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Guo PY, Zhang X, Li F, Lin C, Nguyen A, Sakata R, Higashita R, Okamoto K, Yu M, Aihara M, Aung T, Lin S, Leung CKS. Diagnostic criteria of anterior segment swept-source optical coherence tomography to detect gonioscopic angle closure. Br J Ophthalmol 2024; 108:1130-1136. [PMID: 38594062 PMCID: PMC11287563 DOI: 10.1136/bjo-2023-323860] [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] [Received: 05/07/2023] [Accepted: 11/27/2023] [Indexed: 04/11/2024]
Abstract
AIMS To compare the diagnostic performance of 360° anterior segment optical coherence tomography assessment by applying normative percentile cut-offs versus iris trabecular contact (ITC) for detecting gonioscopic angle closure. METHODS In this multicentre study, 394 healthy individuals were included in the normative dataset to derive the age-specific and angle location-specific normative percentiles of angle open distance (AOD500) and trabecular iris space area (TISA500) which were measured every 10° for 360°. 119 healthy participants and 170 patients with angle closure by gonioscopy were included in the test dataset to investigate the diagnostic performance of three sets of criteria for detection of gonioscopic angle closure: (1) the 10th and (2) the 5th percentiles of AOD500/TISA500, and (3) ITC (ie, AOD500/TISA500=0 mm/mm2). The number of angle locations with angle closure defined by each set of the criteria for each eye was used to generate the receiver operating characteristic (ROC) curve for the discrimination between gonioscopic angle closure and open angle. RESULTS Of the three sets of diagnostic criteria examined, the area under the ROC curve was greatest for the 10th percentile of AOD500 (0.933), whereas the ITC criterion AOD500=0 mm showed the smallest area under the ROC (0.852) and the difference was statistically significant with or without adjusting for age and axial length (p<0.001). The criterion ≥90° of AOD500 below the 10th percentile attained the best sensitivity 87.6% and specificity 84.9% combination for detecting gonioscopic angle closure. CONCLUSIONS Applying the normative percentiles of angle measurements yielded a higher diagnostic performance than ITC for detecting angle closure on gonioscopy.
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Affiliation(s)
- Philip Yawen Guo
- Department of Ophthalmology, The University of Hong Kong, Pok Fu Lam, People's Republic of China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Chen Lin
- Shenzhen Aier Eye Hospital, Shenzhen, China
| | - Anwell Nguyen
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Rei Sakata
- Ophthalmology, The University of Tokyo, Bunkyo-ku, Japan
| | | | | | - Marco Yu
- Singapore Eye Research Institute, Singapore
| | - Makoto Aihara
- Ophthalmology, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Tokyo, Japan
| | - Tin Aung
- Glaucoma, Singapore National Eye Centre, Singapore
| | - Shan Lin
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
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Zhao LL, Lu XZ, Tang GD, Zhang XY, Li RK, Xu J, Feng JJ, Xu Z, Song JK, Bi HS. Anterior chamber and angle characteristics in Chinese children (6-11 years old) with different refractive status using swept-source optical coherence tomography. BMC Ophthalmol 2024; 24:259. [PMID: 38880899 PMCID: PMC11181599 DOI: 10.1186/s12886-024-03520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 06/07/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND The anatomic structure of the anterior chamber (AC) helps to explain differences in refractive status in school-aged children and is closely associated with primary angle closure (PAC). The aim of this study was to quantify and analyze the anterior chamber and angle (ACA) characteristics in Chinese children with different refractive status by swept-source optical coherence tomography (SS-OCT). METHODS In a cross-sectional observational study, 383 children from two primary schools in Shandong Province, China, underwent a complete ophthalmic examination. First, the anterior chamber depth (ACD), anterior chamber width (ACW), angle-opening distance (AOD), and trabecular-iris space area (TISA) were evaluated automatically using a CASIA2 imaging device. AOD and TISA were measured at 500, 750 μm nasal (N1 and N2, respectively), and temporal (T1 and T2, respectively) to the scleral spur (SS). Cycloplegic refraction and axial length (AL) were then measured. According to spherical equivalent refraction (SER), the children were assigned to hyperopic (SER > 0.50D), emmetropic (-0.50D < SER ≤ 0.50D), and myopic groups (SER ≤ -0.50D). RESULTS Out of the 383 children, 349 healthy children (160 girls) with a mean age of 8.23 ± 1.06 years (range: 6-11 years) were included. The mean SER and AL were - 0.10 ± 1.57D and 23.44 ± 0.95 mm, respectively. The mean ACD and ACW were 3.17 ± 0.24 mm and 11.69 ± 0.43 mm. The mean AOD were 0.72 ± 0.25, 0.63 ± 0.22 mm at N1, T1, and 0.98 ± 0.30, 0.84 ± 0.27 mm at N2, T2. The mean TISA were 0.24 ± 0.09, 0.22 ± 0.09mm2 at N1, T1, and 0.46 ± 0.16, 0.40 ± 0.14mm2 at N2, T2. The myopic group had the deepest AC and the widest angle. Compared with boys, girls had shorter AL, shallower ACD, narrower ACW, and ACA (all p < 0.05). By Pearson's correlation analysis, SER was negatively associated with ACD, AOD, and TISA. AL was positively associated with ACD, ACW, AOD, and TISA. In the multiple regression analysis, AOD and TISA were associated with deeper ACD, narrower ACW, and longer AL. CONCLUSION In primary school students, the myopic eyes have deeper AC and wider angle. ACD, ACW, AOD, and TISA all increase with axial elongation. ACA is highly correlated with deeper ACD.
