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Kouroupaki AI, Triantafyllopoulos GI, Pateras E, Karabatsas CH, Plakitsi A. Anterior Segment Changes in Patients With Glaucoma Following Cataract Surgery. Cureus 2024; 16:e58703. [PMID: 38779247 PMCID: PMC11110096 DOI: 10.7759/cureus.58703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
This prospective observational study investigates the impact of cataract surgery on anterior segment parameters in nonglaucomatous and primary open-angle glaucoma (POAG) eyes, utilizing anterior segment optical coherence tomography (AS-OCT). The study involved 42 Caucasian patients, divided into a control group and a POAG group. Comprehensive ophthalmic examinations were performed along with AS-OCT imaging and biometry preoperatively, as well as on one day, one week, and one month following cataract surgery. The results showed significant post-operative changes in anterior chamber depth (ACD) and angle width in both groups, suggesting that cataract surgery may influence the structural parameters associated with glaucoma risk and management. Specifically, a marked increase in ACD and improvement in angle-opening distances were observed, highlighting the potential of cataract extraction to alter intraocular fluid dynamics favorably. Despite these changes, the study noted an initial spike in increased intraocular pressure (IOP) in POAG patients immediately post-operative, which stabilized during follow-up. For the control group, IOP showed gradually reducing IOP values in the follow-up visits. The findings underscore the role of advanced imaging technologies in understanding glaucoma's pathophysiology and the potential benefits of cataract surgery in glaucoma patients. The study advocates for further research with a larger, more diverse patient population and extended follow-up to explore the long-term implications of cataract surgery on glaucoma dynamics, emphasizing the importance of personalized management and treatment strategies particularly for glaucoma patients.
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Affiliation(s)
- Anna I Kouroupaki
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
- Ophthalmology Department, 'Korgialenio-Benakio' Hellenic Red Cross General Hospital, Athens, GRC
| | | | - Evangelos Pateras
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
| | - Costas H Karabatsas
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
| | - Athina Plakitsi
- Biomedical Sciences Department, Course of Optics and Optometry, University of West Attica, Athens, GRC
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Moshirfar M, Santos JM, Cha DS, Herron M, Stoakes IM, Hoopes PC. Exploring Nomograms for Implantable Collamer Lens Size Selection in Myopia: A Literature-based Compilation. Clin Ophthalmol 2023; 17:3307-3322. [PMID: 37933328 PMCID: PMC10625784 DOI: 10.2147/opth.s427815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/05/2023] [Indexed: 11/08/2023] Open
Abstract
Purpose To provide a comprehensive guide of all implantable collamer lens (ICL) sizing nomograms and the respective preoperative diagnostic devices that are required. This guide would help clinicians in choosing the appropriate ICL size for myopic patients to optimize postoperative vault height. Methods A literature search of peer-reviewed journals describing methods and postoperative outcomes of ICL sizing was conducted. Research articles containing ICL nomograms or formulas were identified from this search. Preoperative variables necessary for these nomograms and the required diagnostic devices to measure these parameters such as topography, biometry, or ultrasound biomicroscopy (UBM) were noted. An additional search was conducted to identify artificial intelligence (AI) or machine learning (ML)-derived nomograms. Results Eighteen ICL sizing nomograms were identified through literature search. Five of these nomograms are available for use and require topography or biometry devices. Of these, four include the manufacturer's, optimized white-to-white (WTW), Kang, Kim, and Rocamora Nomograms. Eight of the 18 nomograms available for use require UBM. Eight of these include the Kojima, Nakamura, KS, ZZ, Dougherty, Parkhurst, Russo, and Reinstein Nomograms. Four of the 18 nomograms are ML-derived including Shen, Rocamora, Russo, and Kang Nomograms. Conclusion ICL nomograms are a vital tool in helping clinicians select the right ICL size for myopic patients to optimize postoperative vault reducing risk of postoperative complications. Based on available diagnostic devices such as topography, biometry, or UBM clinicians can integrate specific nomograms into practice.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA
- Utah Lions Eye Bank, Murray, UT, USA
| | - Jordan M Santos
- University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA
| | - David S Cha
- Saint Louis University School of Medicine, St Louis, MO, USA
| | - Michael Herron
- University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Isabella M Stoakes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
- Pacific Northwest University of Health Sciences, Yakima, WA, USA
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Choi H, Kim T, Kim SJ, Sa BG, Ryu IH, Lee IS, Kim JK, Han E, Kim HK, Yoo TK. Predicting Postoperative Anterior Chamber Angle for Phakic Intraocular Lens Implantation Using Preoperative Anterior Segment Metrics. Transl Vis Sci Technol 2023; 12:10. [PMID: 36607625 PMCID: PMC9836008 DOI: 10.1167/tvst.12.1.