Ultrasound Biomicroscopic Evaluation of Uveal Effusion in Acute Primary Angle Closure

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Abstract

Purpose:

The aim of this study was to determine the prevalence of uveal effusion in acute primary angle closure (APAC), chronic primary angle-closure glaucoma (PACG), and primary open-angle glaucoma (POAG).

Methods:

A total of 152 consecutive patients (287 eyes) with APAC, PACG, and POAG were enrolled in this prospective and observational case series study. Intraocular pressure-lowering medications were used and ultrasound biomicroscopy examination was undertaken to determine the presence of uveal effusion and measure anterior chamber parameters.

Results:

Overall, uveal effusion was evident in 40 of 194 affected eyes (20.6%) and no uveal effusion was seen in their fellow eyes. The prevalence of uveal effusion in APAC, chronic PACG, and POAG was 29.3%, 10.9%, and 3.1%, respectively (χ2=226.63, P<0.001). APAC eyes had the highest prevalence of effusion and no effusion in their fellow eyes. In 40 eyes with uveal effusion, grade 1 effusion was seen in 17 eyes (42.5%), grade 2 in 15 eyes (37.5%), and grade 3 in 8 eyes (20%). In APAC eyes, the difference in the mean anterior chamber depth (ACD) among effusion grades 3, 2, and 1 was significant (F=5.425, P=0.017), and the eyes with grade 3 effusion had shallower ACD compared with grade 1 (P=0.031), but the difference was not significant compared with grade 2 (P=0.368).

Conclusions:

The eyes with APAC are associated with a higher prevalence of uveal effusion compared with PACG and POAG and probably as a result of rapid reduction in intraocular pressure with aggressive hypotensive therapy and inflammatory response to the process of acute attack.

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