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Tan SS, Tun TA, Aung T, Nongpiur ME. Comparison of intraocular pressure and anterior segment parameters in subjects with asymmetrical primary angle closure disease. Clin Exp Ophthalmol 2024. [PMID: 38803136 DOI: 10.1111/ceo.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/17/2024] [Accepted: 05/11/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND To compare intraocular pressure (IOP) and anterior segment parameters between eyes with unilateral primary angle closure glaucoma (PACG) and their fellow eyes with primary angle closure (PAC) or primary angle closure suspect (PACS). METHODS Subjects underwent anterior segment imaging using 360-degree swept-source optical coherence tomography (SS-OCT, CASIA Tomey, Nagoya, Japan) and ocular investigations including gonioscopy and IOP measurement. Each SS-OCT scan (divided into 8 frames, 22.5 degrees apart) was analysed and an average was obtained for the following anterior segment parameters: iridotrabecular contact (ITC), angle opening distance (AOD750), iris thickness and curvature, anterior chamber width, depth and area (ACW, ACD and ACA) and lens vault (LV). RESULTS Among 132 unilateral PACG subjects (mean age: 62.91 ± 7.2 years; 59.1% male), eyes with PACG had significantly higher presenting IOP (24.81 ± 0.94 vs. 18.43 ± 0.57 mmHg, p < 0.001), smaller gonioscopic Shaffer grade (2.07 ± 0.07 vs. 2.31 ± 0.07, p < 0.001) and a greater extent of peripheral anterior synechiae (PAS, 1.21 ± 0.21 vs. 0.54 ± 0.16 clock hours, p = 0.001). PACG eyes also exhibited increased ITC, ITC area, greater LV and smaller AOD750, ACD and ACA (all p < 0.05). Using the forward stepwise regression model, an increase in 1 mmHg in presenting IOP before laser peripheral iridotomy (LPI) increases the odds of having PACG by 9% (95% confidence interval 5%-14%). CONCLUSIONS PACG eyes have higher presenting IOP, smaller anterior segment parameters, greater extent of PAS, and larger LV compared to their fellow eyes with angle closure. Narrower anterior chamber dimensions and higher presenting IOP before LPI may increase risk of chronic elevated IOP and glaucomatous optic neuropathy after LPI.
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Affiliation(s)
- Shayne S Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Tin A Tun
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Monisha E Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Müller M, Pavlovic A, Niermann T, Pavlovic I, Priglinger S, Kohnen T, Shajari M, Mackert M. Effect of the iridocorneal angle size on the diurnal pressure profile in a glaucoma suspect cohort and patients with glaucoma. Int Ophthalmol 2023; 43:4067-4078. [PMID: 37658170 PMCID: PMC10520072 DOI: 10.1007/s10792-023-02823-x] [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: 05/31/2021] [Accepted: 07/09/2023] [Indexed: 09/03/2023]
Abstract
PURPOSE To evaluate the impact of the iridocorneal angle size (ICAS) on the diurnal intraocular pressure (IOP) in patients with suspected glaucoma (SG). METHOD Patients with any eye-pressure lowering medication or previous ocular surgery were excluded. In a retrospective study set, diurnal IOP profiles of 120 patients (205 eyes) within a 48-h period were analysed by regression analysis. Of those eyes, 44 were diagnosed to have glaucoma. The remaining eyes were used as healthy control group (HCG). RESULTS The overall mean IOP was 15.63 mmHg ± 2.72 mmHg and mean ICAS was 23.92° ± 4.74°. In the glaucoma cohort, mean IOP was 18.77 ± 1.86 mmHg and mean ICAS was 25.02° ± 4.96°. In the HCG, mean IOP was 14.77 ± 2.25 mmHg and mean ICAS was 23.62° ± 4.64°. In the total cohort, as well as in the subgroups (HCG or glaucoma), regression analysis showed no significant impact even of the minimum ICAS, which was larger than 10°, on average (P = 0.89), maximum (P = 0.88), and range of IOP (P = 0.49) within 48 h. The difference between glaucoma cohort and HCG cohort was significant in terms of IOP (P < 0.001), but not for minimum ICAS (P = 0.07). Chi-square test showed no increase in prevalence of IOP peaks of > 21 mmHg within 48 h in eyes with an angle between 10° and 20° (P = 0.18). CONCLUSION An ICAS of larger than 10° in HCG or glaucoma patients with an open-angle does not influence the minimum, average, maximum or range of IOP. Additionally, an angle size larger than 10° does not allow the prediction of IOP changes in these two cohorts.
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Affiliation(s)
- Michael Müller
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Ana Pavlovic
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Theresa Niermann
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Ivana Pavlovic
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | | | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - Mehdi Shajari
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
- Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany
| | - Marc Mackert
- Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany
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Chen J, Chen S, Zheng Y, Xu Y, Zhong X, Huang Y, Ng TK, Huang C. Association of body mass index and PXDNL gene variants with acute primary angle closure in southern Chinese population. Heliyon 2023; 9:e22240. [PMID: 38034647 PMCID: PMC10686858 DOI: 10.1016/j.heliyon.2023.e22240] [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: 06/20/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
This study aimed to evaluate the association of body mass index (BMI) and the weight-related gene, peroxidasin-like (PXDNL), with acute primary angle closure (APAC) and primary angle-closure glaucoma (PACG) in southern Chinese population. Total 4700 study subjects (1024 APAC, 781 PACG, and 2895 control subjects) with complete ophthalmic examinations were enrolled into this study. The association of BMI with APAC, PACG and ocular biometric parameters was evaluated. Three PXDNL missense variants were genotyped by TaqMan assay, and their association with APAC and PACG was also investigated. Multivariable logistic regression analysis showed that BMI and body weight were significantly associated with both APAC and PACG (P < 0.01). Multiple linear regression analysis demonstrated that each 1 kg/m2 increased in BMI was associated with 0.038 mm increase in axial length, 0.018 mm increase in central anterior chamber depth, 0.002 mm increase in lens position, 0.012 mm increase in corneal diameter and 0.014 mm decrease in lens thickness among the APAC subjects (P < 0.001), but not with PACG. Genetic association analysis identified that PXDNL rs11985241-rs16916207 CT haplotype conferred a higher risk to APAC (OR = 1.25, P = 0.004) than the TG haplotype, but not with PACG. The APAC subjects carrying the rs11985241 C or rs16916207 T alleles showed significantly lower weight than those carrying the corresponding protective alleles. In summary, this study revealed that lower BMI could be associated with higher risk of APAC. PXDNL could be a new associated gene for APAC.
