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Topcu H, Altan C, Ahmet S, Basarir B, Alagoz N, Pasaoglu IB, Solmaz B. Comparison of corneal, endothelial, and anterior segment parameters in eyes with and without pigment dispersion. Photodiagnosis Photodyn Ther 2022; 40:103161. [PMID: 36244679 DOI: 10.1016/j.pdpdt.2022.103161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/01/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND To evaluate the differences of central corneal thickness (CCT), corneal endothelial cell morphology, and biometric parameters of the anterior chamber and iridocorneal angle in pigment dispersion syndrome (PDS), pigmentary glaucoma (PG), primary open-angle glaucoma (POAG), and healthy group. METHODS Twenty- three eyes in the PDS group, 39 eyes in the PG group, 33 eyes in the POAG group, and 45 eyes in the healthy control group were included in this cross-sectional retrospective study. Corneal endothelial cell density, the coefficient of variation in the cell area, hexagonality, and central corneal thickness (CCT) were obtained by specular microscopy (CEM 530, NIDEK, Japan). Anterior chamber depth (ACD), iridocorneal angle parameters and CCT were measured by anterior segment optical coherence tomography (AS-OCT) (Visante OCT, Carl Zeiss AG, Germany). RESULTS The mean CCT via specular microscopy (SM-CCT) was measured at the thinnest value in the PG group (531.20 ± 34.91 µm) and the thickest in the control group (569.13 ± 37.52 µm). CV value was higher in PG (34.65 ± 6.84) and POAG group (34.27 ± 9.93) and lower in control group (28.82 ± 5.18) (p = 0,005). The mean AS-OCT-CCT was the thinnest in the PG group (513.61 ± 39.94 µm), and the thickest in the control group (547.04 ± 36.72 µm) (p = 0.001). All parameters of the iridocorneal angle were larger in the PDS and PG groups (p < 0.001). In the correlation analysis of the glaucomatous eyes, a negative correlation between the C/D ratio and SM-CCT and AS-OCT-CCT (p = 0.037, p = 0.017, respectively) and a positive correlation between the pRNFL thickness and AS-OCT- CCT (p = 0.002). CONCLUSION CCT values obtained with both SM and AS-OCT were found to be significantly thinner in PG cases. CV, which is the measure of polymegatism, was found to be significantly higher in PG cases.
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Affiliation(s)
- Husna Topcu
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey.
| | - Cigdem Altan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey
| | - Sibel Ahmet
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey
| | - Berna Basarir
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey
| | - Nese Alagoz
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey
| | - Isil Basgil Pasaoglu
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey
| | - Banu Solmaz
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Beyoglu, Istanbul, Turkey
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Liu F, Lin D, Zheng C, Wang G. Comparison of iridolenticular contact area under different light brightness between post primary acute angle closure and cataract eyes. BMC Ophthalmol 2022; 22:113. [PMID: 35277133 PMCID: PMC8917619 DOI: 10.1186/s12886-022-02341-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To study the iridolenticular contact area (ILCA) under different light conditions in acute primary angle closure (APAC).
Methods
This cross-sectional, observational study involved 22 unilateral APAC patients and 59 cataract patients (59 eyes). Images of the APAC eyes, fellow eyes and cataract eyes were collected by anterior segment optical coherence tomography (ASOCT) under different light conditions respectively. The ILCA, anterior chamber width (ACW), anterior chamber area (ACA), lens vault (LV), angle opening distance at 750 μm (AOD750), trabecular iris space area at 750 μm (TISA750) and iris area at 750 μm (IA750) were measured using Image J software.
Results
The ILCA of cataract eyes were significantly larger than APAC eyes (4.424 ± 1.208 vs 4.049 ± 2.725mm2, P = 0.034) and fellow eyes (4.424 ± 1.208 vs 3.651 ± 1.629 mm2, P = 0.008) under dark condition. Under dark condition, ILCA of APAC eyes was negatively correlated with AOD750 (r = -0.444, P = 0.038), TISA750 (r = -0.498, P = 0.018). The ILCA of cataract eyes under dark condition was significantly greater than under bright condition (4.424 ± 1.208 vs 2.526 ± 0.992 mm2, P < 0.001).
Conclusions
This study showed that ILCA in both APAC eye and fellow eye were smaller than cataract eye. Future study should focus on both the contact area and force at the interface of lens and iris with larger sample size.
