Iris change after angle closure may not be associated with adverse visual outcome

The development of iris ischemic changes after a single episode of acute primary angle closure may not be associated with an adverse visual outcome, according to a study.

Seng-Chee Loon, MRCS(Ed), and colleagues at the National University of Singapore reviewed the outcomes of 61 subjects with acute primary angle closure who were treated with medical therapy followed by laser peripheral iridotomy after resolution of the acute episode. Most of the subjects were female (82%), and most were Chinese (92%). The mean age was 59 years.

All subjects were examined at 1, 4, 8, 12 and 16 weeks after surgery for signs of iris ischemic changes. Iris ischemic changes were defined as the presence or iris whorling or stromal atrophy.

More than half the subjects (52.5%) were found to have developed iris ischemic changes during the study. Of those subjects, 65% developed signs by the first week. By week 16, six subjects without iris ischemic changes and 13 with iris ischemic changes had an abnormal visual field defect. There was no difference in visual acuity at week 16; the majority of subjects in both groups had a visual acuity of 6/12 or better, the authors reported.

The study is published in the October issue of Clinical & Experimental Ophthalmology.