Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure. Methods Prospective clinical case-control study. A total of 26 patients (30 eyes) with acute primary angle-closure glaucoma (APACG) were in the APACG group, whose intraocular pressure were control after a single episode acute primary angle closure; 30 age-and sex-matched healthy subjects (30 eyes) in the control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm×6 mm macular scanning. The parameters included average thickness of entire CP-RNFL, thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The foveal retinal thickness, center retinal thickness (≤1 mm from the fovea), 4 quadrants of macular inner-ring ( > 1 mm but≤3 mm from the fovea) retinal thickness, 4 quadrants of macular outer-ring ( > 3 mm but≤6 mm from the fovea) retinal thickness, average thickness of macular retinal thickness and macular volume were measured and analyzed. Results The disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22, 4.12, 3.90, 3.00, 3.23; P < 0.05), rim area was smaller than the control group (t=-2.63, P < 0.05). The average thickness (t=-6.68) and the thickness of superior (t=-5.90), temporal (t=-11.64) and inferior (t=-5.06) quadrants of CP-RNFL, center retinal thickness (t=-2.50), 4 quadrants of macular inner-ring retinal thickness (t=-4.91, -4.88, -2.83, -3.59), nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outer-ring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P < 0.05), and the macular volume (t=-2.69) was significantly smaller than the control group (P < 0.05). There was no statistically difference at nasal CP-RNFL (t=-0.11), foveal retinal thickness (t=-0.59), temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P > 0.05). Conclusions In comparison with the healthy subjects, the disc area, disc cup area, C/D area ratio, C/D horizontal diameter ratio, C/D vertical diameter ratio in APACG eyes were bigger, while rim area was smaller; the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL, fovea, temporal and inferior quadrants of macular outer-ring retinal.