Efficacy and Safety of Medical Treatment in Acute Angle Closure Glaucoma at Thammasat Hospital
Keywords:
Acute angle closure glaucoma, Medication treatment, MedicationAbstract
Introduction: Acute angle closure glaucoma (AACG) is a suddenly high intraocular pressure (IOP) from pupillary block which cause optic neuropathy. The key concept of AACG management is to break pupillary block and lower the IOP in order to prevent blindness. The IOP-lowering medical treatments are prescribed to reduce the IOP in the initial stage, which are used to help clear up the cornea and reduce ocular inflammation before performing laser-peripheral iridotomy (L-PI). The purpose of this study is to determine the effectiveness and safety of medical treatments in the initial management of AACG at Thammasat University Hospital.
Methods: Prospective pre-experimental study. Twelve cases of AACG were diagnosed at Thammasat Hospital. All participants were enrolled in this study. Patients without a history of drug allergy underwent a protocol of management in which they received one tablet of oral acetazolamide (250 mg), followed by one tablet every six hours, topical timolol (0.5%) twice daily and brimonidine (0.2%) twice daily which is applied to the affected eye. Patients were recorded IOP at regular interval, and patients were given medication until resolution of AACG which is defined as IOP <= 30 mmHg and resolution of acute symptoms. Qualitative data were calculated into percentage. Quantitative data were calculated as mean and standard deviation.
Results: Fifteen eyes of 12 patients, 5 (41.67%) men and 7 (58.33%) women, with the mean age of 70.58 (6.1) years were studied. With medical therapy, the number of AACG resolved within 1, 12, and 24 hours are 6 (50%), 4 (33.33%), and 1 (8.33%), respectively. No serious adverse effects of IOP-lowering medical treatment were observed in this study. Successful L-PI was performed in all subjects within 1 to 3.5 days after the medical treatments were applied.
Conclusion: According to the result in this study found that IOP-lowering medical treatments prescribed to reduce initial stage of IOP is effective and safe. Medical management of AACG should still remain as the first-line treatment.
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