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Affiliation(s)
- Fuyao Liu
- Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Dongxia Road, Shantou, Guangdong Province, The People’s Republic of China
| | | | | | - Geng Wang
- Joint Shantou International Eye Center, Shantou University and The Chinese University of Hong Kong, Dongxia Road, Shantou, Guangdong Province, The People’s Republic of China
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The Effectiveness of Laser Peripheral Iridotomy in Adolescent Eyes with Ocular Hypertension and Concave Configuration of the Peripheral Iris. J Ophthalmol 2022; 2022:4068026. [PMID: 35265367 PMCID: PMC8901309 DOI: 10.1155/2022/4068026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the efficacy of laser peripheral iridotomy (LPI) in preventing deterioration in eyes with ocular hypertension (OHT) and concave configuration of the iris. Materials and Methods This was a retrospective study, which was carried out within a period of 3–5 years. Twenty-four patients with OHT and concave irises were treated with LPI and followed up periodically. IOP, central corneal thickness (CCT), anterior chamber depth (ACD), scleral spur angle (SSA), global neuroretinal rim (NRR) thickness, and global retinal nerve fiber layer (RNFL) were examined before and after LPI. Results The average age of the 24 patients was 14.21 ± 1.41 (13–17.5) years on admission. The initial IOP of the 48 eyes was 23.21 ± 1.56 mmHg in RE and 22.96 ± 2.1 mmHg in LE before LPI. All 48 eyes had concave irises in both eyes. All eyes treated with LPI have shown iris flattening, which has persisted during follow-up (mean 1.54 ± 0.9 years). At the last follow-up visit, the average IOP was 17.58 ± 2.63 (14–21) mmHg in RE and 17.58 ± 2.86 (14–21) mmHg in LE, which was statistically lower than that of the baseline (p < 0.001). There were significant changes in SSA in both eyes and global RNFL in RE after LPI. Conclusions In the current study, LPI resulted in an IOP-lowering effect and iris flattening in adolescent eyes with a concave configuration of the peripheral iris.
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Lippera M, Nicolosi C, Vannozzi L, Bacherini D, Vicini G, Rizzo S, Virgili G, Giansanti F. The role of anterior segment optical coherence tomography in uveitis-glaucoma-hyphema syndrome. Eur J Ophthalmol 2021; 32:2211-2218. [PMID: 34841924 DOI: 10.1177/11206721211063738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe features of uveitis-glaucoma-hyphema (UGH) syndrome, using Anterior Segment-Optical Coherence Tomography (AS-OCT) and Ultrasound Biomicroscopy (UBM) and to evaluate the diagnostic role of AS-OCT as an imaging technique alternative to UBM. DESIGN Retrospective case series. METHODS Four eyes of 4 patients with UGH syndrome were analyzed. All patients reported previous uncomplicated cataract surgery with in-the-bag implantation of single-piece-intraocular lens (IOL). They underwent at presentation complete ophthalmological examination and imaging with slit-lamp anterior segment photographs, UBM and AS-OCT. RESULTS Although AS-OCT did not allow to visualize the structures behind the iris, it displayed a contact between IOL (plate and/or haptics) and iris and IOL tilting in 3 out of 4 eyes. AS-OCT directly detected the cause of UGH syndrome in one eye, 2 eyes required some expedients to display the iris chafing, like scans in mydriasis and/or patient's gaze direction change. AS-OCT did not allow to appreciate the IOL-iris contact (showed by UBM technique) only in one eye, probably due to the change of patient position from supine to sitting, and consequent anteriorization of iris diaphragm. Furthermore AS-OCT showed fine details, as capsular bag collapse and indirect signs of haptic malposition in 3 out of 4 eyes. CONCLUSION AS-OCT is a non-invasive technique that allows to determine IOL position and IOL-uveal contact in selected cases of UGH syndrome. Considering AS-OCT and UBM advantages and limitations, AS-OCT should be used as first imaging modality when clinical diagnosis is uncertain. When UGH diagnosis cannot be verified using AS-OCT, UBM should be performed.
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Affiliation(s)
- Myrta Lippera
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Cristina Nicolosi
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Lorenzo Vannozzi
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Daniela Bacherini
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Giulio Vicini
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Stanislao Rizzo
- Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Pisa, Italy
| | - Gianni Virgili
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
- 9300University of Florence, Department of Neurosciences, Psychology, Drug Research and Child Health, Florence, Italy
| | - Fabrizio Giansanti
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
- 9300University of Florence, Department of Neurosciences, Psychology, Drug Research and Child Health, Florence, Italy
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Wang J, Rattner A, Nathans J. A transcriptome atlas of the mouse iris at single-cell resolution defines cell types and the genomic response to pupil dilation. eLife 2021; 10:e73477. [PMID: 34783308 PMCID: PMC8594943 DOI: 10.7554/elife.73477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/25/2021] [Indexed: 01/02/2023] Open
Abstract
The iris controls the level of retinal illumination by controlling pupil diameter. It is a site of diverse ophthalmologic diseases and it is a potential source of cells for ocular auto-transplantation. The present study provides foundational data on the mouse iris based on single nucleus RNA sequencing. More specifically, this work has (1) defined all of the major cell types in the mouse iris and ciliary body, (2) led to the discovery of two types of iris stromal cells and two types of iris sphincter cells, (3) revealed the differences in cell type-specific transcriptomes in the resting vs. dilated states, and (4) identified and validated antibody and in situ hybridization probes that can be used to visualize the major iris cell types. By immunostaining for specific iris cell types, we have observed and quantified distortions in nuclear morphology associated with iris dilation and clarified the neural crest contribution to the iris by showing that Wnt1-Cre-expressing progenitors contribute to nearly all iris cell types, whereas Sox10-Cre-expressing progenitors contribute only to stromal cells. This work should be useful as a point of reference for investigations of iris development, disease, and pharmacology, for the isolation and propagation of defined iris cell types, and for iris cell engineering and transplantation.