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Affiliation(s)
- Li Li Zhao
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, PR China
| | - Xiu Zhen Lu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China
| | - Guo Dong Tang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China
| | - Xiu Yan Zhang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China
| | - Run Kuan Li
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, PR China
| | - Jing Xu
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, PR China
| | - Jiao Jiao Feng
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, PR China
| | - Zhe Xu
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, PR China
| | - Ji Ke Song
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, PR China.
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China.
| | - Hong Sheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China.
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250000, PR China.
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Wang M, Zhu J, Keyal K, Liao X, Chen L, Li H, Wang F. Evaluation of the Effect of Scleral Buckling on Anterior Segment and Refractive Changes Using Anterior Segment Optical Coherence Tomography. Semin Ophthalmol 2024; 39:74-82. [PMID: 37309176 DOI: 10.1080/08820538.2023.2223271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE To evaluate the changes of anterior segment and refractive parameters after scleral buckling (SB) surgery for uncomplicated rhegmatogenous retinal detachment (RRD) using anterior segment optical coherence tomography (AS-OCT). METHODS Thirty-six RRD eyes were consecutively enrolled. Analysis concerned the central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), iris-trabecular contact (ITC), angel opening distance (AOD), angle recess area (ARA), trabecular-iris space area (TISA),trabecular iris angle (TIA) and refractive parameters, including average keratometry (AvgK), cylindrical power (CYL), regular astigmatism, asymmetry and high order irregularity (HOI) at baseline and 1 day, 1 month, 2 months, 6 months and 12 months postoperatively. AS-OCT was performed at RRD diagnosis and day 1, week 1, month 1 and month 6 after SB to evaluate the scleral buckling. RESULTS A statistically significant postoperative CCT increase, ACD and ACV decrease were observed at 1 day and 1 month postoperatively. ITC analysis showed that the angle of the entire circumference narrowed at 1 month postoperatively. There was a significant decrease in all the angle parameters (AOD500/750, ARA500/750, TISA500/750, and ARA500/750) at 1 day and 1 month after SB surgery. However, all of the above parameters returned to the preoperative level at 12 months. Refractive parameters including AvgK, regular astigmatism, CYL, asymmetry, and HOI of anterior corneal surface and total corneal increased on the 1 day and 1 month after SB surgery and persisted even after 12 months follow-up. However, there was no significant difference in refractive parameters of posterior corneal surface during follow-up. CONCLUSION The changes in the structure of anterior segments after SB surgery were almost returned to the preoperative levels at 12 months postoperatively. However, SB surgery has a long-term effect on refractive parameters throughout a 12-month follow-up.
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Affiliation(s)
- Minli Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Juming Zhu
- Department of Ophthalmology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School; The First people's Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Khusbu Keyal
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Xin Liao
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Lei Chen
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Hui Li
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
| | - Fang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai, China
- Shanghai Bright Eye Hospital, Shanghai, China
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Su CKY, Guo PY, Chan PPM, Lam AKN, Leung CKS. Retinal Nerve Fiber Layer Optical Texture Analysis: Detecting Axonal Fiber Bundle Defects in Patients with Ocular Hypertension. Ophthalmology 2023; 130:1080-1089. [PMID: 37315588 DOI: 10.1016/j.ophtha.2023.06.004] [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] [Received: 02/04/2023] [Revised: 05/23/2023] [Accepted: 06/06/2023] [Indexed: 06/16/2023] Open
Abstract
