Changes in retinal nerve fiber layer thickness afteracute primary angle closure glaucoma attack

Objective To detect changes in retinal nerve fiber layer (RNFL) thickness in the first 6 months after acute primary angle closure glaucoma (APACG) attack. Methods Twenty-four subjects with a single unilateral APACG attack and 55 eyes from 55 normal subjects were included in our study. The RNFL thickness was accessed in both eyes using optical coherence tomography (OCT) within 3 days, 2 weeks, 1, 3 and 6 months after intraocular pressure(IOP) control. The RNFL thickness was compared within the attacked eyes and the fellow eyes. And at the first and last visits, the RNFL thickness was compared between normal controls and2unaffected fellow eyes. Results Comparing with the unaffected fellow eyes, the mean RNFL thickness for the attacked eyes increased significantly within 3 days ( 121.49±23.84 )μm after IOP control (P＜0.01 ). At 2 week (107.22±24.72 )μm and 1 month (93.58±18.37)μm, there was no difference between the affected eyes and the unaffected fellow eyes for the mean RNFL thickness(P=0.31 and 0.08). At 3 months (84.10±19.89)μm and 6 month (78.98±19.17)μm, the mean RNFL thickness for the attacked eyes decreased significantly (P＜0.01 ). There were significant differences for the changes of RNFL thickness in the attacked eyes among the 5 visits (P＜0.01～0.048 ). No significant difference was demonstrated comparing of the mean RNFL thickness for unaffected fellow eyes with those of the normal subjects at first and last visits(P=0.13～0.98 ). Conclusions After an APACG episode, the RNFL thickness of attacked eyes significantly increased, and then decreased over time in the first 6 months after IOP control. Key words: Optical coherence tomography;  Glaucoma, closed angle;  Retina;  Nerve fiber