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Affiliation(s)
- Jie Wang
- Department of Molecular Biology and Genetics, Johns Hopkins University School of MedicineBaltimoreUnited States
- Howard Hughes Medical Institute, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Amir Rattner
- Department of Molecular Biology and Genetics, Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Jeremy Nathans
- Department of Molecular Biology and Genetics, Johns Hopkins University School of MedicineBaltimoreUnited States
- Howard Hughes Medical Institute, Johns Hopkins University School of MedicineBaltimoreUnited States
- Department of Neuroscience, Johns Hopkins University School of MedicineBaltimoreUnited States
- Department of Ophthalmology, Johns Hopkins University School of MedicineBaltimoreUnited States
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Pigment dispersion syndrome and its implications for glaucoma. Surv Ophthalmol 2021; 66:743-760. [PMID: 33444629 DOI: 10.1016/j.survophthal.2021.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022]
Abstract
Pigment dispersion syndrome (PDS) represents a clinical spectrum of a relatively common and usually underdiagnosed phenomenon produced by spontaneous pigment dispersion from the iris into the anterior segment. PDS is often bilateral, has no gender predisposition, and presents at a young age, particularly in myopes. Although most patients experiencing an episode of pigment dispersion are asymptomatic, extreme photophobia, ocular pain, redness, and blurred vision may occur. Other characteristic signs are iridolenticular contact, concave iris configuration, 360° peripheral iris transillumination, and pigment deposition on the anterior chamber angle or the corneal endothelium (Krukenberg spindle). Early PDS diagnosis is crucial to detect patients with pigment-related ocular hypertension (POHT) that can eventually lead to pigmentary glaucoma (PG). The latter represents a sight-threatening condition in which mechanical, environmental, and genetic factors contribute to optic nerve damage. In this review, we update the pathogenic mechanisms involved in the clinical spectrum of the disease. We describe its clinical presentation, ophthalmologic manifestations, and complications, including the factors influencing the development of POHT and PG. Because PDS has variable clinical presentations that lead to misdiagnoses, we emphasize the differential diagnosis and the actual therapeutic strategies according to disease status.
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Basarir B, Pasaoglu I, Altan C, Solmaz B, Aksoy FE, Tülü B, Taskapili M. Effects of Nd-YAG Laser iridotomy on anterior segment measurements in pigment dispersion syndrome and ocular hypertension. J Fr Ophtalmol 2020; 44:203-208. [PMID: 33384165 DOI: 10.1016/j.jfo.2020.04.057] [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] [Received: 02/11/2020] [Revised: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare the anterior segment optical coherence tomography (AS-OCT) measurements of eyes with pigment dispersion syndrome (PDS) and ocular hypertension (OHT) before and after neodymium:yttrium-aluminum-garnet (Nd:YAG) laser peripheral iridotomy (LPI). METHODS A total of 23 eyes of 23 patients with PDS and OHT with features of PDS were included in this retrospective study. All of the eyes with PDS and OHT were examined by AS-OCT before and after Nd:YAG LPI. Anterior chamber depth, angle opening distance 500, angle opening distance 750, trabecular iris space 500, trabecular iris space 750 and scleral spur angle, iris bowing and iris shape were measured with AS-OCT by the same examiner. RESULTS The differences in all parameters before and after Nd:YAG LPI were statistically significant. Iris configuration was concave in all eyes prior to iridotomy. After Nd:YAG laser iridotomy, the iris configuration became convex in 7 eyes, flat in 9 eyes and remained concave in 7 eyes. CONCLUSION Nd:YAG laser peripheral iridotomy is an effective method for reversing the iris concavity and iris bowing in pigment dispersion syndrome.
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Affiliation(s)
- B Basarir
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - I Pasaoglu
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
| | - C Altan
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - B Solmaz
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - F E Aksoy
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - B Tülü
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - M Taskapili
- University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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Kudsieh B, Fernández-Vigo JI, Vila-Arteaga J, Urcola JA, Martínez-de-la-Casa JM, García-Feijóo J, Ruiz-Moreno JM, Fernández-Vigo JÁ. Update on the usefulness of optical coherence tomography in assessing the iridocorneal angle. ACTA ACUST UNITED AC 2019; 94:478-490. [PMID: 31371112 DOI: 10.1016/j.oftal.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
The iridocorneal angle, due to its implications in the physiopathology of aqueous humour drainage, is a fundamental structure of the anterior chamber. Anterior segment optical coherence tomography is a rapid and non-invasive technique that obtains images in vivo. The high resolution allows it to analyse the normal anatomy of the angle, any alterations, and the changes that occur after different therapeutic interventions. Anterior segment optical coherence tomography technology has evolved to provide images that allow the identification and quantification of the angular structures in healthy subjects and in glaucoma patients, and especially the trabecular meshwork and the Schlemm's canal. It also enables the angle width to be quantified, with some objective parameters that have been standardised in recent years, such as the trabecular-iris angle, the angle opening distance, and the trabecular-iris area. This technique has multiple uses in the study of the different mechanisms of angle closure, the evaluation of changes after a laser peripheral iridotomy or iridoplasty after cataract surgery, as well as after the implantation of phakic lenses.