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose The anterior chamber angle (ACA) is a critical factor in posterior chamber phakic intraocular lens (EVO Implantable Collamer Lens [ICL]) implantation. Herein, we predicted postoperative ACAs to select the optimal ICL size to reduce narrow ACA-related complications. Methods Regression models were constructed using pre-operative anterior segment optical coherence tomography metrics to predict postoperative ACAs, including trabecular-iris angles (TIAs) and scleral-spur angles (SSAs) at 500 µm and 750 µm from the scleral spur (TIA500, TIA750, SSA500, and SSA750). Data from three expert surgeons were assigned to the development (N = 430 eyes) and internal validation (N = 108 eyes) datasets. Additionally, data from a novice surgeon (N = 42 eyes) were used for external validation. Results Postoperative ACAs were highly predictable using the machine-learning (ML) technique (extreme gradient boosting regression [XGBoost]), with mean absolute errors (MAEs) of 4.42 degrees, 3.77 degrees, 5.25 degrees, and 4.30 degrees for TIA500, TIA750, SSA500, and SSA750, respectively, in internal validation. External validation also showed MAEs of 3.93 degrees, 3.86 degrees, 5.02 degrees, and 4.74 degrees for TIA500, TIA750, SSA500, and SSA750, respectively. Linear regression using the pre-operative anterior chamber depth, anterior chamber width, crystalline lens rise, TIA, and ICL size also exhibited good performance, with no significant difference compared with XGBoost in the validation sets. Conclusions We developed linear regression and ML models to predict postoperative ACAs for ICL surgery anterior segment metrics. These will prevent surgeons from overlooking the risks associated with the narrowing of the ACA. Translational Relevance Using the proposed algorithms, surgeons can consider the postoperative ACAs to increase surgical accuracy and safety.
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Affiliation(s)
- Hannuy Choi
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Taein Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Su Jeong Kim
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Beom Gi Sa
- Research and Development Department, VISUWORKS, Seoul, South Korea
| | - Ik Hee Ryu
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Jin Kuk Kim
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea
| | - Eoksoo Han
- Electronics and Telecommunications Research Institute (ETRI), Daejeon, South Korea
| | - Hong Kyu Kim
- Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Tae Keun Yoo
- Department of Refractive Surgery, B&VIIT Eye Center, Seoul, South Korea,Research and Development Department, VISUWORKS, Seoul, South Korea
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Imaging of iris vasculature: current limitations and future perspective. Eye (Lond) 2022; 36:930-940. [PMID: 34650219 PMCID: PMC9046297 DOI: 10.1038/s41433-021-01809-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/22/2021] [Accepted: 10/01/2021] [Indexed: 12/22/2022] Open
Abstract
Fluorescein and indocyanine green angiography have been the traditional ways to image the vasculature of the iris in the last few decades. Because of the invasive nature of these procedures, they are performed in rare situations, and thus, our understanding about iris vasculature is very limited. Optical coherence tomography angiography (OCTA) is a noninvasive imaging method that enables the detailed visualization of the retinal and choroidal vascular networks. More recently, it has been also used for the examination of the iris vasculature in healthy and disease eyes. However, there is a lack of uniformity in the image acquisition protocols and interpretations in both healthy and pathological conditions. Artifacts of iris OCTA include shadowing, motion, segmentations errors, mirror effects. OCTA devices have an eye-tracking system designed for the posterior segment and the applications of these systems on the anterior segment can determine motion lines, vessel duplication, and vessel discontinuity. OCTA of the iris should always be performed under ambient room lighting to create miosis and reduce iris vasculature changes during the examination. In the near future, eye-tracking systems specifically designed for the iris vessels could permit the follow-up function, and the development of new OCTA metrics could reveal interesting applications of this new imaging technique.
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Digital Gonioscopy Based on Three-dimensional Anterior-Segment OCT: An International Multicenter Study. Ophthalmology 2021; 129:45-53. [PMID: 34619247 DOI: 10.1016/j.ophtha.2021.09.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/18/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To develop and evaluate the performance of a 3-dimensional (3D) deep-learning-based automated digital gonioscopy system (DGS) in detecting 2 major characteristics in eyes with suspected primary angle-closure glaucoma (PACG): (1) narrow iridocorneal angles (static gonioscopy, Task I) and (2) peripheral anterior synechiae (PAS) (dynamic gonioscopy, Task II) on OCT scans. DESIGN International, cross-sectional, multicenter study. PARTICIPANTS A total of 1.112 million images of 8694 volume scans (2294 patients) from 3 centers were included in this study (Task I, training/internal validation/external testing: 4515, 1101, and 2222 volume scans, respectively; Task II, training/internal validation/external testing: 378, 376, and 102 volume scans, respectively). METHODS For Task I, a narrow angle was defined as an eye in which the posterior pigmented trabecular meshwork was not visible in more than 180° without indentation in the primary position captured in the dark room from the scans. For Task II, PAS was defined as the adhesion of the iris to the trabecular meshwork. The diagnostic performance of the 3D DGS was evaluated in both tasks with gonioscopic records as reference. MAIN OUTCOME MEASURES The area under the curve (AUC), sensitivity, and specificity of the 3D DGS were calculated. RESULTS In Task I, 29.4% of patients had a narrow angle. The AUC, sensitivity, and specificity of 3D DGS on the external testing datasets were 0.943 (0.933-0.953), 0.867 (0.838-0.895), and 0.878 (0.859-0.896), respectively. For Task II, 13.8% of patients had PAS. The AUC, sensitivity, and specificity of 3D DGS were 0.902 (0.818-0.985), 0.900 (0.714-1.000), and 0.890 (0.841-0.938), respectively, on the external testing set at quadrant level following normal clinical practice; and 0.885 (0.836-0.933), 0.912 (0.816-1.000), and 0.700 (0.660-0.741), respectively, on the external testing set at clock-hour level. CONCLUSIONS The 3D DGS is effective in detecting eyes with suspected PACG. It has the potential to be used widely in the primary eye care community for screening of subjects at high risk of developing PACG.
