To investigate the iatrogenic factors and clinical characteristics associated with acute primary angle‑closure glaucoma (APACG).
Methods
2
A retrospective analysis of APACG patients treated at Zhongnan Hospital of Wuhan University from January 2018 to December 2023 was conducted. Patients were categorized into hospital‑referred and self‑referred groups. Clinical features and iatrogenic factors were compared between the two groups.
Results
2
The in‑hospital referral group exhibited younger age at onset
better visual acuity at onset and discharge
and received treatment faster (
P
<
0.05). Among hospital‑referred patients
18.2% were initially misdiagnosed
and 72.7% underwent surgery. A total of 70 medications were prescribed; 75.7% were in the hospital‑referred group
where anti‑inflammatory drugs were most common. Self‑referred patients used more anti‑Parkinson’s drugs. Higher intravenous fluid volumes were linked to increased bilateral glaucoma attacks.
Conclusion
2
Timely medical intervention was associated with better visual outcomes
and clinicians should carefully assess ocular conditions before prescribing medications or performing surgeries
Glaucoma Group of Ophthalmology Branch of Chinese Medical Association, Glaucoma Group of Ophthalmology Branch of Chinese Medical Doctor Association . Expert consensus on diagnosis and treatment of neovascular glaucoma in China (2019) [J ] . Chin J Ophthalmol , 2019 , 55 ( 11 ): 814 ‑ 817 .
Glaucoma Group of Ophthalmology Branch of Chinese Medical Association , WANG N L . Expert consensus on diagnosis and treatment of primary angle‑closure glaucoma in China (2019) [J ] . Chin J Ophthalmol , 2019 , 55 ( 5 ): 325 ‑ 328 .
STEIN J D , KHAWAJA A P , WEIZER J S . Glaucoma in adults‑screening, diagnosis, and management: A review [J ] . JAMA , 2021 , 325 ( 2 ): 164 ‑ 174 .
LIN S G , LIN Z Q , LIANG Y B , et al . Incidence, risk factors and blindness rate of acute primary angle‑closure glaucoma [J ] . Int Rev Ophthalmol , 2018 , 42 ( 2 ): 73 ‑ 77 .
ZHANG X , LIU Y , WANG W , et al . Why does acute primary angle closure happen? Potential risk factors for acute primary angle closure [J ] . Surv Ophthalmol , 2017 , 62 ( 5 ): 635 ‑ 647 .
KETATA S , ZOUCHE I , DERBEL R , et al . Acute angle‑closure glaucoma after total knee replacement surgery: Case report and literature review [J ] . Pan Afr Med J , 2022 , 41 : 68 .
ROTH S , MOSS H E , VAJARANANT T S , et al . Perioperative care of the patient with eye pathologies undergoing nonocular surgery [J ] . Anesthesiology , 2022 , 137 ( 5 ): 620 ‑ 643 .
HSU E , DESAI M . Glaucoma and systemic disease [J ] . Life (Basel) , 2023 , 13 ( 4 ): 1018 .
AH‑KEE E Y , EGONG E , SHAFI A , et al . A review of drug‑induced acute angle closure glaucoma for non‑ophthalmologists [J ] . Qatar Med J , 2015 , 2015 ( 1 ): 6 .
YANG P Z , FAN X Q . Ophthalmology [M ] . 9th Ed . Beijing : People's Medical Publishing House , 2018 : 151 ‑ 152 .
MAMTANI N H , MAMTANI H G , CHATURVEDI S K . Psychiatric aspects of ophthalmic disorders: A narrative review [J ] . Indian J Ophthalmol , 2023 , 71 ( 5 ): 1810 ‑ 1815 .
LIN Z , WU R , MOONASAR N , et al . Acute primary angle closure in the fellow eye as a complication of facedown position after vitrectomy surgery [J ] . J Glaucoma , 2017 , 26 ( 1 ): e5 ‑ e6 .
STEWART R J , LANDY D C , LEE M J . Unilateral acute angle‑closure glaucoma after lumbar spine surgery: A case report and systematic review of the literature [J ] . Spine (Phila Pa 1976) , 2016 , 41 ( 5 ): E297 ‑ E299 .
DENG W , YE C H . Research progress on body position and intraocular pressure [J ] . Int Eye Sci , 2019 , 19 ( 5 ): 778 ‑ 782 .
KRAWITZ B D , SIRINEK P , DOOBIN D , et al . The challenge of managing bilateral acute angle‑closure glaucoma in the presence of active SARS‑CoV‑2 infection [J ] . J Glaucoma , 2021 , 30 ( 3 ): e50 ‑ e53 .
JAIN N S , RUAN C W , DHANJI S R , et al . Psychotropic drug‑induced glaucoma: A practical guide to diagnosis and management [J ] . CNS Drugs , 2021 , 35 ( 3 ): 283 ‑ 289 .
YANG M C , LIN K Y . Drug‑induced acute angle‑closure glaucoma: A review [J ] . J Curr Glaucoma Pract , 2019 , 13 ( 3 ): 104 ‑ 109 .
NA K I , PARK S P . Association of drugs with acute angle closure [J ] . JAMA Ophthalmol , 2022 , 140 ( 11 ): 1055 ‑ 1063 .
WU A N , Khawaja A P , Pasquale L R , et al . A review of systemic medications that may modulate the risk of glaucoma [J ] . Eye , 2020 , 34 : 12 ‑ 28 .