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Affiliation(s)
- Jiawei Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Shaowan Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yuqian Zheng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yanxuan Xu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Xin Zhong
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yuqiang Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong China
| | - Chukai Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, Guangdong, China
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Tekcan H, Mangan MS, Celik G, Imamoglu S. Lens factor as an underlying mechanism in primary angle closure with gonioscopically-visualized ciliary body processes. Jpn J Ophthalmol 2023; 67:678-684. [PMID: 37596442 DOI: 10.1007/s10384-023-01021-7] [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: 02/18/2023] [Accepted: 07/23/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To compare the differences in anterior segment parameters between eyes with primary angle closure (PAC) with and without gonioscopically-visualized ciliary body processes (CBP). STUDY DESIGN Prospective, observational, comparative clinical study. METHODS Detailed ocular examinations and gonioscopy were performed in 89 eyes of 89 patients with PAC to determine the visibility of the CBP. Anterior chamber depth (ACD), anterior chamber width, lens thickness (LT), lens vault (LV) and pupil diameter were determined using ultrasound biomicroscopy. The lens-axial length factor (LAF) and relative lens position (RLP) were calculated. All parameters were compared between eyes with and without gonioscopically visible CBP (PAC+CBP and PAC-CBP groups) after adjusting for age and gender. The association of the parameters with visible CBP was analyzed by univariate logistic regression analysis. RESULTS PAC+CBP group included 41 eyes and the PAC-CBP group, 48 eyes. The axial length and ACD were statistically significantly smaller (p = 0.009 and p = 0.005, respectively) and LT, LV and LAF were statistically significantly greater (p = 0.03, p = 0.008 and p = 0.004, respectively) in the PAC+CBP group. In the PAC eyes with glaucoma, the LT, LV and LAF were statistically significantly greater in the PAC+CBP group (p = 0.02, p = 0.001 and p = 0.02, respectively). The LAF had the strongest association with visible CBP in the regression analysis (Odds ratio = 141.70, p = 0.002). CONCLUSION Gonioscopical visualization of ciliary processes may suggest that anterior segment crowding, especially lens factor is the underlying mechanism in PAC. It may provide a practical gonioscopic examination method for predicting the predominant pathophysiology of PAC.
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Affiliation(s)
- Hatice Tekcan
- Ophthalmology Department, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Tıbbiye Street, No: 40, Uskudar, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Ophthalmology Department, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Tıbbiye Street, No: 40, Uskudar, Istanbul, Turkey.
| | - Gökhan Celik
- Ophthalmology Department, University of Health Sciences, Zeynep Kamil Gynecologic and Pediatric Training Research Hospital, Istanbul, Turkey
| | - Serhat Imamoglu
- Ophthalmology Department, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Tıbbiye Street, No: 40, Uskudar, Istanbul, Turkey
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Tan RKY, Panda SK, Braeu FA, Muralidharan AR, Nongpiur ME, Chan ASY, Aung T, Najjar RP, Girard MJA. The Structural Layers of the Porcine Iris Exhibit Inherently Different Biomechanical Properties. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 37796489 PMCID: PMC10561784 DOI: 10.1167/iovs.64.13.11] [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: 12/13/2022] [Accepted: 08/09/2023] [Indexed: 10/06/2023] Open
Abstract
Purpose The purpose of this study was to isolate the structural components of the ex vivo porcine iris tissue and to determine their biomechanical properties. Methods The porcine stroma and dilator tissues were separated, and their dimensions were assessed using optical coherence tomography (OCT). The stroma underwent flow test (n = 32) to evaluate for permeability using Darcy's Law (ΔP = 2000 Pa, A = 0.0391 mm2), and both tissues underwent stress relaxation experiments (ε = 0.5 with initial ramp of δε = 0.1) to evaluate for their viscoelastic behaviours (n = 28). Viscoelasticity was characterized by the parameters β (half width of the Gaussian distribution), τm (mean relaxation time constant), E0 (instantaneous modulus), and E∞ (equilibrium modulus). Results For the stroma, the hydraulic permeability was 9.49 ± 3.05 × 10-6 mm2/Pa · s, and the viscoelastic parameters were β = 2.50 ± 1.40, and τm = 7.43 ± 4.96 s, with the 2 moduli calculated to be E0 = 14.14 ± 6.44 kPa and E∞ = 6.08 ± 2.74 kPa. For the dilator tissue, the viscoelastic parameters were β = 2.06 ± 1.33 and τm = 1.28 ± 1.27 seconds, with the 2 moduli calculated to be E0 = 9.16 ± 3.03 kPa and E∞ = 5.54 ± 1.98 kPa. Conclusions We have established a new protocol to evaluate the biomechanical properties of the structural layers of the iris. Overall, the stroma was permeable and exhibited smaller moduli than those of the dilator muscle. An improved characterization of iris biomechanics may form the basis to further our understanding of angle closure glaucoma.
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Affiliation(s)
- Royston K. Y. Tan
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Satish K. Panda
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Mechanical Engineering, Indian Institute of Technology, Bhubaneswar, India
| | - Fabian A. Braeu
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Critical Analytics for Manufacturing Personalized-Medicine, Singapore-MIT Alliance for Research and Technology, Singapore
| | - Arumugam R. Muralidharan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Monisha E. Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Anita S. Y. Chan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Raymond P. Najjar
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Centre for Innovation & Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michaël J. A. Girard
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
- Department of Biomedical Engineering, NUS College of Design and Engineering, National University of Singapore, Singapore
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Xiong K, Wang L, Li W, Wang W, Meng J, Gong X, Lu P, Liang X, Huang J, Huang W. Risk of acute angle-closure and changes in intraocular pressure after pupillary dilation in patients with diabetes. Eye (Lond) 2023; 37:1646-1651. [PMID: 36008530 PMCID: PMC10220020 DOI: 10.1038/s41433-022-02215-y] [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: 10/19/2021] [Revised: 07/08/2022] [Accepted: 08/12/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To evaluate the risk of AAC and intraocular pressure (IOP) changes in diabetic patients after pupil dilation. METHODS This cross-sectional study enrolled 2,287 diabetic patients among community residents in Guangzhou, China. All participants underwent routine pupil dilation unless they had a history of glaucoma. IOP was measured using a non-contact tonometer before and one hour after pupil dilation with tropicamide 0.5% and phenylephrine 0.5% eye drop. The proportion of AAC and changes in IOP after pupil dilation were evaluated. RESULTS Only one of the 2,287 participants (0.04%) with diabetes developed post-dilation AAC. The mean pre and post-dilation IOP in the right was 16.1 ± 2.7 and 16.5 ± 2.8 mmHg (P < 0.001); mean pre and post-dilation IOP in the left was 16.5 ± 2.7 and 16.8 ± 2.8 mmHg (P < 0.001). Sixty-one participants (2.7%) showed an increase in IOP ≥ 5 mmHg and 25 participants (1.1%) showed a post-dilation IOP > 25 mmHg, including 11 participants (0.5%) who had both an increase in IOP ≥ 5 mmHg and post-dilation IOP > 25 mmHg. Lower pre-dilation IOP (OR = 0.827; 95% CI, 0.742-0.922; P = 0.001) and shallower anterior chamber depth (ACD) (OR = 0.226; 95% CI, 0.088-0.585; P = 0.002) were significant risk factors for an increase in IOP ≥ 5 mmHg in multivariate logistic regression analysis. CONCLUSIONS The risk of developing AAC after pupil dilation in diabetic patients was very low. Lower pre-dilation IOP and shallower ACD are risk factors for increased post-dilation IOP.
