Predictive factors and development of traumatic angle recession glaucoma following blunt ocular trauma

PurposeTo predict the development of traumatic angle recession glaucoma (TARG) and identify associated risk factors using Kaplan-Meier survival analysis.Materials and MethodsThis 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.ResultsOf 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).ConclusionOlder 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.