A comparison of two approaches to managing acute primary angle closure in Asian eyes

Figures & data

Table 1 Demographic characteristics of all subjects who presented with APAC

Demographics	All (n = 92)	SNEC (n = 52)	NUH (n = 40)	P-value
Age (years)*	61.5 (9.70)	62.58 (8.50)	60.10 (11.01)	0.157
Gender
Female§	65 (70.7)	36 (69.2)	29c (72.5)	0.819
Race§
Chinese	82 (89.1)	45 (86.5)	37 (92.5)	0.845
Malay	9 (9.8)	6 (11.5)	3 (7.5)
Others	1 (1.1)	1 (1.9)	0 (0.0)

Notes: Data presented are mean (standard deviation) or frequency (percentage), where appropriate;

* Mann–Whitney U-test;

§ Fisher’s exact test.

Abbreviations: NUH, National University Hospital; SNEC, Singapore National Eye Centre.

Table 2 Comparison of characteristics of the attack eye by hospital

Characteristics	SNEC (n = 52)	NUH (n = 40)	P-value
Duration of symptoms§
≤3 days	37 (71.2%)	36 (90.0%)	0.037
>3 days	15 (28.8%)	4 (10.0%)
Initial VA of attack eye	1.05 (0.76)	0.98 (0.56)	0.590
Initial IOP	55.7 (12.1)	54.7 (12.2)	0.974
Time to LPI (hours)*	13.2 (19.8)	18.6 (27.4)	0.302
Duration to break attack (hours)*	18.2 (32.9)	9.8 (10.6)	0.109

Notes: Data presented as mean (standard deviation) or frequency (percentage), where appropriate;

* Mann–Whitney U-test;

§ Fisher’s exact test.

Abbreviations: IOP, intraocular pressure; LPI, laser peripheral iridotomy; NUH, National University Hospital; SNEC, Singapore National Eye Centre; VA, visual acuity.

Table 3 Management of patients during acute attack

Management	SNEC (n = 52)	NUH (n = 40)	P-value*
Use of IV diamox
No	1 (1.9%)	2 (5.0%)	0.578
Yes	51 (98.1%)	38 (95.0%)
Use of oral diamox
No	21 (40.4%)	31 (77.5%)	0.001
Yes	31 (59.6%)	9 (22.5%)
Use of mannitol
No	35 (67.3%)	39 (97.5%)	<0.001
Yes	17 (32.7%)	1 (2.6%)
Iridoplasty done
No	52 (100.0%)	28 (70.0%)	<0.001
Yes	0 (0.0%)	12 (30.0%)

Notes: Data presented are frequency (percentage);

* Fisher’s exact test.

Abbreviations: IV, intravenous; NUH, National University Hospital; SNEC, Singapore National Eye Centre.

Table 4 Comparison of the management of subjects from NUH by iridoplasty status

Characteristics	Iridoplasty done		P-value
	No (n = 28)	Yes (n = 12)
Initial VA of attack eye	0.81 (0.41)	1.37 (0.66)	0.018
Initial IOP	53.6 (11.2)	57.2 (14.6)	0.469
Duration of symptoms
≤3 days	26 (92.9%)	10 (83.3%)	0.570
>3 days	2 (7.1%)	2 (16.7%)
Use of IV diamox
No	2 (7.1%)	0 (0.0%)	1.000
Yes	26 (92.9%)	12 (100%)
Use of oral diamox
No	21 (75.0%)	10 (83.3%)	0.697
Yes	7 (25.0%)	2 (16.7%)
Use of mannitol
No	27 (96.4%)	12 (100.0%)	1.000
Yes	1 (3.6%)	0 (0.0%)
Time to LPI (hours)	21.5 (32.0)	11.8 (8.4)	0.516
Duration to break attack (hours)	8.6 (11.2)	12.5 (9.1)	0.086
Time to IOP rise
No rise	21 (75.0%)	10 (83.3%)	1.000
≤12 months	4 (14.3%)	1 (8.3%)
>12 months	3 (10.7%)	1 (8.3%)
Development of raised IOP
No	23 (71.4%)	11 (83.3%)	0.648
Yes	5 (28.6%)	1 (16.7%)
Development of GON
No	23 (71.4%)	11 (83.3%)	0.648
Yes	5 (28.6%)	1 (16.7%)

Notes: Data presented as mean (standard deviation) or frequency (percentage), where appropriate; Mann–Whitney U-test or Fisher’s exact test is used, where appropriate.

Abbreviations: GON, glaucomatous optic neuropathy; IOP, intraocular pressure; IV, intravenous; LPI, laser peripheral iridotomy; NUH, National University Hospital; SNEC, Singapore National Eye Centre; VA, visual acuity.

Table 5 One year outcome after acute primary angle closure

Outcome	SNEC (n = 52)	NUH (n = 40)	P-value*
Development of raised IOP§
No	33 (63.5%)	34 (77.5%)	0.032
Yes	19 (36.5%)	6 (22.5%)
Cataract surgery
No	35 (67.3%)	27 (67.5%)	1.000
Yes	17 (32.7%)	13 (32.5%)
Time to cataract surgery			0.700
≤3 months	10 (58.8%)	5 (45.5%)
>3 months	7 (41.2%)	6 (54.5%)
Development of GON
No	39 (75.0%)	34 (75.0%)	0.303
Yes	13 (25.0%)	6 (25.0%)
Time to glaucoma surgery
No surgery	51 (98.1%)	32 (80.0%)	0.011
≤12 months	1 (1.9%)	5 (12.5%)
>12 months	0 (0.0%)	3 (7.5%)

Notes: Data presented as frequency (percentage);

* P-value based on Fisher’s exact test;

§ defined as IOP >21 mmHg.

Abbreviations: GON, glaucomatous optic neuropathy; IOP, intraocular pressure; NUH, National University Hospital; SNEC, Singapore National Eye Centre.