Abstract:  Objective To observe the changes of retinal nerve fiber layer thickness (RNFLT) and optic disc blood flow after the first attack of acute primary angle-closure glaucoma (APACG). Design Prospective comparative case series. Participants 41 cases with acute onset of APACG during January 2017 and June 2017 in Fushun Eye Hospital. Methods The acute attack 41 eye was the observation group, and the fellow 41 eye was the control group. RNFLTs of peripapilla were measured by Spectralis OCT and vascular density (VD) were measured by angiovue OCT at 1 week, 3 months and 6 months after IOP control. The differences of the RNFLTs and VDs at different observation time points were compared with generalized estimation equation. The correlation between RNFLT and peripheral VD were explored with Pearson correlation analysis. Main Outcome Measures peripapilla RNFLT, peripapilla VD. Results The temporal, superior temporal, inferior temporal RNFL in the acute attack eye were thicker than those in the lateral eye at 1 week (all P<0.05). The superior nasal and inferior nasal RNFLTs were significantly lower than those in the fellow eye in 3 month (all P<0.001). The nasal, superior nasal and inferior nasal RNFLTs were significantly lower than those in the fellow eye in 6 month (P=0.011, 0.000, 0.000). Compared with the self-follow-up of each parameter in the acute attack eye at 3 months, 6 months and 1 week, the RNFLTs in all quadrants was significantly thinner(all P<0.001). The peripapilla VD of the acute attack eye in 1 week, 3 month, 6 month of follow-up showed a continuous decline. The peripapilla nasal VD in 3 month and 6 month were significantly lower than 1 week (P=0.001, 0.001). The peripapilla superior temporal, inferior temporal, superior nasal and temporal VD continued to decline, 6 month compared with 1 week significantly decreased(P=0.007, 0.011, 0.013, 0.008). The parameters of the peripapilla VD were significantly decreased in the acute attack eye than in the lateral eye, and the difference was statistically significant (all P<0.05). The Pearson correlation analysis indicates that there was no correlation between changes in peripapilla VD and RNFLT changes in the corresponding quadrant in 1 week (all P>0.05), while changes in 3 month and 6 month were found to be relevant (all P<0.05). Conclusion RNFLT was increased in the early stage after intraocular pressure control in the acute attack of APACG. The peripapilla VD continued to decline within half a year, and the overall trend of the peripapilla VD was consistent with that of RNFLT. (Ophthalmol CHN, 2020, 29: 26-31)

Key words: acute primary angle-closure glaucoma, retinal nerve fiber layer thickness, blood flow of the optic disc