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Kang EM, Ryu IH, Lee G, Kim JK, Lee IS, Jeon GH, Song H, Kamiya K, Yoo TK. Development of a Web-Based Ensemble Machine Learning Application to Select the Optimal Size of Posterior Chamber Phakic Intraocular Lens. Transl Vis Sci Technol 2021; 10:5. [PMID: 34111253 PMCID: PMC8107636 DOI: 10.1167/tvst.10.6.5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Purpose Selecting the optimal lens size by predicting the postoperative vault can reduce complications after implantation of an implantable collamer lens with a central-hole (ICL with KS-aquaport). We built a web-based machine learning application that incorporated clinical measurements to predict the postoperative ICL vault and select the optimal ICL size. Methods We applied the stacking ensemble technique based on eXtreme Gradient Boosting (XGBoost) and a light gradient boosting machine to pre-operative ocular data from two eye centers to predict the postoperative vault. We assigned the Korean patient data to a training (N = 2756 eyes) and internal validation (N = 693 eyes) datasets (prospective validation). Japanese patient data (N = 290 eyes) were used as an independent external dataset from different centers to validate the model. Results We developed an ensemble model that showed statistically better performance with a lower mean absolute error for ICL vault prediction (106.88 µm and 143.69 µm in the internal and external validation, respectively) than the other machine learning techniques and the classic ICL sizing methods did when applied to both validation datasets. Considering the lens size selection accuracy, our proposed method showed the best performance for both reference datasets (75.9% and 67.4% in the internal and external validation, respectively). Conclusions Applying the ensemble approach to a large dataset of patients who underwent ICL implantation resulted in a more accurate prediction of vault size and selection of the optimal ICL size. Translational Relevance We developed a web-based application for ICL sizing to facilitate the use of machine learning calculators for clinicians.
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Affiliation(s)
| | - Ik Hee Ryu
- B&VIIT Eye Center, Seoul, South Korea.,VISUWORKS, Seoul, South Korea
| | | | - Jin Kuk Kim
- B&VIIT Eye Center, Seoul, South Korea.,VISUWORKS, Seoul, South Korea
| | | | - Ga Hee Jeon
- B&VIIT Eye Center, Seoul, South Korea.,VISUWORKS, Seoul, South Korea
| | - Hojin Song
- B&VIIT Eye Center, Seoul, South Korea.,VISUWORKS, Seoul, South Korea
| | - Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Tae Keun Yoo
- B&VIIT Eye Center, Seoul, South Korea.,Department of Ophthalmology, Aerospace Medical Center, Republic of Korea Air Force, Cheongju, South Korea
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Hao H, Zhao Y, Yan Q, Higashita R, Zhang J, Zhao Y, Xu Y, Li F, Zhang X, Liu J. Angle-closure assessment in anterior segment OCT images via deep learning. Med Image Anal 2021; 69:101956. [PMID: 33550010 DOI: 10.1016/j.media.2021.101956] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
Precise characterization and analysis of anterior chamber angle (ACA) are of great importance in facilitating clinical examination and diagnosis of angle-closure disease. Currently, the gold standard for diagnostic angle assessment is observation of ACA by gonioscopy. However, gonioscopy requires direct contact between the gonioscope and patients' eye, which is uncomfortable for patients and may deform the ACA, leading to false results. To this end, in this paper, we explore a potential way for grading ACAs into open-, appositional- and synechial angles by Anterior Segment Optical Coherence Tomography (AS-OCT), rather than the conventional gonioscopic examination. The proposed classification schema can be beneficial to clinicians who seek to better understand the progression of the spectrum of angle-closure disease types, so as to further assist the assessment and required treatment at different stages of angle-closure disease. To be more specific, we first use an image alignment method to generate sequences of AS-OCT images. The ACA region is then localized automatically by segmenting an important biomarker - the iris - as this is a primary structural cue in identifying angle-closure disease. Finally, the AS-OCT images acquired in both dark and bright illumination conditions are fed into our Multi-Sequence Deep Network (MSDN) architecture, in which a convolutional neural network (CNN) module is applied to extract feature representations, and a novel ConvLSTM-TC module is employed to study the spatial state of these representations. In addition, a novel time-weighted cross-entropy loss (TC) is proposed to optimize the output of the ConvLSTM, and the extracted features are further aggregated for the purposes of classification. The proposed method is evaluated across 66 eyes, which include 1584 AS-OCT sequences, and a total of 16,896 images. The experimental results show that the proposed method outperforms existing state-of-the-art methods in applicability, effectiveness, and accuracy.
