in the PEG group than in the other two groups (PEG: 61.1 ± 12.6; POAG: 71.6 ± 17.9; PACG: 75.7 ± 11.6), p < 0.001. General health, eye pain, distance vision, social functioning, peripheral vision, reduced ability in daily activities, and dependence on others were also statistically significantly lower in the PEG group. The highest value of near vision was recorded for the POAG group (76.2 ± 21.2). The highest mean value in glaucomatous visual field defect was recorded in the PEG group (14.5 ± 3.6 dB). Conclusion. This research has demonstrated that the QoL is significantly lower in patients suffering from PEG compared to those suffering from POAG and PACG. Concerning the general health of patients, eye pain, distance vision, as well as the domain of social and everyday functioning, the lowest scores for individual areas of examination according to the NEI VFQ-25 were recorded in PEG patients. The results indicate that serious measures should be taken in order to improve the QoL of glaucoma patients.

ABSTRACT Objective: To evaluate structural and visual field (VF) changes after ≥1 year of a single acute primary angle closure (APAC) attack using spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP). Methods: Patients with a single unilateral APAC crisis at least 1 year ago were included consecutively from 2013 to 2016. Contralateral eye was used as control. All patients underwent ophthalmic examination, RNFL imaging by SD-OCT, and SAP using Octopus 1-2-3. Results: 54 eyes (27 patients) were enrolled. Male-to-female ratio was 1:2. Mean time for the SD-OCT and SAP assessment after the crisis was 5.0±5.1 (1.0–23.5) years, and IOP was 52.5±9.8 mmHg. In APAC eyes, the thicknesses of all quadrants of peripapillary RNFL (36.3%; P