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Affiliation(s)
- Kun Xiong
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Lanhua Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Wangting Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Wei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Jie Meng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Xia Gong
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Peng Lu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - Xiaoling Liang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China
| | - JingJing Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China.
| | - Wenyong Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, PR China.
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Un Y, Imamoglu S, Tekcan H, Celik G, Ozturk Y, Mangan MS. Factors defining the intraocular pressure-lowering effect of phacoemulsification and laser peripheral iridotomy in patients with primary angle closure : Factors defining IOP lowering effect of PE and LPI in PAC. Lasers Med Sci 2023; 38:100. [PMID: 37059933 DOI: 10.1007/s10103-023-03772-8] [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: 09/15/2022] [Accepted: 04/08/2023] [Indexed: 04/16/2023]
Abstract
To identify whether gonioscopic ciliary body visibility and factors including anterior chamber depth (ACD), axial length (AL), acute attack history, and preoperative intraocular pressure (IOP) had any effect on IOP decrease in primary angle closure (PAC) and primary angle-closure glaucoma (PACG) after phacoemulsification (PE) and/or laser peripheral iridotomy (LPI). This retrospective-design study was conducted with 81 eyes with PAC and PACG; 33 eyes whose IOP was controlled with LPI and PE constituted group 1, and 48 eyes whose IOP was controlled using LPI alone comprised group 2. The effects on preoperative and last-visit IOP levels, ciliary body visibility, ACD, AL, and acute attacks were analyzed. Eyes within the groups were similar in AL, ACD, and preoperative IOP except for acute attack history, which was found to be higher in group 1. For group 1, none of the factors was found to have a differentiative effect on IOP decrease after PE, except eyes with preoperative IOP > 21 mm Hg, which had significantly more IOP reduction. For group 2, no difference was found in ciliary body visibility, and higher or lower ACD. However, eyes with AL ≥ 22 mm, positive acute attack history, and higher preoperative IOP were associated with significantly better IOP reduction. We found no relationship between ciliary body visibility and an IOP-reducing effect of PE and LPI. Although we found PE effective in IOP reduction in all eyes, we determined LPI to have a lesser IOP-reducing effect in eyes with IOP ≤ 21 mm Hg and AL < 22 mm.
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Affiliation(s)
- Yasemin Un
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey.
| | - Serhat Imamoglu
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Hatice Tekcan
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Gokhan Celik
- Department of Ophthalmology, Zeynep Kamil Obstetric and Pediatric Hospital Uskudar, 34668, Istanbul, Turkey
| | - Yucel Ozturk
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
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Savur S, Kaup S, Dinesh A, Shivalli S, Kondal D. Can ultrasonic biometric indices with optimal cut-offs be a potential screening tool for primary angle closure disease? A case-control study. Eye (Lond) 2023; 37:1284-1289. [PMID: 35624303 PMCID: PMC10101967 DOI: 10.1038/s41433-022-02118-y] [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: 11/11/2021] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES Despite a significant disease burden and potential to cause blindness, primary angle closure disease (PACD) does not have a population-based screening programme. Biometric indices using ultrasound A-scan is a potential tool for glaucoma case-detection. Given that genetic and environmental factors influence these parameters and paucity of data on their discrimination thresholds in Indian populace, we conducted a matched case-control study to determine the biometric indices and their discrimination thresholds associated with PACD. METHODS We studied 172 eyes of 86 participants (43 cases; 43 controls). We compared the following biometric parameters of cases (PACD, occludable angle ≥180° ± raised intraocular pressure) with age and gender-matched controls (1:1): Anterior chamber depth (ACD), lens thickness (LT), axial length (AXL), lens position (LP), relative lens position (RLP), lens axial factor (LAF), simple crowding value (Cs), ACD/AXL). We performed conditional logistic regression (to identify factors associated with PACD) and Receiver operating characteristic (ROC) analysis (to determine discrimination thresholds). RESULTS Reduced ACD (Adj OR 0.01; 95% CI: 0.0003-0.15, p < 0.001) and increased LT (Adj OR 10.3; 95% CI:2.42-43.93, p < 0.001) were associated with PACD. On ROC analysis, ACD, Cs, and ACD/AXL had optimum sensitivity/specificity at ≤3.015, ≥0.056 and ≤0.1303, respectively. ACD (88.4%) and Cs (94.2%) had highest sensitivity and specificity, respectively. CONCLUSION Ultrasonic biometric parameters differed significantly between PACD and controls. ACD and Cs (at discrimination thresholds of ≤3.015 mm and ≥ 0.056, respectively) using ultrasound A-scan could be a potential tool for PACD case-detection that requires evaluation of its diagnostic yield and cost-effectiveness.
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Affiliation(s)
- Sheetal Savur
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya Deemed to be University, Mangalore, India
| | - Soujanya Kaup
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya Deemed to be University, Mangalore, India.
| | - Anagha Dinesh
- Department of Ophthalmology, Yenepoya Medical College, Yenepoya Deemed to be University, Mangalore, India
| | - Siddharudha Shivalli
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Dimple Kondal
- Public Health Foundation of India, Gurgaon, India
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Zeng HB, Jiang JD, Li R, Li J, Zeng WJ, Li XK, Hu B, Zhou F, Yu HY, Xie JG, Ning ZN, Wang X. The inflammatory cytokine profiles and ocular biometric characteristics of primary angle-closure glaucoma. J Int Med Res 2023; 51:3000605221147434. [PMID: 36631983 PMCID: PMC9841865 DOI: 10.1177/03000605221147434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate the pathogenesis of primary angle-closure disease (PACG) by measuring the anatomical structures of the anterior and posterior segments of the eye and inflammatory markers in the peripheral blood. METHODS This case-control study enrolled patients diagnosed with acute PACG (APACG) and chronic PACG (CPACG). It also enrolled control subjects without PACG. The anterior and posterior anatomical features were measured in all study participants. The levels of interleukin (IL)-6, tumour necrosis factor-α and the neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood were measured. RESULTS This study analysed a total of 99 eyes: 34 eyes from 34 patients with APACG, 28 eyes from 28 patients with CPACG and 37 eyes from 37 control patients with senile cataract. The axis length, corneal diameter, anterior chamber depth and anterior chamber volume were significantly smaller in the APACG and CPACG groups compared with the controls. The level of IL-6 in the peripheral blood of patients with PACG was significantly lower than that of the controls. The NLR in the peripheral blood of patients with PACG was significantly greater than that of the controls. CONCLUSIONS Changes in the ocular anatomy and some inflammatory markers might be involved in the pathogenesis of PACG.