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Affiliation(s)
- B Kudsieh
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España; Centro Internacional de Oftalmología Avanzada, Madrid, España.
| | - J I Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, España; Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J Vila-Arteaga
- Hospital La Fe, Valencia, España; Clínica Vila-Innova Ocular, Valencia, España
| | - J Aritz Urcola
- Departamento de Oftalmología, Hospital Universitario de Álava, Vitoria, España; Begitek Clínica Oftalmológica, Innova Ocular, Donostia-San Sebastián, España
| | - J M Martínez-de-la-Casa
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, España
| | - J M Ruiz-Moreno
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, España; Departamento de Oftalmología, Universidad de Extremadura, Badajoz, España
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Li M, Song Y, Zhao Y, Yan X, Zhang H. Influence of exercise on the structure of the anterior chamber of the eye. Acta Ophthalmol 2018; 96:e247-e253. [PMID: 29068522 PMCID: PMC5836894 DOI: 10.1111/aos.13564] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/19/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE To measure changes in anterior chamber structure before and after exercise in healthy individuals using anterior segment optical coherence tomography (ASOCT). METHODS Thirty-two healthy young individuals performed jogging for 20 min. Eye blinking rate was recorded during rest and exercise. The anterior chamber angle (ACA), angle opening distance at 500 μm from the scleral spur (AOD500), trabecular-iris space area at 500 μm from the scleral spur (TISA500), iris concavity (IC), iris concavity ratio (CR), iris thickness at 750 μm from the scleral spur (IT750), anterior chamber depth (ACD), anterior chamber width (ACW), pupil diameter (PD), intraocular pressure (IOP), blood pressure (BP) and heart rate (HR) were recorded before and after exercise. Anterior chamber angle (ACA), AOD500, TISA500, IC, IT750, ACD, ACW and PD were measured with ASOCT. RESULTS Compared with rest, the blinking rate during exercise did not change significantly (13.04 ± 5.80 versus 13.52 ± 5.87 blinks/min, p = 0.645). The average IOP (15.4 ± 2.4 versus 12.4 ± 2.1 mmHg), ACA (35.96 ± 11.35 versus 40.25 ± 12.64 degrees), AOD500 (0.800 ± 0.348 versus 0.942 ± 0.387 mm), TISA500 (0.308 ± 0.155 versus 0.374 ± 0.193 mm2 ), IC (-0.078 ± 0.148 versus -0.153 ± 0.159 mm) and CR (-0.027 ± 0.050 versus -0.054 ± 0.056) changed significantly (all p < 0.001), while the average IT750 (0.463 ± 0.084 versus 0.465 ± 0.086 mm; p = 0.492), ACD (3.171 ± 0.229 versus 3.175 ± 0.238 mm; p = 0.543) and ACW (11.768 ± 0.377 versus 11.755 ± 0.378 mm; p = 0.122) showed no significant change after exercise. CONCLUSION The blinking rate did not change significantly during exercise, while ACA, AOD500 and TISA500 increased after exercise. Exercise also induced or increased IC. These changes in anterior chamber structure were only associated with exercise, but not with the postexercise change in PD or IOP.
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Affiliation(s)
- Mu Li
- Department of OphthalmologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yinwei Song
- Department of OphthalmologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yin Zhao
- Department of OphthalmologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiaoqin Yan
- Department of OphthalmologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Hong Zhang
- Department of OphthalmologyTongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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Steeper Iris Conicity Is Related to a Shallower Anterior Chamber: The Gutenberg Health Study. J Ophthalmol 2017; 2017:2190347. [PMID: 29085672 PMCID: PMC5612323 DOI: 10.1155/2017/2190347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 06/14/2017] [Accepted: 07/16/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To report the distribution of iris conicity (steepness of the iris cone), investigate associated factors, and test whether pseudophakia allows the iris to sink back. METHODS A population-based cross-sectional study was carried out. Ophthalmological examination including objective refraction, biometry, noncontact tonometry, and Scheimpflug imaging (Pentacam®, Oculus) was performed including automated measurement of iris conicity. 3708 phakic subjects, 144 subjects with bilateral and 39 subjects with unilateral pseudophakia were included. Multivariable analyses were carried out to determine independently associated systemic and ocular factors for iris conicity in phakic eyes. RESULTS Mean iris conicity was 8.28° ± 3.29° (right eyes). Statistical analysis revealed associations between steeper iris conicity and shallower anterior chamber depth, thicker human lens and higher corneal power in multivariable analysis, while older age was related to a flatter iris conicity. Refraction, axial length, central corneal thickness, pupil diameter, and intraocular pressure were not associated with iris conicity. Pseudophakia resulted in a 5.82° flatter iris conicity than in the fellow phakic eyes. CONCLUSIONS Associations indicate a correlation between iris conicity with risk factors for angle-closure, namely, shallower anterior chamber depth and thicker human lens. In pseudophakic eyes, iris conicity is significantly lower, indicating that cataract surgery flattens the iris.