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Affiliation(s)
- Huaying Hao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China
| | - Yitian Zhao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China.
| | - Qifeng Yan
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China
| | - Risa Higashita
- Tomey Corporation, Nagoya, Japan; Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Jiong Zhang
- Laboratory of Neuro Imaging (LONI), Keck School of Medicine, University of SouthernCalifornia, Los Angeles, USA
| | - Yifan Zhao
- School of Aerospace, Transport and Manufacturing, Cranfield University, Bedford, UK
| | - Yanwu Xu
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China
| | - Fei Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China
| | - Jiang Liu
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China; Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, China; Glaucoma Artificial Intelligence Diagnosis and Imaging Analysis Joint Research Lab, Guangzhou & Ningbo, China.
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8
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Ziaul YH, Mahale A, Varghese S, Khanam F, AlFutaise M, Ahad MA, Edward DP, Khandekar RB. The Iris Thickness in a Healthy Saudi Population. Cureus 2021; 13:e12521. [PMID: 33564525 PMCID: PMC7863027 DOI: 10.7759/cureus.12521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Iris thickness (IT), a known risk factor for angle closure glaucoma, has not been evaluated in the normal Saudi population. Methods Quantitative information on IT was evaluated in healthy Saudi eyes using anterior segment optical coherence tomography (ASOCT). IT and iris volume was measured with the room ‘light on’ (LON) and ‘light off’ (LOFF) using Image J software. IT in the nasal and temporal iris was measured at 500 µm (IT500) and 750 µm (IT750) from the scleral spur (SS). Differences in IT measurements by age, gender and type of refractive error were evaluated. Results We included 100 eyes of 50 healthy adult Saudis without ocular disease other than refractive errors. The mean age of 56 males and 44 females in the study group was 41.7 ± 14.5 years. The refractive status was as follows: emmetropia (35 eyes), mild/moderate myopia (33 eyes), high myopia (17 eyes) and hyperopia (15 eyes). The IT750 with LON was significantly more than IT500 both nasally (P = 0.03) and temporally (P < 0.001). The difference in IT750 and IT500 with LOFF was significantly more nasally (P = 0.03), temporally (P = 0.02), and with LON nasally (P = 0.005). IT was thicker in males when compared to females and variation of IT by refractive error was significant but not by age. The mean pupil diameter and anterior chamber depth decreased with age (P < 0.001). Anterior chamber width was not affected by age or illumination. Conclusion The baseline iris thickness in the Saudi eyes could be used to compare iris thickness in eyes with angle closure glaucoma among the Arab population.
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Affiliation(s)
- Yasir H Ziaul
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Alka Mahale
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Sejo Varghese
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Farheen Khanam
- Research, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | | | - Muhammad A Ahad
- Anterior Segment, King Khaled Eye Specialist Hospital, Riyadh, SAU
| | - Deepak P Edward
- Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, USA
| | - Rajiv B Khandekar
- Epidemiology and Public Health, King Khalid Eye Specialist Hospital, Riyadh, SAU
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Comparative Study of the Effects of 1% Atropine on the Anterior Segment. J Ophthalmol 2020; 2020:5125243. [PMID: 33062312 PMCID: PMC7539084 DOI: 10.1155/2020/5125243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/15/2020] [Accepted: 07/21/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose To investigate the influences of atropine on changes in anterior segment geometry, as measured by ultrasound biomicroscopy in children. Methods A prospective observational study was performed. Anterior segment parameters were obtained by UBM before and after the instillation of 1% atropine. Univariate linear regression was performed to identify the variables contributing to the changes in the trabecular meshwork-iris angle (TIA). Results The study included 21 boys and 37 girls with a mean age of 10.79 ± 2.53 years. Anterior chamber parameters including the central anterior chamber depth, TIA, angle opening distance at 500 μm from the scleral spur, iris thickness 750 μm and 1500 μm from the scleral spur, trabecular-ciliary angle (TCA), trabecular-ciliary process distance, sclera-iris angle (SIA), and sclera-ciliary process angle significantly increased after cycloplegia (P < 0.05). In contrast, the lens vault, iris cross-sectional area, and maximum ciliary muscle thickness significantly decreased after cycloplegia. Univariate analysis identified the change in TCA and the change in SIA and the TIA before mydriasis as determinants of the change in TIA. Conclusions Atropine causes statistically significant changes in various anterior segment parameters in children. The change in anterior chamber angle is associated with the change in TCA and the change in SIA and the TIA before mydriasis.
