Acute Angle Closure and Blindness in China: A Multicenter Retrospective Study on Treatment Effectiveness and Visual Outcomes.

PURPOSE: Acute angle closure (AAC) is a sight-threatening ophthalmic emergency. However, it remains uncertain whether the incidence of AAC-related blindness has declined in recent years. This study aimed to provide a contemporary analysis of the rate, clinical characteristics, and management outcomes of AAC-related blindness in China.

DESIGN

A multicentric, retrospective observational study.

SUBJECTS: Data of consecutive AAC cases were collected from 23 hospitals throughout China during 3 distinct periods: September 7, 2020, to January 6, 2021; September 7, 2021, to January 6, 2022; and September 7, 2022, to January 6, 2023.

METHODS

Clinical data were retrospectively gathered through a standardized chart review. Generalized estimating equations was employed to compare biometric parameters, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), and blindness rates before and after treatment.

MAIN OUTCOME MEASURES: The primary outcome was the rate of blindness, determined by CDVA and UDVA, both before and after treatments. Secondary outcomes included the time from symptom onset to treatment and its effect on blindness rates, along with the effectiveness of laser and surgical interventions in reducing these rates.

RESULTS

Among the 2626 consecutive AAC patients included in the study (76.0% female; mean age 66.8 ± 9.2 years), only 34.3% sought treatment within 72 hours of symptom onset. At presentation, blindness rates were 28.6% for CDVA and 42.4% for UDVA. After intervention, these rates significantly decreased to 16.4% for CDVA (P < 0.001) and 20.1% for UDVA (P < 0.001). Both laser and surgical treatments significantly improved mean logarithm of the minimum angle of resolution visual acuity with CDVA improving from 0.42 to 0.29 for laser treatment and from 0.88 to 0.65 for surgery.

CONCLUSIONS

Active treatment significantly reduced the AAC-related blindness rate from 28.6% at presentation to 16.4% after intervention. However, the persistently high rate of blindness was strongly associated with delayed medical presentation, underscoring an urgent need for initiatives that improve early access to care.

FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.