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Bang SP, Joo CK, Jun JH. Reverse pupillary block after implantation of a scleral-sutured posterior chamber intraocular lens: a retrospective, open study. BMC Ophthalmol 2017; 17:35. [PMID: 28356143 PMCID: PMC5372338 DOI: 10.1186/s12886-017-0427-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/20/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND To report the clinical features of patients with reverse pupillary block (RPB) after scleral-sutured posterior chamber intraocular lens (PC IOL) implantation and biometric changes after laser peripheral iridotomy (LPI). METHODS Eight patients attending our hospital's ophthalmology outpatient clinic, who developed RPB after implantation of a scleral-sutured PC IOL due to subluxation of the crystalline lens or IOL, were investigated in this retrospective, observational study. RESULTS Preoperative evaluations showed angle pigmentation in all cases and iridodonesis in 2 cases. Two subjects had used an α1A-adrenoceptor antagonist for benign prostatic hyperplasia. Pars plana or anterior partial vitrectomy was performed in all cases. All eyes showed an extremely deep anterior chamber, a concave iris configuration, and contact between the IOL optic and the iris at the pupillary margin. Pupil capture was detected in 2 cases. The mean (± SD) anterior chamber angle (ACA) was 89.91 ± 10.06°, and the anterior chamber depth (ACD) was 4.42 ± 0.16 mm before LPI. After LPI, the iris immediately became flat with a decreased ACA (51.70 ± 2.59°; P = 0.018) and ACD (4.14 ± 0.15 mm; P = 0.012). After LPI, the intraocular pressure decreased from 19.75 ± 3.77 mmHg to 15.63 ± 4.30 mmHg (P = 0.011), and the spherical equivalent decreased from -0.643 ± 0.385 D to - 0.875 ± 0.505 D (P = 0.016). CONCLUSION Concomitant vitrectomy, angle pigmentation, and iridodonesis may be risk factors for RPB after scleral-sutured PC IOL implantation. LPI is effective for relieving the RPB.
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Affiliation(s)
- Seung Pil Bang
- Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56, Dalseong-ro, Jung-gu, 41931 Daegu South Korea
| | - Choun-Ki Joo
- Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jong Hwa Jun
- Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, #56, Dalseong-ro, Jung-gu, 41931 Daegu South Korea
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Abstract
PURPOSE OF REVIEW The present article reviews the clinical features and pathogenesis of pigment dispersion syndrome and pigmentary glaucoma and provides an update regarding their diagnosis and management. RECENT FINDINGS Newer imaging modalities including ultrasound biomicroscopy and anterior segment optical coherence tomography facilitate visualization of the iris concavity characteristic of eyes with pigment dispersion syndrome and pigmentary glaucoma. Patients with pigmentary glaucoma may be distinguished from those with other glaucoma types by the presence of typical symptoms, personality type, and patterns of diurnal intraocular pressure fluctuation. Although laser iridotomy has been shown to alter iris anatomy in pigmentary glaucoma, it is not proven to slow visual field progression. Multiple trials have validated the safety and efficacy of filtering surgery in treating pigmentary glaucoma, with fewer studies published on the role of micro-invasive glaucoma surgery. SUMMARY Literature from the review period has further defined the unique clinical characteristics of pigment dispersion syndrome and pigmentary glaucoma. Laser surgery has a limited role in the management of these entities, whereas trabeculectomy remains an acceptable first-line surgical treatment. Further studies are needed to define the potential application of the newer micro-invasive glaucoma procedures in pigmentary glaucoma.
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Schuster AK, Fischer JE, Vossmerbaeumer U. Curvature of iris profile in spectral domain optical coherence tomography and dependency to refraction, age and pupil size - the MIPH Eye&Health Study. Acta Ophthalmol 2017; 95:175-181. [PMID: 27488961 DOI: 10.1111/aos.13184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 06/03/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Optical coherence tomography (OCT) of the anterior segment allows quantitative analysis of the geometry of the iris. We performed spectral domain OCT examinations in healthy emmetropic, hyperopic and myopic subjects to investigate iris curvature and its associations. METHODS In a cross-sectional study, out of 4617 eyes (2309 subjects) those with refractive errors of <-4 or >+3 dioptres were identified by objective refraction. The iris was examined using the anterior segment mode of a spectral domain 3D OCT-2000 (Topcon Inc., Japan) in the temporal meridian, and OCT scans were investigated with respect to presence and amount of convex and concave iris configuration. Ninety-three eyes of 50 subjects served as emmetropic group (-0.5 ≤ x ≤+0.5 dioptres). Previous ocular surgery was exclusion criterion. RESULTS Six hundred and sixty-eight eyes of 398 persons [292 male (76%); age range; 18-66 years] were included in the study. In the myopic group, 105 eyes had a concave iris configuration (26%), while in the hyperopic group, no eye had this configuration (0%) and in the emmetropic group five eyes (5%). Convex iris configuration was found in 96% of hyperopic, in 85% of the emmetropic and in 67% of the myopic eyes. There was an association between concave iris configuration and myopia, younger age and male gender, and with anterior chamber angle width. CONCLUSION Spectral domain OCT images can be used for analysis of the iris structure and geometry. Our results are limited to the properties of the study population having an age range from 18 to 66 years and consisting mainly of men.