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10
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Descemet Membrane Endothelial Keratoplasty in Asian Eyes. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Voronin GV, Petrov SY, Volzhanin AV, El-Sangahawi AA, Avetisov KS. [Iris shape change and risk of anterior chamber angle closure]. Vestn Oftalmol 2020; 136:93-98. [PMID: 32366076 DOI: 10.17116/oftalma202013602193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Potential obstruction of the anterior chamber angle by iris root is a key factor of the pathogenesis of angle-closure glaucoma. Development and adoption of ultrasound biomicroscopy and optical coherence tomography in clinical practice have significantly expanded the capabilities of studying the structures of the anterior eye segment in terms of angle closure risk factors through improving visualization depth and quality of examination, including different variants of iris structure and potential changes of its shape in mydriasis. The article reviews various studies dedicated to the progression of primary angle-closure glaucoma and its dependence on the biometric parameters of the eye and changes in pupil size.
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Affiliation(s)
- G V Voronin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Research Institute of Eye Diseases, Moscow, Russia
| | - S Yu Petrov
- Research Institute of Eye Diseases, Moscow, Russia
| | | | - A A El-Sangahawi
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - K S Avetisov
- Research Institute of Eye Diseases, Moscow, Russia
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12
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Wang SB, Cornish EE, Grigg JR, McCluskey PJ. Anterior segment optical coherence tomography and its clinical applications. Clin Exp Optom 2019; 102:195-207. [PMID: 30635934 DOI: 10.1111/cxo.12869] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/05/2018] [Accepted: 11/29/2018] [Indexed: 11/29/2022] Open
Abstract
Anterior segment optical coherence tomography (AS-OCT) has become one of the cornerstones of non-contact imaging modalities for assessing such structures as the cornea, anterior chamber angle, aqueous outflow pathway, sclera, and ocular surface structures. As such, it has a broad range of clinical applications, which have been independently reported in the literature. This paper aims to present a review of extant literature on the utility of AS-OCT and its efficacy in clinical applications, and to evaluate the quality of available evidence. The following databases were searched from inception to 24 June 2018: Medline via Ovid, Cochrane Central Register of Controlled Trials, PubMed, World Health Organization International Clinical Trials Registry Platform, EMBASE, and CINAHL. Bibliographies of identified papers were hand searched. Inclusion criteria: articles describing or assessing the use of OCT for visualising the AS. The authors excluded studies without an identified primary outcome variable. One author independently selected studies, extracted data, and assessed for risk of bias using PRISMA guidelines. This review included 82 studies, of which there were 11 cohort studies, 37 case series, 10 case studies, 21 comparative observational studies, and three non-systematic review articles. Primary outcome variables included anterior chamber angle, angle opening distance, angle recess area, trabecular iris angle, trabecula-iris space area, corneal thickness, tear meniscus height, tear meniscus area, tear meniscus volume, and the morphology of AS structures, including the ocular surface, blebs, flaps, and graft sites. This review attempts to encompass the breadth and depth of evidence for AS-OCT in the arena of diagnostics, therapeutics, and prognostics. At the same time, it brings to light the dearth of high-level evidence on this topic, suggesting the important role of randomised controlled trials and meta-analyses for the future validation of this technology.
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Affiliation(s)
- Sarah B Wang
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Elisa E Cornish
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney Eye Hospital, Sydney, New South Wales, Australia.,Sydney Eye Hospital Foundation, Sydney Eye Hospital, Sydney, New South Wales, Australia.,Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - John R Grigg
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney Eye Hospital, Sydney, New South Wales, Australia
| | - Peter J McCluskey
- Faculty of Medicine and Health, Save Sight Institute, The University of Sydney, Sydney Eye Hospital, Sydney, New South Wales, Australia
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Dastiridou A, Marion K, Niemeyer M, Francis B, Sadda S, Chopra V. Pilot Study of the Effects of Ambient Light Level Variation on Spectral Domain Anterior Segment OCT-Derived Angle Metrics in Caucasians versus Asians. Curr Eye Res 2018; 43:955-959. [PMID: 29641953 DOI: 10.1080/02713683.2018.1464192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the effects of ambient light level variation on spectral domain anterior segment optical coherence tomography (SD-ΟCT)-derived anterior chamber angle metrics in Caucasians versus Asians. MATERIALS AND METHODS Caucasian (n = 24) and Asian participants of Chinese ancestry (n = 24) with open angles on gonioscopy had one eye imaged twice at five strictly controlled, ambient light levels. Ethnicity was self-reported. Light levels were strictly controlled using a light meter at 1.0, 0.75, 0.5, 0.25, and 0 foot candle illumination levels. SD-OCT 5-line raster scans at the inferior 270° irido-corneal angle were measured by two trained, masked graders from the Doheny Image Reading Center using customized Image-J software. Schwalbe's line-angle opening distance (SL-AOD) and SL-trabecular iris space area (SL-TISA) in different light meter readings (LMRs) between the two groups were compared. RESULTS Baseline light SL-AOD and SL-TISA measured 0.464 ± 0.115mm/0.351 ± 0.110mm2 and 0.344 ± 0.118mm/0.257 ± 0.092mm2, respectively, in the Caucasian and the Asian group. SL-AOD and SL-TISA in each LMR were significantly larger in the Caucasian group compared to the Asian group (p < 0.05). Despite this difference in angle size between the groups, there were no statistically significant differences in the degree of change in angle parameters from light to dark (% changes in SL-AOD or SL-TISA between the two groups were statistically similar with all p-values >0.3). CONCLUSION SL-based angle dimensions using SD-OCT are sensitive to changes in ambient illumination in participants with Caucasian and Asian ancestry. Although Caucasian eyes had larger baseline angle opening under bright light conditions, the light-to-dark change in angle dimensions was similar in the two groups.