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Affiliation(s)
- Hong-Bo Zeng
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Jun-Di Jiang
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Rong Li
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Jian Li
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Wen-Juan Zeng
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Xiong-Kai Li
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Bin Hu
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Fei Zhou
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Hai-Ying Yu
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Jian-Guo Xie
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Zhi-Neng Ning
- Department of Glaucoma and Cataract, Aier Eye Hospital of Shaoyang, Shaoyang, Hunan Province, China
| | - Xian Wang
- Department of Ophthalmology, The Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
- Xian Wang, Department of Ophthalmology, The Hospital of Guizhou Medical University, 28 Guiyi Street, Yunyan District, Guiyang 550004, Guizhou Province, China.
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10
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Chakrabarti K, Samant S, Mohapatra R, Mishra S, Das S, Chakrabarti M. A comparison of lens parameters in patients with various subtypes of primary angle-closure disease and the normal population: A prospective study. Indian J Ophthalmol 2022; 70:2889-2894. [PMID: 35918938 PMCID: PMC9672764 DOI: 10.4103/ijo.ijo_3007_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: To assess the role of lens parameters in the detection and progression of primary angle-closure disease (PACD) by combining A-scan and A-scan optical coherence tomography (AS-OCT) parameters. Methods: A cross-sectional study was conducted in a tertiary health-care center in eastern India. A total of 91 study subjects including cases and controls were included in the study. The parameters studied were lens thickness (LT), lens axial factor (LAF), relative lens position (RLP), and lens vault (LV). Anterior chamber depth (ACD) and axial length (AL) were also analyzed using A-scan. Results: The LT was significantly more in all subtypes of PACD (from 4.24 ± 0.84 to 5.02 ± 0.18 mm) than in controls (4.04 ± 0.46 mm; P < 0.01). Similarly, LAF was significantly less among all subtypes of PACD compared to controls (P < 0.001). The RLP, calculated using the formula (ACD + 0.5 LT)/AL × 10, showed no significant difference (P > 0.05) between various study groups. The LV in acute angle-closure glaucoma (AcCG) patients was significantly higher compared to the control population (P < 0.01). Ocular parameters like ACD decreased, whereas LT and LAF increased from normal through primary angle closure (PAC) to primary angle-closure glaucoma (PACG). Logistic regression analysis found a significant association between a decrease in ACD and an increased risk of PACG (P-value was 0.0001) and an increase in LT and LAF with increased risk of PACG (P = 0.040 and P = 0.006, respectively). Conclusion: Inclusion of lens parameter assessment in the workup of a patient with PACD helps in detection and close monitoring of the progression from suspected to disease state.
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Affiliation(s)
- Keya Chakrabarti
- Institute of Medical Science and SUM Hospital, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha, India
| | - Swati Samant
- Institute of Medical Science and SUM Hospital, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha, India
| | - Ramesh Mohapatra
- Institute of Medical Science and SUM Hospital, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha, India
| | - Suchismita Mishra
- Institute of Medical Science and SUM Hospital, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha, India
| | - Suprava Das
- Institute of Medical Science and SUM Hospital, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha, India
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11
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Ryu KJ, Lee JY. Comparison of Anterior Chamber Depth with Posture Change Between Primary and lens-induced Angle Closure Glaucomas. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.3.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To compare the changes in central anterior chamber depth between supine and sitting positions using an ultrasound biomicroscope among acute angle closure glaucoma, lens-induced angle closure glaucoma, and normal groups.Methods: This study included 18, 13, and 29 individuals with acute angle closure glaucoma, lens-induced angle closure glaucoma, and control, respectively. The central anterior chamber depth, trabecular iris angle, corneal curvature, and axial length were measured in the sitting and supine positions.Results: The central anterior chamber depth in the supine and sitting positions were 1.61 ± 0.47 mm and 1.55 ± 0.46 mm in the acute angle closure glaucoma, which were significantly smaller than those in the normal group (2.48 ± 0.49 mm and 2.47 ± 0.50 mm) (p = 0.01 and p = 0.009, respectively). In lens-induced angle closure glaucoma, the central anterior chamber depth in the supine and sitting positions were 1.65 ± 0.84 mm and 1.52 ± 0.82 mm, respectively, which were significantly smaller than those in the normal group (p < 0.001 for both). The absolute change in central anterior chamber depth with posture alteration was significantly larger in both acute angle closure glaucoma (0.15 ± 0.09 mm) and lens-induced angle closure glaucoma (0.25 ± 0.11 mm) than in the normal control (0.09 ± 0.08 mm) (p = 0.011, p < 0.001, respectively). The largest amount of change was shown in the lens-induced angle closure glaucoma (p = 0.012). The absolute change in anterior chamber angle with posture change wa not significantly different between the groups (p = 0.165).Conclusions: Compared to the control group, the central anterior chamber depth was smaller in both glaucoma groups. The absolute change in the anterior chamber depth with posture was significantly larger in the lens-induced angle closure glaucoma than in acute angle closure glaucoma.
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12
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Ghadamzadeh M, Karimi F, Ghasemi Moghaddam S, Daneshvar R. Anterior Chamber Angle Changes in Primary Angle-closure Glaucoma Following Phacoemulsification Versus Phacotrabeculectomy: A Prospective Randomized Clinical Trial. J Glaucoma 2022; 31:147-155. [PMID: 35210384 DOI: 10.1097/ijg.0000000000001977] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022]
Abstract
PRCIS We used anterior segment optical coherence tomography to investigate anterior chamber angle in primary angle-closure glaucoma (PACG) eyes following phacoemulsification and phacotrabeculectomy. Angle widening was significantly greater after phacoemulsification up to 6 months after the surgery. PURPOSE To compare anterior chamber angle following 2 common surgeries for PACG. METHODS One hundred ten glaucoma patients were evaluated in this single center, prospective, randomized clinical trial. Those with concomitant PACG and senile cataract and without a history of ocular surgery, trauma, or chronic miotic use were recruited. Monocular patients were also excluded. Finally, 52 eligible subjects were randomly assigned to phacoemulsification ("Phaco" group, 25 eyes) or phacotrabeculectomy ("Combined" group, 27 eyes) surgeries. A swept-source, anterior segment optical coherence tomography device (CASIA SS-1000 OCT) was used to image the anterior segment. Mask graders used the images to measure the following parameters before and 1 week, 1 month, and 6 months after surgery: angle opening distance at 500 µm, trabecular iris surface area at 500 µm, and trabecular iris angle at 500 µm. RESULTS There was no significant difference between study groups regarding best-corrected visual acuity, intraocular pressure (IOP), and the number of glaucoma medications in preoperative or postoperative visits (P>0.076). Also, the measured angle parameters were not statistically significantly different between the 2 groups before surgery (P>0.123). After surgery, all measured parameters were significantly increased in both groups (P<0.0001). At the 6-month follow-up, nasal angle opening distance at 500 µm was 0.383±0.027 vs. 0.349±0.017, trabecular iris surface area at 500 µm was 0.141±0.007 vs. 0.125±0.005, and trabecular iris angle at 500 µm was 40.1±12.9 vs. 34.6±3.1 in Phaco and Combined groups, respectively (P<0.0001 for all). CONCLUSIONS Anterior chamber angle widening by anterior segment optical coherence tomography was observed in PACG patients following surgery and was significantly greater after phacoemulsification compared with combined phacotrabeculectomy at all time points. Similar IOP and medication burden were noted for up to 6 months as secondary outcomes. The contribution of angle changes to the IOP-lowering effect of phacoemulsification in PACG eyes needs further study.