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Affiliation(s)
- Alexander K. Schuster
- Mannheim Institute of Public Health, Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Department of Ophthalmology; Mainz University Medical Center; Mainz Germany
| | - Joachim E. Fischer
- Mannheim Institute of Public Health, Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - Urs Vossmerbaeumer
- Mannheim Institute of Public Health, Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Department of Ophthalmology; Mainz University Medical Center; Mainz Germany
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Singh H, Modabber M, Safran SG, Ahmed IIK. Laser iridotomy to treat uveitis-glaucoma-hyphema syndrome secondary to reverse pupillary block in sulcus-placed intraocular lenses: Case series. J Cataract Refract Surg 2016; 41:2215-23. [PMID: 26703298 DOI: 10.1016/j.jcrs.2015.10.057] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/23/2015] [Accepted: 02/23/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To present cases of uveitis-glaucoma-hyphema (UGH) syndrome due to reverse pupillary block in sulcus-placed posterior chamber intraocular lenses (PC IOLs) that were managed with laser peripheral iridotomy (LPI). SETTING Community-based subspecialty clinics. DESIGN Retrospective interventional case series. METHODS A chart review of patients with a sulcus-placed PC IOLs presenting with UGH syndrome and reverse pupillary block with posterior iris bowing as diagnosed by gonioscopy and anterior segment optical coherence tomography was carried out. Laser peripheral iridotomy was performed in the eyes included in the study. The main outcome measure was clinical resolution of UGH syndrome. RESULTS The study included 6 eyes of 6 patients with a mean age of 59.8 years (range 43.0 to 66.0 years) who presented with unilateral UGH syndrome a mean of 28.7 months (range 0.3 to 84.0 months) after PC IOL implantation. All patients were previously myopic, with 5 (83.3%) having a history of vitrectomy. The mean axial length was 27.0 mm ± 1.4 (SD). An LPI was used to treat the reverse pupillary block with resultant improvement in iris profile and resolution of UGH syndrome in all eyes. The mean intraocular pressure decreased from 30.5 ± 10.0 mm Hg on 0.5 ± 0.8 glaucoma medications to 15.5 ± 3.2 mm Hg postoperatively on 0.7 ± 1.2 medications. CONCLUSIONS The UGH syndrome due to reverse pupillary block occurred after sulcus-placed PC IOLs in susceptible patients, those with axial myopia, and post-vitrectomized eyes. The cases were managed with LPIs. FINANCIAL DISCLOSURE Dr. Ahmed is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Harmanjit Singh
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA
| | - Milad Modabber
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA
| | - Steven G Safran
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA
| | - Iqbal Ike K Ahmed
- From the Department of Ophthalmology and Vision Sciences (Singh, Ahmed), University of Toronto, Toronto, the Department of Ophthalmology (Modabber), McGill University, Montreal, Quebec, and Trillium Health Partners (Ahmed) and Credit Valley EyeCare (Ahmed), Mississauga, Ontario, Canada; Capital Health System (Safran), Pennington, New Jersey, USA.
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Blieden LS, Chuang AZ, Baker LA, Bell NP, Fuller TS, Mankiewicz KA, Feldman RM. Optimal number of angle images for calculating anterior angle volume and iris volume measurements. Invest Ophthalmol Vis Sci 2015; 56:2842-7. [PMID: 25829412 DOI: 10.1167/iovs.14-15883] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We determined the optimal number of angle images required to obtain reliable measurements of trabecular-iris circumferential volume (TICV) and iris volume (IV) using swept-source Fourier domain anterior segment optical coherence tomography (SSFD-ASOCT) scans in narrow angle eyes. METHODS Scleral spur landmarks (SSL) were manually identified on ASOCT angle images from 128 meridians from each of 24 eyes with chronic primary angle closure (PAC) spectrum of disease. The anterior and posterior corneal curves, and the anterior and posterior iris surfaces were identified automatically by the anterior chamber analysis and interpretation (ACAI) software, then manually examined and edited by the reader if required. Trabecular-iris circumferential volume at 750 μm from SSL (TICV750) and IV were subsequently calculated using varying numbers of angle images. Threshold error was determined to be less than the lower 95% confidence limit of mean absolute percent error (MAPE) of the change in TICV or IV resulting from laser peripheral iridotomy, which would be 17% for TICV and 5% for IV, based on previous studies. The optimal number of angle images was the smallest number of images where MAPE was less than this threshold for TICV and IV. RESULTS A total of 32 equally-spaced angle images (16 meridians) was required to estimate TICV750 and 16 angle images (8 meridians) to estimate IV. Both were within 4.6% and 1.6% of MAPE, respectively. CONCLUSIONS It is possible to determine TICV and IV parameters reliably in narrow angles without evaluating all 128 meridians obtained with SSFD-ASOCT.
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Affiliation(s)
- Lauren S Blieden
- Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, United States 2Robert Cizik Eye Clinic, Houston, Texas, United States
| | - Alice Z Chuang
- Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, United States
| | - Laura A Baker
- Robert Cizik Eye Clinic, Houston, Texas, United States
| | - Nicholas P Bell
- Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, United States 2Robert Cizik Eye Clinic, Houston, Texas, United States
| | - Timothy S Fuller
- Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, United States 2Robert Cizik Eye Clinic, Houston, Texas, United States
| | - Kimberly A Mankiewicz
- Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, United States
| | - Robert M Feldman
- Ruiz Department of Ophthalmology and Visual Science, The University of Texas Medical School at Houston, Houston, Texas, United States 2Robert Cizik Eye Clinic, Houston, Texas, United States
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Qazi Y, Aggarwal S, Hamrah P. Image-guided evaluation and monitoring of treatment response in patients with dry eye disease. Graefes Arch Clin Exp Ophthalmol 2014; 252:857-872. [PMID: 24696045 DOI: 10.1007/s00417-014-2618-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 03/05/2014] [Accepted: 03/10/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Dry eye disease (DED) is one of the most common ocular disorders worldwide. The pathophysiological mechanisms involved in the development of DED are not well-understood, and thus treating DED has been a significant challenge for ophthalmologists. Most of the currently available diagnostic tests demonstrate low correlation to patient symptoms and have low reproducibility. METHODS Recently, sophisticated in vivo imaging modalities have become available for patient care, namely, in vivo confocal microscopy (IVCM) and optical coherence tomography (OCT). These emerging modalities are powerful and non-invasive, allowing real-time visualization of cellular and anatomical structures of the cornea and ocular surface. Here we discuss how, by providing both qualitative and quantitative assessment, these techniques can be used to demonstrate early subclinical disease, grade layer-by-layer severity, and allow monitoring of disease severity by cellular alterations. Imaging-guided stratification of patients may also be possible in conjunction with clinical examination methods. CONCLUSIONS Visualization of subclinical changes and stratification of patients in vivo allows objective image-guided evaluation of tailored treatment response based on cellular morphological alterations specific to each patient. This image-guided approach to DED may ultimately improve patient outcomes and make it possible to study the efficacy of novel therapies in clinical trials.