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Affiliation(s)
- Anna Dastiridou
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA
| | - Kenneth Marion
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA
| | - Moritz Niemeyer
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA
| | - Brian Francis
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA.,b Department of Ophthalmology , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - Srinivas Sadda
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA.,b Department of Ophthalmology , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - Vikas Chopra
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA.,b Department of Ophthalmology , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
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Lin J, Wang Z, Chung C, Xu J, Dai M, Huang J. Dynamic changes of anterior segment in patients with different stages of primary angle-closure in both eyes and normal subjects. PLoS One 2017; 12:e0177769. [PMID: 28542344 PMCID: PMC5436810 DOI: 10.1371/journal.pone.0177769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 05/03/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare changes in anterior segment parameters under light and dark (light-to-dark) conditions among eyes with chronic primary angle-closure glaucoma (CPACG), fellow eyes with confirmed or suspect primary angle-closure (PAC or PACS), and age-matched healthy eyes. Methods Consecutive patients with CPACG in one eye and PAC/PACS in the fellow eye, as well as age-matched healthy subjects were recruited. Anterior segment optical coherence tomography measurements were conducted under light and dark conditions, and anterior chamber, lens, and iris parameters compared. Demographic and biometric factors associated with light-to-dark change in iris area were analyzed by linear regression. Results Fifty-seven patients (mean age 59.6±8.9 years) and 30 normal subjects matched for age (60.6±9.3 years) and sex ratio were recruited. In regards to differences under light–to-dark conditions, angle opening distance at 500 μm (AOD500μm) and iris area during light-to-dark transition were smaller in CPACG eyes than fellow PACS/PAC eyes and normal eyes (P<0.017). Pupil diameter change was largest in normal eyes, and larger in PACS/PAC eyes than CPACG eyes (P<0.017). There was an average reduction of 0.145 mm2 in iris area for each millimeter of pupil diameter increase in CPACG eyes, 0.161 mm2 in fellow PAC/PACS eyes, and 0.165 mm2 in normal eyes. Larger iris curvature in the dark and diagnosis of PACG were significantly associated with less light-to-dark iris area changes. Conclusions Dynamic changes in iris parameters with light-to-dark transition differed significantly among CPACG eyes, fellow PAC/PACS eyes, and normal eyes. Greater iris curvature under dark conditions was correlated with reduced light-to-dark change in iris area and pupil diameter, which may contribute to disease progression.
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Affiliation(s)
- Jialiu Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhonghao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chuchen Chung
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jianan Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Miaomiao Dai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jingjing Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- * E-mail:
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DYNAMIC CHANGES OF THE ANTERIOR CHAMBER ANGLE PRODUCED BY INTRAVITREAL ANTI-VASCULAR GROWTH FACTOR INJECTIONS. Retina 2016; 36:1874-81. [DOI: 10.1097/iae.0000000000001018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Comparison of Mydriatic Provocative and Dark Room Prone Provocative Tests for Anterior Chamber Angle Configuration. J Glaucoma 2016; 25:482-6. [DOI: 10.1097/ijg.0000000000000310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Prakash G, Srivastava D. Single session, intrauser repeatability of anterior chamber biometric and corneal pachy-volumetric parameters using a new Scheimpflug+Placido device. JOURNAL OF OPTOMETRY 2016; 9:85-92. [PMID: 26338543 PMCID: PMC4812002 DOI: 10.1016/j.optom.2015.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/23/2015] [Indexed: 05/13/2023]
Abstract
PURPOSE To analyze single session, intrauser reliability of a Scheimpflug device for anterior chamber (AC) and corneal parameters. METHODS In this observational study, 100 normal candidates underwent Scheimpflug analysis with Sirius 3D Rotating Scheimpflug Camera and Topography System (Costruzione Strumenti Oftalmici, Italy). Two scans in dark room conditions were performed by the same experienced user. The candidates were asked to keep both eyes closed for 5min before the scans. Exclusion criteria were previous ocular surgery, corneal scarring and anterior segment/posterior segment anomalies. Only the right eyes were used for the analysis. Both corneal (central, minimum, and apical thickness, volume, horizontal visible iris diameter, and apical curvature) and anterior chamber (volume, depth, angle, horizontal diameter) measurements were evaluated. RESULTS There was no difference in the means of repeated measurements (p>0.05, ANOVA). Intraclass correlations between the measures were high and ranged from 0.995-0.997 for corneal to 0.964-0.997 for anterior chamber (AC) parameters. The precision of repeatability measures (1.96×Sw) was approximately 5μ for the central and minimum corneal thickness, 8μ for the apical corneal thickness, 0.06mm for AC (anterior chamber) depth and less than 2° for the AC angle. CONCLUSIONS Sirius Scheimpflug system has high repeatability for both corneal and AC parameters in normal eyes.