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Affiliation(s)
| | - Farshid Karimi
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Ophthalmology, University of Florida, Gainesville, FL
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13
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Anterior Lens Curvature Matters in the Course of Primary Angle Closure: An Analysis Based on Ultrasound Biomicroscopic Imaging. J Ophthalmol 2022; 2022:5570633. [PMID: 35132362 PMCID: PMC8817843 DOI: 10.1155/2022/5570633] [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: 03/02/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the effect of anterior lens curvature in primary angle closure (PAC) and find additional anatomical features of crystalline lens that may predispose primary angle closure to the acute course. Methods. 435 eyes (263 subjects) were enrolled in this study. Four groups of eyes were included based on angle configurations and clinical features: (i) acute primary angle closure (APAC, 140 eyes); (ii) chronic primary angle closure (CPAC, 116 eyes); (iii) primary angle closure suspect (PACS, 84 eyes); and (iv) normal controls (95 eyes). All patients underwent thorough ophthalmic exams including applanation tonometry, gonioscopy, low-coherence interferometry, and ultrasound biomicroscopic imaging. Based on the panoramic anterior segment images from ultrasound biomicroscopic imaging measurements, the radius of anterior lens curvature (ALR) was calculated using the least-squares curve fitting technique. ALR, in addition to axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), was compared among different groups using univariate and multivariate analysis with mixed effects linear model. Results. APAC, CPAC, and PACS groups all had steeper ALR, shorter AL, shallower ACD, and thicker LT than normal control group. ACD and LT further differ between APAC and CPAC or PACS eyes. Moreover, a steeper ALR was also found in the APAC group as compared to CPAC, PACS, and normal control groups. Conclusions. A steeper ALR may predispose the acute attack of PAC. In addition to the relative lens position and size, lens curvature is another variable that contributes to the pathophysiological mechanisms of primary angle closure.
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14
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Primary Angle-Closure Disease Preferred Practice Pattern®. Ophthalmology 2021; 128:P30-P70. [PMID: 34933744 DOI: 10.1016/j.ophtha.2020.10.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 01/10/2023] Open
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15
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You S, Liang Z, Yang K, Zhang Y, Oatts J, Han Y, Wu H. Novel Discoveries of Anterior Segment Parameters in Fellow Eyes of Acute Primary Angle Closure and Chronic Primary Angle Closure Glaucoma. Invest Ophthalmol Vis Sci 2021; 62:6. [PMID: 34730791 PMCID: PMC8572512 DOI: 10.1167/iovs.62.14.6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate the biometric differences of anterior segment parameters between fellow eyes of acute primary angle closure (F-APAC) and chronic primary angle closure glaucoma (F-CPACG) to get information about differences between APAC and CPAC. Methods Patients with F-APAC and F-CPACG without prior treatment were enrolled from glaucoma clinics. Parameters were measured on ultrasound biomicroscopy images, including pupil diameter, lens vault (LV), anterior chamber depth, anterior chamber width, iris area, iris thickness (IT 750 and 2000), angle-opening distance (AOD 500 and 750), trabecular-iris space area (TISA 500 and 750), trabecular iris angle (TIA 500 and 750), trabecular–ciliary angle, and ciliary process area. Multivariate logistic regression analysis was performed to determine the most important parameters associated with F-APAC compared with F-CPACG. Results Fifty-five patients with APAC and 55 patients with CPACG were examined. The anterior chamber depth, IT 750, AOD 750, trabecular iris angle 750, and trabecular–ciliary angle were smaller, and LV and ciliary process area were greater in F-APAC as compared with F-CPACG (P ≤ 0.01). Multivariate logistic regression showed that thinner IT 750, smaller AOD 750, and larger LV were significantly associated with F-APAC (P < 0.01). IT 750 (area under the curve, 0.703) performed relatively better than AOD 750 (area under the curve, 0.696) in distinguishing F-APAC from F-CPACG, with the best cutoff of 0.404 mm and 0.126 mm, respectively. Conclusions Compared with F-CPACG, F-APAC had thinner peripheral iris, narrower anterior chamber angle, shallower anterior chamber depth, greater LV, larger and anteriorly positioned ciliary body. IT 750, AOD 750, and LV played important roles in distinguishing eyes predisposed to APAC or CPAC.
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Affiliation(s)
- Shuqi You
- Department of Ophthalmology, Peking University People's Hospital; College of Optometry, Beijing, China.,University Health Science Center; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.,Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Zhiqiao Liang
- Department of Ophthalmology, Peking University People's Hospital; College of Optometry, Beijing, China.,University Health Science Center; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kangyi Yang
- Department of Ophthalmology, Peking University People's Hospital; College of Optometry, Beijing, China.,University Health Science Center; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yu Zhang
- Department of Ophthalmology, Peking University People's Hospital; College of Optometry, Beijing, China.,University Health Science Center; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Julius Oatts
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Ying Han
- Department of Ophthalmology, University of California, San Francisco, California, United States
| | - Huijuan Wu
- Department of Ophthalmology, Peking University People's Hospital; College of Optometry, Beijing, China.,University Health Science Center; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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16
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Tang Y, Pan X, Cao K, Feng H, Yang Y, Hu Z, Yan F, Han Y, Li S. Ganglion Cell Complex Parameters in Primary Angle Closure Suspects. Ophthalmic Res 2021; 64:844-850. [PMID: 34139705 DOI: 10.1159/000516538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Yizhen Tang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiaohua Pan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China,
| | - Kai Cao
- Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China
| | - Hui Feng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Yue Yang
- Department of Ophthalmology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Zhongyin Hu
- Department of Ophthalmology, First People's Hospital of Yunnan Province, Kunming, China
| | - Fancheng Yan
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying Han
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Shuning Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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17
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Huang W, Li X, Gao X, Zhang X. The anterior and posterior biometric characteristics in primary angle-closure disease: Data based on anterior segment optical coherence tomography and swept-source optical coherence tomography. Indian J Ophthalmol 2021; 69:865-870. [PMID: 33727449 PMCID: PMC8012975 DOI: 10.4103/ijo.ijo_936_20] [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: 11/17/2022] Open
Abstract
Purpose: Obtaining a better understanding of the pathogenesis of primary angle-closure disease (PACD) still requires studies that provide measurements of anterior and posterior biometric characteristics together and that assess the relationship between them. Methods: In total, 201 eyes were enrolled in this cross-sectional study: 50 normal controls, 49 primary angle-closure suspect (PACS), 38 primary angle closure (PAC), and 64 primary angle-closure glaucoma (PACG) eyes. The anterior and posterior structural features were measured by anterior segment optical coherence tomography and swept-source optical coherence tomography. Results: All PACD groups had smaller anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber volume (ACV), angle opening distance at 750 μm from the scleral spur (AOD750), trabecular–iris space area at 750 μm from the scleral spur (TISA750), and angle recess area (ARA), as well as a larger lens vault (LV), than controls (all P < 0.001). The PACS and PAC groups had thicker iris thickness at 750 μm from the scleral spur (IT750) than controls (P = 0.017 and P = 0.002, respectively). Choroidal thickness (CT) was not statistically different among normal, PACS, PAC, and PACG eyes. Univariate and multivariate linear regression analysis revealed a significant association between thinner IT750 and increased CT in PACD eyes (P = 0.031, univariate analysis; P = 0.008, multivariate analysis). Conclusion: Thinner iris thickness was associated with increased CT in PACD eyes; however, the underlying mechanism needs further investigation.
