Predictive factors and development of traumatic angle recession glaucoma following blunt ocular trauma
Hussin Izyani, Hanafi Rahimie, Pulanisamy Saranya, Mat Abu Siti-Hajar, Buang Nurhamiza, Yaakub Azhany, Husain Norhalwani, Ahmad Tajudin Liza-SharminiPurpose
To predict the development of traumatic angle recession glaucoma (TARG) and identify associated risk factors using Kaplan–Meier survival analysis.
Materials and Methods
This retrospective cohort study was conducted across three tertiary hospitals in Malaysia, involving patients treated for blunt ocular trauma and traumatic hyphaema between 1 January 2010 and 31 December 2020. Eligible patients had a minimum of one year of follow-up between 1 January and 31 December 2021. Data collected included demographics, medical and ocular history, injury mechanism, and initial ophthalmic assessment. Kaplan–Meier survival analysis and Cox proportional hazards regression were employed to evaluate glaucoma onset and prognostic indicators.
Results
Of 114 patients with angle recession, 30 (26.3%) developed TARG over a mean follow-up of 66.8 ± 52.1 months. Kaplan–Meier analysis estimated a mean survival time of 8.8 years, with most cases detected within nine months post-trauma. Age was a significant predictor, with a 1% increased risk per year (HR 1.02; 95% CI: 1.00–1.04; p = 0.022). Presence of peripheral anterior synechiae (PAS) conferred a 4.3-fold higher risk of developing TARG (HR 4.29; 95% CI: 2.02–9.13; p < 0.001).
Conclusion
Older patients with PAS following blunt ocular trauma are at significantly increased risk for TARG and warrant close surveillance. Further research is needed to establish optimal follow-up duration and develop predictive tools for early identification of high-risk individuals.