Nesher Ronit, Mimouni Michael D, Khoury Shafik, Nesher Gideon, Segal Ori
Department of Ophthalmology, Meir Medical Center, the Sackler Medical School, Tel Aviv University, 59 Tchernichovsky St., Kfar Saba, Israel,
Acta Neurol Belg. 2014 Dec;114(4):269-72. doi: 10.1007/s13760-014-0290-2. Epub 2014 Mar 28.
Subacute angle closure glaucoma (SACG) may lead to chronic angle closure glaucoma and irreversible vision loss. Headaches may be the sole presenting symptom. This study characterizes the medical course and symptoms of patients with SACG in whom headache was the major symptom. This retrospective observational study consisted of 30 consecutive patients, suffering from headaches and diagnosed with SACG, collected from the Glaucoma Service at the Ophthalmology Department of Meir Medical Center, Kfar Saba, Israel, a tertiary care referral facility. The primary study outcomes were reasons for referral, number of specialists visited and number of imaging studies performed before diagnosing SACG and headache characteristics. The majority of the patients experienced headaches once or twice a week. Four patients suffered a classic SACG pain involving the eye and frontal or hemicranial area. The mean time from onset of headaches to diagnosis was 2.6 years. The main reason for referral to the glaucoma clinic was consultation (53 %), and SACG was suspected by the referring physicians in two patients. Seventy-three percent of the patients were referred to at least three physicians in various medical specialties prior to referral to the glaucoma clinic. Patients usually do not volunteer history regarding headaches and clinicians often do not associate headaches with SACG in the absence of ocular symptoms. SACG should be included in the differential diagnosis in individuals older than 40 years presenting with late onset of headaches. Such patients should be referred to an ophthalmologist.
亚急性闭角型青光眼（SACG）可能会导致慢性闭角型青光眼和不可逆的视力丧失。头痛可能是唯一的症状表现。本研究对以头痛为主要症状的SACG患者的病程及症状进行了特征描述。这项回顾性观察研究连续纳入了30例因头痛就诊并被诊断为SACG的患者，这些患者来自以色列卡法萨巴市梅尔医学中心眼科青光眼科，该科室为三级医疗转诊机构。主要研究结果包括转诊原因、在诊断SACG之前就诊的专科医生数量和进行的影像学检查数量以及头痛特征。大多数患者每周经历一到两次头痛。4例患者出现典型的SACG疼痛，累及眼部及额部或半侧颅部区域。从头痛发作到诊断的平均时间为2.6年。转诊至青光眼门诊的主要原因是咨询（53%），转诊医生仅怀疑2例患者患有SACG。73%的患者在转诊至青光眼门诊之前曾被转诊至至少三名不同医学专科的医生处。患者通常不会主动提及头痛病史，并且在没有眼部症状的情况下，临床医生常常不会将头痛与SACG联系起来。对于40岁以上出现迟发性头痛的个体，鉴别诊断应包括SACG。此类患者应转诊至眼科医生处。