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Affiliation(s)
- Wenbin Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou; Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, People's Republic of China
| | - Xingyi Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xinbo Gao
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
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18
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Kang YS, Sung MS, Heo H, Ji YS, Park SW. Long-term outcomes of prediction error after combined phacoemulsification and trabeculectomy in glaucoma patients. BMC Ophthalmol 2021; 21:60. [PMID: 33499825 PMCID: PMC7839202 DOI: 10.1186/s12886-021-01824-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background To investigate long-term outcomes of prediction error after phacotrabeculectomy and to determine risk factors that may cause unstable prediction error after phacotrabeculectomy in glaucoma patients. Methods A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable prediction error (MAE ≥ 0.5) were investigated in the combined group. Results In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable prediction error after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable prediction error after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive error analyzed by the ROC curve was 0.855 mm. Conclusions Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unstable prediction error after phacotrabeculectomy.
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Affiliation(s)
- Yeon Soo Kang
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Mi Sun Sung
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Hwan Heo
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Yong Sok Ji
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea
| | - Sang Woo Park
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea.
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Wang X, Chen J, Kong X, Sun X. Quantification of Retinal Microvascular Density Using Optic Coherence Tomography Angiography in Primary Angle Closure Disease. Curr Eye Res 2020; 46:1018-1024. [PMID: 33170750 DOI: 10.1080/02713683.2020.1849728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose: To evaluate the microvascular density of the peripapillary and parafoveal areas of the eyes with primary angle closure disease (PACD) using optical coherence tomography angiography (OCTA).Materials and methods: An observational study was conducted with 76 PACD patients (29 eyes with primary angle closure suspect, 22 eyes with primary angle closure [PAC], and 25 eyes with primary angle closure glaucoma [PACG]) and 27 control eyes. OCTA was performed for all subjects to acquire a 4.5 × 4.5 mm scanning area centered on the optic discs and a 3 × 3 mm parafoveal cubes. Peripapillary and parafoveal vessel density (VD) were compared between these four groups, and the relationship between VD values and structural and functional changes was evaluated.Results: Among all four groups, the peripapillary VD of the PACG eyes was the lowest in all six sections (all P < .01), while the parafoveal VD was lower than that of the normal group only in the average, superior, and inferior areas (all P < .05). The PAC group had lower peripapillary VD than the normal group (62.6[55.2-67.4] vs. 66.7[54.7-69.3], P = .01), while their retinal nerve fiber layer (RNFL) and ganglion cell complex thickness were not significantly different than those of the control group (all P > .05). In addition, the stages of PACD, visual field mean deviation, and RNFL thickness were shown to be predictors of the peripapillary VD in the multiple linear regression analysis.Conclusions: The PAC eyes had lower peripapillary VD than normal eyes when their RNFL and GCC thickness did not differ. This suggests that a reduction in retinal VD may occur before structural loss in PAC eyes. Retinal VD measurement may be a useful tool for the assessment of PACD.
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Affiliation(s)
- Xiaolei Wang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Ministry of Health (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Junyi Chen
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Ministry of Health (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xiangmei Kong
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Ministry of Health (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Ministry of Health (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.,State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
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20
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Costa VP, Leung CK, Kook MS, Lin SC, Al-Aswad LA, Araie M, Baudouin C, Coupal DJ, Fechtner R, Tee Khaw P, Khaderi KR, Khawaja A, Mattox C, Miller-Ellis E, Nagori S, Olivier M, Pfeiffer N, Serle J, Stalmans I, Varma DK. Clear lens extraction in eyes with primary angle closure and primary angle-closure glaucoma. Surv Ophthalmol 2020; 65:662-674. [DOI: 10.1016/j.survophthal.2020.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
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21
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Wang X, Chen X, Tang Y, Wang J, Chen Y, Sun X. Morphologic Features of Crystalline Lens in Patients with Primary Angle Closure Disease Observed by CASIA 2 Optical Coherence Tomography. Invest Ophthalmol Vis Sci 2020; 61:40. [PMID: 32441758 PMCID: PMC7405781 DOI: 10.1167/iovs.61.5.40] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose To investigate the morphologic features of crystalline lens in primary angle closure disease (PACD) by the swept-source anterior segment optical coherence tomography. Methods This cross-sectional observational study included 125 consecutive eyes from 125 patients who underwent anterior segment optical coherence tomography (CASIA 2, Tomey, Nagoya, Japan) examination, including 38 eyes of normal controls, 57 eyes of PAC suspects (PACS), and 30 eyes with PAC or PAC glaucoma (PACG). Crystalline lens parameters were compared among the three groups. Spearman correlation analysis and multiple linear regression models were performed to evaluate the relationships between the lens parameters and related factors. Results Significant differences were found for anterior chamber depth, axial length, iridotrabecular contact index, lens vault, lens thickness (all P < 0.001), the anterior radius curvature of lens (normal vs PACS vs PAC/PACG: 9.35 ± 1.29 mm vs 8.40 ± 0.62 mm vs 8.12 ± 0.54 mm; P < 0.001), lens decentration (normal vs PACS vs PAC/PACG: 0.14 ± 0.07 mm vs 0.19 ± 0.09 mm vs 0.22 ± 0.12 mm; P = 0.004), and tilt (normal vs PACS vs PAC/PACG: 4.9 ± 1.0° vs 5.3 ± 1.2° vs 5.8 ± 1.8°; P = 0.033) among the three groups. The multivariate regression analysis found that both iridotrabecular contact index and the stage of the PACD were negatively correlated with the anterior radius curvature of lens, positively correlated with lens thickness and decentration after adjustment for age, sex, and axial length (all P < 0.05). Conclusions Steep anterior curvature and decentration of the crystalline lens may be another anatomic characteristic of eyes with PACD. These findings support that the crystalline lens morphologic features may have great contribution to the development of PACD.
