Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.

<h4>Purpose</h4>To determine the factors associated with retinal nerve fiber layer (RNFL) loss in eyes with acute primary angle-closure (APAC), particularly focusing on the influence of the change in the anterior lamina cribrosa surface depth (LCD).<h4>Methods</h4>After the i...

Full description

Saved in:
Bibliographic Details
Main Authors: Eun Ji Lee, Tae-Woo Kim, Kyoung Min Lee, Seung Hyen Lee, Hyunjoong Kim
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168678&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849765083007156224
author Eun Ji Lee
Tae-Woo Kim
Kyoung Min Lee
Seung Hyen Lee
Hyunjoong Kim
author_facet Eun Ji Lee
Tae-Woo Kim
Kyoung Min Lee
Seung Hyen Lee
Hyunjoong Kim
author_sort Eun Ji Lee
collection DOAJ
description <h4>Purpose</h4>To determine the factors associated with retinal nerve fiber layer (RNFL) loss in eyes with acute primary angle-closure (APAC), particularly focusing on the influence of the change in the anterior lamina cribrosa surface depth (LCD).<h4>Methods</h4>After the initial presentation, 30 eyes with unilateral APAC were followed up at the following specific time points over a 12-month period: 1 week, 1~2 months, 2~3 months, 5~6 months, and 11~12 months. These follow-ups involved intraocular pressure measurements, enhanced depth-imaging spectral-domain optical coherence tomography (SD-OCT) scanning of the optic disc, and measurements of the circumpapillary RNFL thickness. The prelaminar tissue thickness (PLT) and LCD were determined in the SD-OCT images obtained at each follow-up visit.<h4>Results</h4>Repeated measures analysis of variance revealed a significant pattern of decrease in the global RNFL thickness, PLT, and LCD (all p<0.001). The global RNFL thickness decreased continuously throughout the follow-up period, while the PLT decreased until 5~6 months and did not change thereafter. The LCD reduced until 2~3 months and then also remained steady. Multivariable regression analysis revealed that symptoms with a longer duration before receiving laser peripheral iridotomy (LI) (p = 0.049) and a larger LCD reduction (p = 0.034) were significant factors associated with the conversion to an abnormal RNFL thickness defined using OCT normative data.<h4>Conclusion</h4>Early short-term decreases in the PLT and LCD and overall long-term decrease in the peripapillary RNFL were observed during a 12-month follow-up after an APAC episode. A longer duration of symptoms before receiving LI treatment and larger LCD reduction during follow-up were associated with the progressive RNFL loss. The LCD reduction may indicate a prior presence of significant pressure-induced stress that had been imposed on the optic nerve head at the time of APAC episode. Glaucomatous progression should be suspected in eyes showing LCD reduction after the APAC remission.
format Article
id doaj-art-0250023a29b34fecb1ed5e08683911ef
institution DOAJ
issn 1932-6203
language English
publishDate 2017-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-0250023a29b34fecb1ed5e08683911ef2025-08-20T03:04:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01121e016867810.1371/journal.pone.0168678Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.Eun Ji LeeTae-Woo KimKyoung Min LeeSeung Hyen LeeHyunjoong Kim<h4>Purpose</h4>To determine the factors associated with retinal nerve fiber layer (RNFL) loss in eyes with acute primary angle-closure (APAC), particularly focusing on the influence of the change in the anterior lamina cribrosa surface depth (LCD).<h4>Methods</h4>After the initial presentation, 30 eyes with unilateral APAC were followed up at the following specific time points over a 12-month period: 1 week, 1~2 months, 2~3 months, 5~6 months, and 11~12 months. These follow-ups involved intraocular pressure measurements, enhanced depth-imaging spectral-domain optical coherence tomography (SD-OCT) scanning of the optic disc, and measurements of the circumpapillary RNFL thickness. The prelaminar tissue thickness (PLT) and LCD were determined in the SD-OCT images obtained at each follow-up visit.<h4>Results</h4>Repeated measures analysis of variance revealed a significant pattern of decrease in the global RNFL thickness, PLT, and LCD (all p<0.001). The global RNFL thickness decreased continuously throughout the follow-up period, while the PLT decreased until 5~6 months and did not change thereafter. The LCD reduced until 2~3 months and then also remained steady. Multivariable regression analysis revealed that symptoms with a longer duration before receiving laser peripheral iridotomy (LI) (p = 0.049) and a larger LCD reduction (p = 0.034) were significant factors associated with the conversion to an abnormal RNFL thickness defined using OCT normative data.<h4>Conclusion</h4>Early short-term decreases in the PLT and LCD and overall long-term decrease in the peripapillary RNFL were observed during a 12-month follow-up after an APAC episode. A longer duration of symptoms before receiving LI treatment and larger LCD reduction during follow-up were associated with the progressive RNFL loss. The LCD reduction may indicate a prior presence of significant pressure-induced stress that had been imposed on the optic nerve head at the time of APAC episode. Glaucomatous progression should be suspected in eyes showing LCD reduction after the APAC remission.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168678&type=printable
spellingShingle Eun Ji Lee
Tae-Woo Kim
Kyoung Min Lee
Seung Hyen Lee
Hyunjoong Kim
Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.
PLoS ONE
title Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.
title_full Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.
title_fullStr Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.
title_full_unstemmed Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.
title_short Factors Associated with the Retinal Nerve Fiber Layer Loss after Acute Primary Angle Closure: A Prospective EDI-OCT Study.
title_sort factors associated with the retinal nerve fiber layer loss after acute primary angle closure a prospective edi oct study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168678&type=printable
work_keys_str_mv AT eunjilee factorsassociatedwiththeretinalnervefiberlayerlossafteracuteprimaryangleclosureaprospectiveedioctstudy
AT taewookim factorsassociatedwiththeretinalnervefiberlayerlossafteracuteprimaryangleclosureaprospectiveedioctstudy
AT kyoungminlee factorsassociatedwiththeretinalnervefiberlayerlossafteracuteprimaryangleclosureaprospectiveedioctstudy
AT seunghyenlee factorsassociatedwiththeretinalnervefiberlayerlossafteracuteprimaryangleclosureaprospectiveedioctstudy
AT hyunjoongkim factorsassociatedwiththeretinalnervefiberlayerlossafteracuteprimaryangleclosureaprospectiveedioctstudy