Glaucomatous Optic Nerve Damage in the Fellow Eyes of Acute Angle-Closure Glaucoma

ABSTRACT

PURPOSE: To determine whether glaucomatous optic nerve damage occurs in the fellow eyes of patients with unilateral acute primary angle-closure glaucoma. METHODS: This study included both eyes of 75 subjects with unilateral acute primary angle-closure glaucoma in one eye, and 92 eyes of age- and refraction-matched normal controls. The presence or absence of qualitative signs for differentiating between normal and glaucoma eyes, vertical cup to disc ratio, and extent of zone beta were recorded. All subjects underwent examination with a Humphrey Field Analyser. RESULTS: Twelve fellow eyes (16%), 28 attacked eyes (37.3%), and no eyes in the control group had a vertical cup to disc ratio of 0.7 or greater (p<0.05). Thinnest rim width outside the temporal sector, rim shape alteration (alteration of ISN'T rule), baring of circumlinear vessel, and abnormal form of peripapillary atrophy were detected more frequently in fellow eyes than in normal controls (P<0.05). After excluding the attacked eyes with vertical cup to disc ratios of 0.69 or less and their fellow eyes, interocular correlation of mean deviation (r=0.31), corrected pattern standard deviation (r=0.32), extent of zone beta (r=0.57), and vertical cup to disc ratio (r=0.38) for attacked and fellow eyes were significant (p<0.05). CONCLUSIONS: Some of the fellow eyes of patients with unilateral acute primary angle-closure glaucoma had glaucomatous optic nerve damage, particularly the fellow eyes with a large cup to disc ratio.