ALPI vs Medical Therapy Effects on Optic Nerve Structure & Function

• Status: Unknown status
• Trial end date: 2008-12-01
• Target enrollment: 0
• Participant gender: All

Summary

The aim is to determine which approach, immediate argon laser peripheral iridoplasty or conventional systemic medical treatment efficiently breaks acute angle closure attack without consequent visual morbidities. The specific objectives are to see whether sudden intraocular pressure(IOP) lowering brought about by laser iridoplasty or medical treatment affects optic nerve head structure and function and identify if immediate decompression is associated with greater incidence of ocular problems like corneal endothelial compromise, optic disc edema, macular edema, decompression retinopathy, cataract formation, progression to chronic angle closure.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: National University Hospital, Singapore
• Treatments: Acetazolamide

Criteria

Inclusion Criteria:

• Age more than 21 years with ability to give informed consent and cooperate for a slit lamp laser procedure

• Subjects at their first presentation of acute primary angle closure attack.

• Intraocular pressure levels of 40 mm Hg or higher by applanation tonometry or tonopen

• Pupillary block as the main mechanism of angle closure

• No previous treatment

Exclusion Criteria:

• Age less than 21 years

• Angle closure due to non-pupil block mechanism (e.g. plateau iris, pseudoplateau, phacomorphic, malignant glaucoma) or other secondary causes (subluxed lens, neovascular, uveitic, traumatic, post-operative)

• Angle closure patients whose IOP's are not lowered by 20% or more, and are unresponsive to maximum medical IOP-lowering agents after one hour of initiating treatment and needing other intervention/s to lower IOP(e.g. iridoplasty, surgery).

• Corneal opacities or abnormalities obstructing laser application

• Use of contact lens

• Single-eyed patients