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Affiliation(s)
- Gaurav Prakash
- Department of Cornea and Refractive Surgery, NMC Eye Care, New Medical Center Specialty Hospital, Abu Dhabi, United Arab Emirates.
| | - Dhruv Srivastava
- Department of Cornea and Refractive Surgery, NMC Eye Care, New Medical Center Specialty Hospital, Abu Dhabi, United Arab Emirates
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Guo JM, Li M, Xu XL, Zhang H, Wang JM. Anterior segment changes after pharmacologic mydriasis using Pentacam and optical coherence tomography in angle closure suspects. Int J Ophthalmol 2015; 8:980-4. [PMID: 26558213 DOI: 10.3980/j.issn.2222-3959.2015.05.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 12/23/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To compare the dynamic changes of anterior segment parameters especially iris morphology induced by pharmacologic mydriasis between angle closure suspects and normal controls. METHODS The study group comprised 19 eyes of 19 angle closure suspects and 19 eyes of 19 age- and sex-matched normal open-angle eyes. Pentacam and optical coherence tomography measurements before and 30min after instillation of compound tropicamide eye drop were performed and compared. Biometric evaluations of iris tomography and anterior chamber angle were estimated by a customized image-processing software. RESULTS Baseline axial length, iris cross sectional area and volume did not differ significantly between angle closure suspects and normal controls. Angle closure suspects had smaller pupil size, narrower anterior segment dimension and axial length, thinner iris with greater curve in comparison with normal controls. Pharmacologic mydriasis led to significant increments in iris thickness at 750 µm, anterior chamber depth and volume, whereas significant decrements in iris curve, cross sectional area and volume in both groups. Angle opening distance at 500 µm was increased significantly in normal controls (from 0.465±0.115 mm to 0.539±0.167 mm, P=0.009), but not in angle closure suspects (from 0.125±0.100 mm to 0.145±0.131 mm, P=0.326). Iris volume change per millimeter of pupil dilation (ΔIV/ΔPD) decreased significantly less in angle closure suspects than normal controls (-2.47±1.33 mm(2) vs -3.63±1.58 mm(2), P=0.019). Linear regression analysis showed that the change of angle opening distance at 500 µm was associated most with the change of central anterior chamber depth (β=0.841, P=0.002) and ΔIV/ΔPD (β=0.028, P=0.002), followed by gender (β=0.062, P=0.032). CONCLUSION Smaller iris volume decrement per millimeter of pupil dilation is related significantly with the less anterior angle opening in angle closure suspects after pharmacologic mydriasis. Dynamic iris change may be as a prospective indicator of iris compressibility and angle closure glaucoma.
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Affiliation(s)
- Jing-Min Guo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
| | - Mu Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
| | - Xiao-Lan Xu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
| | - Hong Zhang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
| | - Jun-Ming Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
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Comparison of Physiologic versus Pharmacologic Mydriasis on Anterior Chamber Angle Measurements Using Spectral Domain Optical Coherence Tomography. J Ophthalmol 2015; 2015:845643. [PMID: 25878896 PMCID: PMC4386293 DOI: 10.1155/2015/845643] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To compare the effects of physiologic versus pharmacologic pupil dilation on anterior chamber angle (ACA) measurements obtained with spectral domain optical coherence tomography (SD-OCT). Methods. Forty eyes from 20 healthy, phakic individuals with open angles underwent anterior segment OCT imaging under 3 pupillary states: (1) pupil constricted under standard room lighting, (2) physiologic mydriasis in a darkened room, and (3) postpharmacologic mydriasis. Inferior angle Schwalbe's line-angle opening distance (SL-AOD) and SL-trabecular-iris-space area (SL-TISA) were computed for each eye and pupillary condition by masked, certified Reading Center graders using customized grading software. Results. SL-AOD and SL-TISA under pupillary constriction to room light were 0.87 ± 0.31 mm and 0.33 ± 0.14 mm(2), respectively; decreased to 0.75 ± 0.29 mm (P < 0.01) and 0.29 ± 0.13 mm(2) (P < 0.01), respectively, under physiologic mydriasis; and increased to 0.90 ± 0.38 mm (P < 0.01) and 0.34 ± 0.17 mm(2) (P = 0.06) under pharmacologic mydriasis compared to baseline. Conclusions. Using SD-OCT imaging, pharmacologic mydriasis yielded the widest angle opening, whereas physiologic mydriasis yielded the most angle narrowing in normal individuals with open iridocorneal angles. Accounting for the state of the pupil and standardizing the lighting condition would appear to be of importance for future studies of the angle.