PURPOSE To apply retinal nerve fiber layer (RNFL) optical texture analysis (ROTA) to investigate the prevalence, patterns, and risk factors of RNFL defects in patients with ocular hypertension (OHT) who showed normal optic disc and RNFL configuration in clinical examination, normal RNFL thickness on OCT analysis, and normal visual field (VF) results. DESIGN Cross-sectional study. PARTICIPANTS Six hundred eyes of 306 patients with OHT. METHODS All participants underwent clinical examination of the optic disc and RNFL, OCT RNFL imaging, and 24-2 standard automated perimetry. To detect RNFL defects, ROTA was applied. The risk score for glaucoma development was calculated according to the Ocular Hypertension Treatment Study and European Glaucoma Prevention Study (OHTS-EGPS) risk prediction model. Risk factors associated with RNFL defects were analyzed using multilevel logistic regression analysis. MAIN OUTCOME MEASURES Prevalence of RNFL defects. RESULTS The average intraocular pressure (IOP) measured from 3 separate visits within 6 months was 24.9 ± 1.8 mmHg for the eye with higher IOP and 23.7 ± 1.7 mmHg for the eye with lower IOP; the respective central corneal thicknesses were 568.7 ± 30.8 μm and 568.8 ± 31.2 μm. Of 306 patients with OHT, 10.8% (33 patients, 37 eyes) demonstrated RNFL defects in ROTA in at least 1 eye. Of the 37 eyes with RNFL defects, the superior arcuate bundle was the most frequently involved (62.2%), followed by the superior papillomacular bundle (27.0%) and the inferior papillomacular bundle (21.6%). Papillofoveal bundle defects were observed in 10.8% of eyes. The smallest RNFL defect spanned 0.0° along Bruch's membrane opening margin, whereas the widest RNFL defect extended over 29.3°. Age (years) (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.03-1.13), VF pattern standard deviation (decibels [dB]) (OR, 1.82; 95% CI, 1.01-3.29), cup volume (mm3) (OR, 1.24; 95% CI, 1.01-1.53), and the OHTS-EPGS risk score (OR, 1.04; 95% CI, 1.01-1.07) were associated with RNFL defects. CONCLUSIONS A considerable proportion of patients with OHT who showed no signs of optic disc and RNFL thickness abnormalities on clinical and OCT examination exhibited RNFL defects on ROTA. Axonal fiber bundle defects on ROTA may represent the earliest discernible sign of glaucoma in the glaucoma continuum. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Clarice Kai-Ying Su
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Philip Yawen Guo
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Poemen Pui Man Chan
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; Hong Kong Eye Hospital, Kowloon City, Hong Kong, China
| | - Alexander Ka-Ngai Lam
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Christopher Kai Shun Leung
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Hong Kong Eye Hospital, Kowloon City, Hong Kong, China; Queen Mary Hospital, Pok Fu Lam, Hong Kong, China.
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Wu JH, Moghimi S, Nishida T, Kamalipour A, Liebmann JM, Fazio M, Girkin CA, Zangwill LM, Weinreb RN. Association Between Longitudinal 10-2 Central Visual Field Change and the Risk of Visual Acuity Loss in Mild-to-Moderate Glaucoma. J Glaucoma 2023; 32:549-555. [PMID: 37171991 PMCID: PMC10330348 DOI: 10.1097/ijg.0000000000002236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/16/2023] [Indexed: 05/14/2023]
Abstract
PRCIS Faster worsening of 10-2 visual field (VF) was associated with the development of visual acuity (VA) loss in mild-to-moderate glaucoma, suggesting longitudinal 10-2 VF change is associated with the risk of VA impairment. PURPOSE To examine whether longitudinal 10-2 central VF change is associated with the risk of VA loss in glaucoma. PATIENTS AND METHODS Primary open angle glaucoma and glaucoma suspect eyes with ≥3 years and 5 visits of 10-2 VF examinations were included. Cox proportional hazard modeling with shared frailty was used to evaluate the hazard ratio (HR) of 10-2 VF mean deviation (MD), superior hemifield mean sensitivity (hemi-MS), and inferior hemi-MS worsening rates for developing VA loss, defined as a change in logMAR VA ≥95% test-retest variability. RESULTS Among the 252 eyes (148 participants, mean follow-up = 5.8 y), 30 eyes (21 participants, mean follow-up = 4.9 y) developed VA loss. There was no difference in baseline VF between eyes with and without VA loss ( P > 0.05). Eyes with VA loss showed faster 10-2 VF MD worsening [-0.39 (95% CI: -0.60, -0.18) dB/y] and hemi-MS decrease (range: -0.42~-0.38 dB/y), as compared with no-VA loss eyes [10-2 VF MD change = -0.11 (-0.16, -0.07) dB/y; hemi-MS change: -0.12~-0.07 dB/y; P < 0.05]. In the multivariable model, faster 10-2 VF MD worsening [HR (95% CI) = 4.05 (1.61, 10.22), per 1 dB/y faster], superior hemi-MS decrease [HR (95% CI) = 7.07 (2.48, 20.14), per 1 dB/y faster], and inferior hemi-MS decrease [HR (95% CI) = 8.32 (1.99, 34.91), per 1 dB/y faster] were all associated with increased risk of developing VA loss ( P < 0.05). CONCLUSIONS Faster 10-2 VF MD and hemifield MS worsening are associated with the development of VA loss. Monitoring the longitudinal central 10-degree VF change may suggest that there is impending VA impairment in glaucoma.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York
| | - Massimo Fazio
- Department of Ophthalmology and Vision Sciences, Heersink School of Medicine, University of Alabama-Birmingham, Birmingham
| | - Christopher A Girkin
- Department of Ophthalmology and Vision Sciences, Heersink School of Medicine, University of Alabama-Birmingham, Birmingham
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, United States
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