Wong J S, Chew P T, Alsagoff Z, Poh K
Department of Ophthalmology, National University Hospital, Singapore.
Singapore Med J. 1997 Jan;38(1):16-8.
Data is lacking with regard to the factors which may predict the outcome of an acute glaucoma eye to treatment and its long-term prognosis. This study was carried out to identify such factors, in particular among Singaporeans.
Fifty-seven eyes were included in this retrospective analysis and factors analysed included age and sex; the duration of onset of symptoms to the time they presented to hospital; state of pupil and presenting intraocular pressure (IOP); whether attack is terminated by medical treatment alone or a second procedure (eg laser, trabeculectomy) was required; final outcome with respect to the development of chronic angle closure glaucoma and state of pupil at last follow-up.
Patients with 24 to 72 hours' delay in presentation had a relative risk of 2.78 (CI = 1.03-7.46) in developing chronic glaucoma. Those who required the addition of a laser procedure to control the initial presenting IOP while those who proceeded to a trabeculectomy had relative risks of 3.63 (CI = 1.49-8.89) and 4.83 (CI = 1.18-19.7) respectively in developing chronic glaucoma when compared to patients who did not require any secondary treatment.
Delay in presentation, and unresponsiveness to medical treatment in termination of the acute attack in an acute angle closure glaucoma patient carry a significant risk of chronic glaucoma.
关于可能预测急性青光眼患者治疗结果及其长期预后的因素，目前缺乏相关数据。本研究旨在确定这些因素，特别是在新加坡人中的情况。
本回顾性分析纳入了57只眼睛，分析的因素包括年龄和性别；症状出现至就诊的持续时间；瞳孔状态和就诊时的眼压；急性发作是否仅通过药物治疗终止，还是需要进行第二种手术（如激光、小梁切除术）；慢性闭角型青光眼的发展情况以及最后一次随访时的瞳孔状态等最终结果。
就诊延迟24至72小时的患者发生慢性青光眼的相对风险为2.78（可信区间=1.03 - 7.46）。与不需要任何二次治疗的患者相比，那些需要增加激光手术来控制初始就诊眼压的患者以及那些进行小梁切除术的患者发生慢性青光眼的相对风险分别为3.63（可信区间=1.49 - 8.89）和4.83（可信区间=1.18 - 19.7）。
急性闭角型青光眼患者就诊延迟以及急性发作时对药物治疗无反应，会显著增加发生慢性青光眼的风险。