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Association between baseline iris thickness and prophylactic laser peripheral iridotomy outcomes in primary angle-closure suspects. Ophthalmology 2014; 121:1194-202. [PMID: 24534754 DOI: 10.1016/j.ophtha.2013.12.027] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 12/13/2013] [Accepted: 12/13/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the association between baseline measurements of iris thickness at 3 positions and change in anterior segment biometric parameters after prophylactic laser peripheral iridotomy (LPI). DESIGN Prospective clinical cohort study. PARTICIPANTS Fifty-two eyes of 52 nonglaucomatous subjects with anatomically narrow angles. METHODS Anterior segment optical coherence tomography (ASOCT) images captured before and after LPI were analyzed using customized software, the Zhongshan Angle Assessment Program (ZAAP) (Zhongshan Ophthalmic Centre, Guangzhou, China). Differences in preoperative and postoperative measurements for anterior segment biometric parameters were compared by paired Student t tests. Multivariate linear regression models, adjusted for age, sex, ethnicity, and preoperative pupil diameter, were used to examine the association between the baseline measurements of iris thickness at 3 positions and the change in anterior segment biometric parameters after LPI. MAIN OUTCOME MEASURES Baseline iris thickness measured at 750 μm from the scleral spur (IT750), iris thickness measured at 2000 μm from the scleral spur (IT2000), and maximal iris thickness (ITM). Changes in iris curvature (ICURV) and trabecular-iris space area at 500 μm from the scleral spur (TISA500) and 750 μm from the scleral spur (TISA750) after LPI. RESULTS The ICURV significantly decreased, whereas TISA500 and TISA750 significantly increased after LPI (all P < 0.0001). Lower baseline IT750 was significantly associated with greater postoperative increases in TISA500 and TISA750 (both P < 0.05). Lower baseline IT2000 and ITM were significantly associated with greater postoperative decrease in ICURV (both P < 0.05). CONCLUSIONS Our results showed that lower baseline measurements of iris thickness are associated with greater decrease in ICURV and increases in TISA500 and TISA750 after LPI. This suggests that eyes with thinner irides undergoing LPI were more likely to exhibit greater magnitude of change in terms of flattening of the iris convexity (i.e., ICURV) and widening of the anterior chamber angle (i.e., TISA500 and TISA750).
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Maruyama Y, Mori K, Ikeda Y, Ueno M, Kinoshita S. Morphological analysis of age-related iridocorneal angle changes in normal and glaucomatous cases using anterior segment optical coherence tomography. Clin Ophthalmol 2013; 8:113-8. [PMID: 24379654 PMCID: PMC3873234 DOI: 10.2147/opth.s52370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To analyze age-related morphological changes of the iridocorneal angle in normal subjects and glaucomatous cases, using anterior segment optical coherence tomography (AS-OCT). METHODS This study involved 58 eyes of 58 open-angle glaucoma cases and 72 eyes of 72 age-matched normal-open-angle control subjects. Iridocorneal angle structures in nasal and temporal regions and anterior chamber depth (ACD) were measured using AS-OCT. Axial length and refractive error were measured by use of an ocular biometer and auto refractor keratometer. Angle opening distance (AOD), angle recess area (ARA), and trabecular-iris space area (TISA), measured at 500 μm (TISA500) and 750 μm (TISA750) distant from the scleral spur, were calculated, in the nasal and temporal regions. A new index, the peripheral angle frame index (PAFI), which represents the peripheral angle structure, was proposed, and was defined as (TISA750-TISA500)/TISA500. RESULTS Refractive power in the glaucoma cases was less than in control cases (P<0.0001). Axial length (P<0.0001) and ACD (P=0.0004) were longer and deeper, respectively, in the glaucoma cases, compared with the control cases. In both control and glaucoma groups, ACD, AOD, ARA, and TISA decreased linearly in an age-dependent manner, while PAFI stayed at relatively constant values throughout the age distribution. AOD in the glaucoma group was longer than in the control group, in both the temporal and nasal regions; ARA and TISA were larger in the glaucoma than in the control group. However, no significant differences in nasal or temporal PAFI were found between the glaucoma and control groups. CONCLUSION The findings of this study show that AS-OCT is useful for the quantitative evaluation of age-related changes in peripheral angle structure in glaucoma and control cases.
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Affiliation(s)
- Yuko Maruyama
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuhiko Mori
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoko Ikeda
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Morio Ueno
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shigeru Kinoshita
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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