AIM: To investigate the changes and significance of retinal nerve fiber layer(RNFL)thickness in patients with acute and chronic angle-closure glaucoma.

METHODS: Totally 37 patients(40 eyes)with acute angle-closure glaucoma and 35 cases(38 eyes)patients with chronic angle-closure glaucoma in our hospital from January 2016 to January 2018 were studied, and 30 cases with normal check-up in our hospital were compared. All the objects were scanned by optical coherence tomography(OCT). All subjects underwent visual field examination and OCT examination. According to the visual field examination results, the patients were divided into 2 subgroups of visual field defect and normal visual field. To study the relationship between RNFL thickness and visual field defect.

RESULTS: The superior, inferior, nasal side and average RNFL thickness of the acute group were obviously higher than that in the normal group(160.41±39.87μm vs 124.50±14.86μm, 155.38±31.79μm vs 127.75±20.08μm, 96.12±32.01μm vs 75. 79±13.10μm, 121.49±21.46μm vs 101.79±10.34μm), and the average RNFL thickness of the chronic group was lower than that in the normal group(superior: 91.57±30.22μm, inferior: 96.23±30.68μm, nasal side: 65.46±16.94μm, temporal side: 63.28±16.94μm, average: 80.58±22.18μm; P<0.05). The RNFL thickness of the superior and inferior part of normal visual field in the acute group was lower than that of the same group with visual field defect(159.68±27.49μm vs 163.32±37.76μm; 152.31±21.86μm vs 161.27±32.09μm; P<0.05); however, there was no significant difference on nasal side, temporal side and average RNFL thickness between the two subgroups(P>0.05). And the RNFL thickness of the subjects in chronic group with visual field defect was significantly lower than that in normal visual field(120.83±13.19μm vs 88.82±25.18μm, 124.83±17.01μm vs 85.89±30.91μm, 76.06±11.79μm vs 62.03±12.13μm, 75.17±9.99μm vs 63.09±8.24μm; P<0.05).

CONCLUSION: The RNFL thickening of acute PACG is mainly caused by optic nerve edema, while chronic PACG's RNFL thinning is due to the damage of ganglion cells and the loss of nerve fibers, different reasons cause different PACG thickness.