Current understanding of the treatment and outcome of acute primary angle-closure glaucoma: an Asian perspective.

INTRODUCTION: Primary angle-closure glaucoma (PACG) is a major cause of blindness among Asians. A better understanding of the disease will improve the treatment and outcome of this condition.

METHODS: A literature review of all recent publications on PACG was carried out. Articles were retrieved using a key word search of MEDLINE, PubMed and Science Citation Index databases.

RESULTS: Following laser peripheral iritodomy for acute angle-closure, Asians were found to have a higher tendency to develop a subsequent rise in intraocular pressure compared to Caucasians. Furthermore, the extent and severity of visual field damage was more severe in Asians than Caucasians, particularly in eyes that presented insidiously with chronic PACG. Prophylactic laser iridotomy in the contralateral eye was found to be highly effective in preventing acute angle-closure attacks.

CONCLUSION: PACG is more difficult to manage and is associated with more severe long-term visual morbidity in Asians than Caucasians. Regular follow-up of patients with PACG is important for the early detection of progression of the disease and visual field deterioration.