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Luo Q, Xue W, Yuan Y, Fu C, He J, Zou H, Tong X, Lee RK, Ge L. Peripheral anterior chamber depth and screening techniques for primary angle closure disease in community elderly Chinese. BMC Ophthalmol 2020; 20:353. [PMID: 32859174 PMCID: PMC7456037 DOI: 10.1186/s12886-020-01618-3] [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] [Received: 02/10/2020] [Accepted: 08/20/2020] [Indexed: 11/23/2022] Open
Abstract
Background To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening. We performed a population-based survey in Pudong New District of Shanghai, China, in 2011. Methods Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results Two thousand five hundred twenty-eight adults participated in the study with 91 patients diagnosed with PACD. Two thousand four hundred sixty-three subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04 ± 0.46 (range 0.11–2.93) CT and 0.87 ± 0.41 (range 0.12–2.96) CT respectively (t = − 4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P < 0.0001) per diopter of SE and was 0.19 CT (P < 0.0001) shallower in women than in men (r2 = 0.1304, P < 0.0001). Peripheral ACD performed best in screening for PACD. Conclusions Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.
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Affiliation(s)
- Qin Luo
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200040, China
| | - Wenwen Xue
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China
| | - Yin Yuan
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China
| | - Chaowei Fu
- Department of Social Medicine, School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Jiangnan He
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China
| | - Haidong Zou
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200040, China
| | - Xiaowei Tong
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China
| | - Richard K Lee
- Bascom Palmer Eye Institute, 900 N.W. 17th Street, Miami, FL, 33136, USA
| | - Ling Ge
- Department of Ophthalmology, Shanghai Eye Disease Prevention & Treatment Center/ Shanghai Eye Hospital, No. 380 Kangding Road, Shanghai, 200040, China. .,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Shanghai, 200040, China.
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Zhao M, Sun Q, Oatts J, Hu G, Ge L, Zhu B, Fu M, Wang Y, Miao Y, Luo Q, Niu T, Yu Y, Ying GS, Aung T, Xu X, Han Y. Changes in Intraocular Pressure and Angle Structure after Dilation in Primary Angle-Closure Suspects with Visually Significant Cataract. Ophthalmology 2020; 128:39-47. [PMID: 32652206 DOI: 10.1016/j.ophtha.2020.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/18/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the safety of pupillary dilation in primary angle-closure suspects (PACS) with concurrent visually significant cataract (VSC), to identify risk factors associated with elevated intraocular pressure (IOP), and to describe changes in anterior segment anatomy after pupillary dilation. DESIGN Prospective study. PARTICIPANTS Patients with PACS and VSC and no prior laser or intraocular surgery were recruited. Visually significant cataract was defined as best-corrected visual acuity ≤ 20/40 due to cataract. METHODS Subjects' eyes were dilated with 0.5% tropicamide and 0.5% phenylephrine hydrochloride. A standardized eye examination, biometry, and swept-source OCT (SS-OCT) were performed before dilation. Intraocular pressure and SS-OCT were repeated 1, 4, and 6 hours postdilation (PDH1, PDH4, and PDH6, respectively). All parameters were compared between time points before and after dilation using paired t test. Linear regression models were used to determine the risk factors associated with postdilation IOP changes. MAIN OUTCOME MEASURES Change in IOP and SS-OCT parameters from baseline. RESULTS Seventy-eight eyes from 78 patients were included, with 78, 66, and 12 patients completing the study at PDH1, PDH4, and PDH6, respectively. Mean IOP increased from 14.8 ± 2.6 mmHg at baseline to 15.5 ± 3.5 mmHg at PDH1 (P = 0.03) and decreased to 14.9 ± 3.1 mmHg at PDH4 (P = 0.09). Four patients (5.13%) and 3 patients (3.85%) had an increase in IOP ≥ 5 mmHg at PDH1 and PDH4, respectively. Two patients (2.56%) and 1 patient (1.28%) had an increase in IOP ≥ 8 mmHg at PDH1 and PDH4, respectively. None developed acute primary angle-closure during the observation period. Almost all anterior chamber parameters showed a significant increase after dilation at PDH1 and PDH4, except lens vault and iris volume, which decreased at PDH1 and PDH4 from baseline. Increase in anterior chamber depth was negatively associated with the level of IOP elevation after dilation (P < 0.01). CONCLUSIONS Dilation of patients' eyes with PACS and VSC in this cohort appears to have a low risk for IOP spike. This may be associated with relaxation of the ciliary muscle leading to posterior displacement of the lens-iris diaphragm and deepening of the anterior chamber.
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Affiliation(s)
- Mengya Zhao
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Qian Sun
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Julius Oatts
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Guangyi Hu
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Ge
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Bijun Zhu
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingshui Fu
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yulan Wang
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Yuyu Miao
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Luo
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Tian Niu
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yinxi Yu
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gui-Shuang Ying
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
| | - Ying Han
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California.
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Asefa NG, Neustaeter A, Jansonius NM, Snieder H. Heritability of glaucoma and glaucoma-related endophenotypes: Systematic review and meta-analysis. Surv Ophthalmol 2019; 64:835-851. [DOI: 10.1016/j.survophthal.2019.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/28/2019] [Accepted: 06/07/2019] [Indexed: 02/09/2023]
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Effect of Visibility of the Ciliary Body Processes on Ocular Biometric Parameters in Patients with Primary Angle Closure. Jpn J Ophthalmol 2019; 63:467-473. [PMID: 31522329 DOI: 10.1007/s10384-019-00686-3] [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: 01/25/2019] [Accepted: 07/29/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the differences in ocular biometric parameters between eyes with primary angle closure (PAC) with and without visible ciliary body processes (CBP) (PAC+CBP and PAC-CBP) and normal open-angle controls. STUDY DESIGN Cross-sectional study. METHODS Eyes with PAC and normal open-angle controls underwent detailed ocular examinations and gonioscopy to determine the visibility of the CBP. The following ocular biometric parameters were determined using A-scan ultrasound biometry: axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous length (VL). The lens-axial length factor (LAF) and relative lens position (RLP) were also calculated. Continuous variables were assessed by analysis of variance with Bonferroni correction. Multiple linear regression analysis was performed to adjust for confounding factors. Area under the receiver operating characteristic curves were calculated to determine the diagnostic capability of biometric parameters. RESULTS 84 PAC+CBP eyes, 57 PAC-CBP eyes, and 32 normal open angle control eyes were evaluated. The means of the ocular biometric values were significantly different among the three groups. AL, ACD, LT, VL, LAF, and RLP were also significantly different among the three groups in the multivariate regression analysis. AL, ACD, and VL were lower in the PAC+CBP group and LT, RLP, and LAF were greater in the PAC+CBP group than in the PAC-CBP and control groups. LAF ≥ 2.4 is the cutting point with the highest sensitivity and specificity to differentiate PAC+CBP from PAC-CBP. CONCLUSIONS The ocular biometric parameters in the PAC+CBP group were more strongly associated with a crowded anterior segment than in the other groups. Visibility of CBP in PAC-affected eyes may serve as a surrogate for an anterior segment crowding mechanism and help to select the most appropriate treatment in individual cases.