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Affiliation(s)
- Yureeda Qazi
- Cornea and Ocular Surface Imaging Center, Department of Ophthalmology- Cornea Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Shruti Aggarwal
- Cornea and Ocular Surface Imaging Center, Department of Ophthalmology- Cornea Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
| | - Pedram Hamrah
- Cornea and Ocular Surface Imaging Center, Department of Ophthalmology- Cornea Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA
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Aptel F, Chiquet C, Gimbert A, Romanet JP, Thuret G, Gain P, Campolmi N. Anterior segment biometry using spectral-domain optical coherence tomography. J Refract Surg 2014; 30:354-60. [PMID: 24694582 DOI: 10.3928/1081597x-20140326-01] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 12/03/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the anterior chamber and anterior chamber angle measurements obtained with spectral-domain anterior segment optical coherence tomography (AS-OCT) and time-domain AS-OCT. METHODS The anterior chamber of healthy participants was imaged with spectral-domain AS-OCT (Casia SS-1000; Tomey, Nagoya, Japan) and time-domain AS-OCT (Visante; Carl Zeiss Meditec, Dublin, CA). Central corneal thickness (CCT), anterior chamber depth (ACD), angle opening distance at 500 and 750 μm (AOD 500 and AOD 750), trabecular iris space area at 500 and 750 μm (TISA 500 and TISA 750), and scleral spur angle were measured. The intraclass correlation coefficients (ICCs) were calculated. The Pearson correlation test was used to evaluate the correlation between the measurements and Bland-Altman plots to evaluate the agreement. RESULTS One hundred one eyes of 101 healthy participants were analyzed. Excellent repeatability was found with both devices for CCT, AOD 500, AOD 750, TISA 750, and scleral spur angle (ICC = 0.90 to 0.98 and 0.89 to 0.97, respectively) and excellent to moderate repeatability was found for TISA 500 (ICC = 0.68 to 0.97 and 0.70 to 0.93, respectively). For all parameters, Casia and Visante measurements were significantly correlated (r = 0.76 to 0.98; P < .02). ACD measured with the Casia was significantly larger (mean difference = 0.12 ± 0.08 mm; P < .0001), and the scleral spur angle measured with the Casia was significantly lower (mean difference = 4.85° ± 5.30°; P < .01). There were nonsignificant differences between the devices for the other parameters (P > .06). CONCLUSIONS Both Casia and Visante AS-OCT demonstrate high repeatability. Except for the ACD and scleral spur angles, the two devices show good agreement.
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Klingenstein A, Kernt M, Seidensticker F, Kampik A, Hirneiss C. Anterior-segment morphology and corneal biomechanical characteristics in pigmentary glaucoma. Clin Ophthalmol 2014; 8:119-26. [PMID: 24403816 PMCID: PMC3883583 DOI: 10.2147/opth.s53088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The aim of the study reported here was to evaluate characteristics of the anterior-segment via anterior-segment optical coherence tomography (AS-OCT) and corneal biomechanical properties using an ocular response analyzer and their changes by peripheral laser iridotomy (PI) in patients with pigmentary glaucoma (PG). Materials and methods Seventeen eyes with PG were included consecutively. AS-OCT and ocular response analyzer measurements were taken before and 3 months after PI. Baseline morphology and change in morphology were analyzed by correlation and multiple linear regression analysis. The main parameters assessed were anterior-chamber (AC) angles and volume as well as corneal hysteresis (CH) and corneal resistance factor. Results AC angles were found to have decreased significantly in each quadrant after PI (P<0.001), with the highest effect seen in the temporal quadrant, which decreased from 57.0°±9.6° to 44.1°±5.2° (± standard deviation). Mean AC volume decreased significantly from 213.1±36.4 to 187.0±23.4 mm3 (P<0.001). CH and corneal resistance factor did not change after PI. CH was found to correlate with the preoperative superior and inferior angle width (Spearman’s rho 0.553 and 0.615, respectively, P<0.05). Biomechanical parameters showed no predictive value on the change of AC angles or volume. Conclusion PI in eyes with PG results in a highly significant reduction in the AC angles and volume as visualized by AS-OCT, with the largest effect seen in the temporal quadrant. CH is strongly positively correlated with the superior and inferior preoperative AC angles, emphasizing the importance of the biomechanical properties of the cornea for glaucoma pathogenesis in PG, but corneal biomechanical properties cannot predict PI-related AC changes.
