The incidence of acute angle closure in Scotland: a prospective surveillance study

Paul Y. Chua, Alexander C. Day, Ken L. Lai, Nikki Hall, Lai L Tan, Kamran Khan, Lik Thai Lim, Barny Foot, Paul J. Foster, Augusto Azuara-Blanco (Lead / Corresponding author)

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    Abstract

    Purpose To estimate the incidence, and describe the clinical features and short-term clinical outcomes of acute angle closure (AAC). Methods Patients with newly diagnosed AAC were identified prospectively over a 12-month period (November 2011 to October 2012) by active surveillance through the Scottish Ophthalmic Surveillance Unit reporting system. Data were collected at case identification and at 6 months follow-up. Results There were 114 cases (108 patients) reported, giving an annual incidence of 2.2 cases (95% CI 1.8 to 2.6) or 2 patients (95% CI 1.7 to 2.4) per 1 00 000 in the whole population in Scotland. Precipitating factors were identified in 40% of cases. Almost one in five cases was associated with topical dilating drops. Best-corrected visual acuity (BCVA) at presentation ranged from 6/6 to perception of light. The mean presenting intraocular pressure (IOP) was 52 mm Hg (SD 11). Almost 30% cases had a delayed presentation of 3 or more days. At 6 months follow-up, 75% had BCVA of 6/12 or better and 30% were found to have glaucoma at follow-up. Delayed presentation (≥3 days) was associated with higher rate of glaucoma at follow-up (22.6% vs 60.8%, p<0.001), worse VA (0.34 vs 0.74 LogMAR, p<0.0001) and need for more topical medication (0.52 vs 1.2, p=0.003) to control IOP. Conclusion The incidence of AAC in Scotland is relatively low compared with the Far East countries, but in line with previous European data. Almost one in five cases were associated with pupil dilation for retinal examination.

    Original languageEnglish
    Pages (from-to)539-543
    Number of pages5
    JournalBritish Journal of Ophthalmology
    Volume102
    Issue number4
    Early online date9 Aug 2017
    DOIs
    Publication statusPublished - Apr 2018

    Keywords

    • epidemiology
    • glaucoma
    • public health

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  • Cite this

    Chua, P. Y., Day, A. C., Lai, K. L., Hall, N., Tan, L. L., Khan, K., Lim, L. T., Foot, B., Foster, P. J., & Azuara-Blanco, A. (2018). The incidence of acute angle closure in Scotland: a prospective surveillance study. British Journal of Ophthalmology, 102(4), 539-543. https://doi.org/10.1136/bjophthalmol-2017-310725