METHODS

PATIENTS: This was a case-control study. Twenty-one consecutive Chinese patients with a history of
unilateral acute PACG, who visited the ophthalmology department of Peking Union Medical College
Hospital from April 1, 2015 to July 8, 2015, were enrolled.

The inclusion criteria were as follows:

(1) 1 eye of each patient had a history of acute angle-closure attack and corresponding glaucoma-
tous optic neuropathy, while the other eye was unaffected.

(2) acute angle-closure attack, defined by the presence of at least 2 symptoms (such as ocular pain
and nausea/vomiting elevated IOP (>21 mm Hg), and at least 3 findings from the clinical examination
(eg, corneal edema, peripheral anterior chamber depth equal to or less than one quarter of the
peripheral corneal thickness, gonioscopic confirmation of angle closure).

(3) glaucomatous optic neuropathy, defined as loss of the neuroretinal rim with compatible
reproducible VF loss.

(4) the unaffected eye had no symptoms or signs of acute angle-closure attack, glaucomatous optic
neuropathy, or reproducible visual field loss.

The exclusion criteria were as follows:

(1) secondary angle closure, such as glaucoma associated with lens dislocation

(2) evidence of any kind of retina disease

(3) history of previous intraocular surgery that was not concerned with glaucoma (except cataract
surgery)

(4) any eye with obvious refractive media opacity that might affect imaging quality

(5) the patient was not cooperative and could not complete the examination.

The eyes with a history of acute PACG comprised the case group, while the contralateral unaffected
eyes served as the control group.

The study was approved by the institutional review board of Peking Union Medical College Hospital.
All patients provided written informed consent.
EXAMINATIONS:

All patients enrolled underwent thorough ophthalmic examinations including

best-corrected visual acuity (BCVA, measured by Snellen chart)

IOP measurement

slit-lamp examination

fundus examination

and gonioscopy.

IOP was measured by Goldmann applanation tonometry.

Gonioscopy was performed with a Goldmann 2-mirror lens at high magnification (316) by

glaucoma specialists.

Visual field examinations were performed with the Octopus 101 Perimeter (Haag-Streit,

Inc, Koeniz, Switzerland) tG2 program with Tendency Oriented Perimetry strategy.

The retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thickness, and

vertical cup-to-disc ratio (VCDR) were assessed with spectral-domain optical coherence tomography