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Affiliation(s)
- Annemarie Klingenstein
- Department of Ophthalmology, University of Munich Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Marcus Kernt
- Department of Ophthalmology, University of Munich Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Florian Seidensticker
- Department of Ophthalmology, University of Munich Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Anselm Kampik
- Department of Ophthalmology, University of Munich Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Christoph Hirneiss
- Department of Ophthalmology, University of Munich Hospital, Ludwig-Maximilians University, Munich, Germany
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Reverse pupillary block associated with pigment dispersion syndrome after in-the-bag intraocular lens implantation. J Cataract Refract Surg 2013; 39:1925-8. [PMID: 24140374 DOI: 10.1016/j.jcrs.2013.08.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/10/2013] [Indexed: 11/22/2022]
Abstract
A 61-year-old man with high myopia who had received a systemic α1A-adrenoceptor antagonist had phacoemulsification and in-the-bag intraocular lens implantation in the right eye. One day postoperatively, marked pigment dispersion in the anterior chamber, posterior bowing of the iris, and iridodonesis were noted associated with a subsequent elevation in intraocular pressure (IOP). Pharmacological pupil dilation was effective in reducing pigment dispersion and IOP, and laser peripheral iridotomy was performed to alleviate posterior bowing of the iris. We hypothesize that dynamic changes in the aqueous humor flow by cataract surgery and latent flaccidity of the iris due to the systemic α1A-adrenoceptor antagonist caused reverse pupillary block. High myopia may be another risk factor for this complication.
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Sharma R, Sharma A, Arora T, Sharma S, Sobti A, Jha B, Chaturvedi N, Dada T. Application of anterior segment optical coherence tomography in glaucoma. Surv Ophthalmol 2013; 59:311-27. [PMID: 24138894 DOI: 10.1016/j.survophthal.2013.06.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 02/02/2023]
Abstract
Optical coherence tomography (OCT) is a cross-sectional, three-dimensional, high-resolution imaging modality that uses low coherence interferometry to achieve axial resolution in the range of 3-20 μm. Two OCT platforms have been developed: time domain (TD-OCT) and spectral (or Fourier) domain (SD/FD-OCT). Visante anterior segment OCT (Carl Zeiss Meditec) is a TD-OCT widely used for anterior segment imaging. The SD-OCT systems with both posterior and anterior segment imaging capabilities include the RTVue, iVue (Optovue), the Cirrus (Carl Zeiss Meditec), and the Spectralis (Heidelberg Engineering, Inc.). Each of the SD-OCTs has a wavelength in the range of 820-879 nm. Anterior segment OCT is a non-contact method providing high resolution tomographic cross-sectional imaging of anterior segment structures. Anterior segment OCT provides qualitative and quantitative assessment of the anterior segment structures important to the pathogenesis and the anatomical variations of glaucoma, and the approach to and success of treatment. We summarize the clinical applications of anterior segment OCT in glaucoma.
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Affiliation(s)
- Reetika Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tarun Arora
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sourabh Sharma
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Sobti
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bhaskar Jha
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Chaturvedi
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tanuj Dada
- Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Birner B, Tourtas T, Wessel J, Jünemann A, Mardin C, Kruse F, Laemmer R. Melanindispersionssyndrom und -glaukom. Ophthalmologe 2013; 111:638-43. [DOI: 10.1007/s00347-013-2943-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Anterior segment imaging allows objective assessment of the anterior segment of the eye, particularly the anterior chamber angle. Both qualitative and quantitative analyses are possible and aid in detecting and managing closed-angle and open-angle mechanisms in various forms of glaucoma. This review focuses primarily on anterior segment optical coherence tomography and ultrasound biomicroscopy, with emphasis on principles of technology, commercially available devices, and clinical applications in glaucoma with potential advantages and disadvantages of each technology.
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Affiliation(s)
- Sarwat Salim
- Glaucoma Service, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA.
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Abstract
Despite theoretical considerations concerning the advantage of iridotomy in eyes with pigment dispersion syndrome or early pigment glaucoma, there is a lack of clinical evidence that this procedure has a long-term effect in preventing glaucoma damage under these circumstances. However, several factors may contribute to this lack of evidence, e.g. the statistical problem of a low conversion rate from pigment dispersion syndrome to pigment glaucoma or the inclusion criteria in the studies treating patients older than 40 years or genetic dispositions in pigment glaucoma that are not yet fully clear. On the basis of current data the decision for YAG iridotomy should only be taken in patients younger than 40 years, if the midperipheral iris shows an inverse bowing and the intraocular pressure is normal or slightly increased with no progressive signs of optic nerve damage. In cases of insufficient intraocular pressure and visual defects due to glaucomatous optic nerve damage, incisional glaucoma surgery is usually necessary especially in younger patients with a long life expectancy.
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The role of anterior segment optical coherence tomography in glaucoma. J Ophthalmol 2012; 2012:476801. [PMID: 22900146 PMCID: PMC3415232 DOI: 10.1155/2012/476801] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 06/10/2012] [Indexed: 01/10/2023] Open
Abstract
The anterior segment optical coherence tomography provides an objective method to assess the anterior segment of the eye, including the anatomy of the anterior chamber angle. This technology allows both qualitative and quantitative analyses of the angle and has shown potential in detecting and managing angle-closure glaucoma. In addition, it has a role in identifying pathology in some forms of secondary open-angle glaucoma and postsurgical management of glaucoma. Limitations of this technology include its cost and inability to visualize well structures posterior to the iris, such as the ciliary body. This paper focuses on potential benefits and limitations of anterior segment optical coherence tomography when compared with conventional gonioscopy and ultrasound biomicroscopy. Various clinical entities will be described to discuss its potential role in glaucoma practice.
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