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Narayanaswamy A, Nai MH, Nongpiur ME, Htoon HM, Thomas A, Sangtam T, Lim CT, Wong TT, Aung T. Young's Modulus Determination of Normal and Glaucomatous Human Iris. ACTA ACUST UNITED AC 2019; 60:2690-2695. [DOI: 10.1167/iovs.18-26455] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Arun Narayanaswamy
- Singapore Eye Research Institute and Singapore National Eye Center, Singapore
| | - Mui Hoon Nai
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Monisha E. Nongpiur
- Singapore Eye Research Institute and Singapore National Eye Center, Singapore
- Duke-NUS Graduate Medical School, Singapore
| | - Hla Myint Htoon
- Singapore Eye Research Institute and Singapore National Eye Center, Singapore
- Duke-NUS Graduate Medical School, Singapore
| | - Anoop Thomas
- Department of Ophthalmology & Visual Sciences Khoo Teck Puat Hospital, Singapore
| | - Tiakumzuk Sangtam
- Department of Ophthalmology & Visual Sciences Khoo Teck Puat Hospital, Singapore
| | - Chwee Teck Lim
- Department of Biomedical Engineering, National University of Singapore, Singapore
- Mechanobiology Institute, National University of Singapore, Singapore
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore
| | - Tina T. Wong
- Singapore Eye Research Institute and Singapore National Eye Center, Singapore
- Duke-NUS Graduate Medical School, Singapore
| | - Tin Aung
- Singapore Eye Research Institute and Singapore National Eye Center, Singapore
- Duke-NUS Graduate Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Li F, Zhou R, Gao K, Jin L, Zhang X. Volumetric parameters-based differentiation of narrow angle from open angle and classification of angle configurations: an SS-OCT study. Br J Ophthalmol 2019; 104:92-97. [PMID: 31036585 DOI: 10.1136/bjophthalmol-2018-313386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/02/2019] [Accepted: 02/26/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND To evaluate the diagnostic ability of volumetric parameters to differentiate narrow angle from open angle and distinguish different configurations of narrow angle. METHODS The current study was composed of two parts. In the first part, with gonioscopy as reference standard, we tested power of each parameter to differentiate narrow angle from open angle. In the second part, we evaluated the efficacy of different parameters to distinguish angle configurations which were subclassified into type 1 (pupillary block) and type 2 (non-pupillary block and multiple mechanisms) based on ultrasound biomicroscopy (UBM) images. RESULTS In part 1, the training set was composed of 117 narrow-angle eyes and 60 open-angle eyes, and the validation set included 38 narrow-angle eyes and 37 open-angle eyes. Anterior chamber volume (ACV) outperformed all the other parameters with an area under the curve (AUC) of 0.988. The sensitivity and specificity of the cut-off value 98.1 mm3 in the validation set were 90.0% and 97.1%, respectively. In part 2, training set was composed of 96 eyes of 88 patients with primary angle-closure disease, with 49 diagnosed as type 1 and 47 as type 2 configuration. 32 eyes were used for validation. A model comprised of iris volume (IV), iris thickness (IT) 2000 µm from the scleral spur and angle open distance (AOD) 750 µm from the scleral spur was found to have an AUC of 0.793 (95% CI, 0.695 to 0.870). Sensitivity and specificity of the model were 82.6% and 77.8% respectively in the validation set. CONCLUSIONS With ACV, we can detect patients with narrow angle from open angle faster and more easily than AOD and anterior chamber depth. Then, for patients with narrow angle, the combination of IV, IT and AOD750 measured by swept-source optical coherence tomography could further classify configurations of angle closure compared with UBM.
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Affiliation(s)
- Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Rouxi Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Kai Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
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Primary Angle-Closure Glaucoma With Normal Intraocular Pressure at the First Visit: Its Prevalence and Ocular Characteristics. J Glaucoma 2018; 28:32-37. [PMID: 30300309 DOI: 10.1097/ijg.0000000000001099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the prevalence of normal intraocular pressure (IOP) at first visit among patients with primary angle-closure glaucoma (PACG) and their ocular characteristics. PATIENTS AND METHODS We retrospectively reviewed patients with PACG in a referral center. According to untreated IOP, we divided PACG eyes into 2 groups: those with normal IOP and those with high IOP (>21 mm Hg) at the first visit. RESULTS One hundred sixty eyes of 160 Korean PACG patients were included. Sixty percent (97/160) of the patients had normal IOP at their first visit. The PACG patients with initially normal IOP had significantly longer axial length (mean±SD, 22.99±0.76 vs. 22.74±0.61) and deeper "true" anterior chamber depth (ACD) (2.09±0.27 vs. 1.82±0.33) than those with initially high IOP (both P<0.05). Multiple logistic regression revealed that deeper "true" ACD (per 0.1 mm; odds ratio, 1.38) and more hyperopic refractive errors (odds ratio, 1.48) were independent predictors of initially normal IOP in PACG eyes (P<0.05). The prevalence of disc hemorrhage was higher in PACG patients with initially normal IOP than in those with initially high IOP (29.9% vs. 14.3%, P=0.029). CONCLUSIONS Sixty percent of patients with PACG had normal IOP at their first visit. This suggests that without gonioscopy clinicians may misdiagnose PACG as normal tension glaucoma. ACD measurement can aid the diagnosis of PACG because even PACG eyes with initially normal IOP have shallow ACD.
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Is combined mechanism glaucoma a distinct entity? Graefes Arch Clin Exp Ophthalmol 2018; 256:1961-1969. [DOI: 10.1007/s00417-018-4050-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 10/28/2022] Open
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Tsuchiya A, Tanaka K, Sakurada I, Oba S, Mizuki N. Ultrasound Biomicroscopic Measurement of Anterior Chamber Biometry between before and after Pupil Dilation in Children. Eur J Ophthalmol 2018; 18:532-9. [DOI: 10.1177/112067210801800405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- A.K. Tsuchiya
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama - Japan
- Kanagawa Children's Medical Center, Yokohama - Japan
| | - K. Tanaka
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama - Japan
| | - I. Sakurada
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama - Japan
| | - S. Oba
- Kanagawa Children's Medical Center, Yokohama - Japan
| | - N. Mizuki
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama - Japan
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Sun X, Dai Y, Chen Y, Yu DY, Cringle SJ, Chen J, Kong X, Wang X, Jiang C. Primary angle closure glaucoma: What we know and what we don’t know. Prog Retin Eye Res 2017; 57:26-45. [DOI: 10.1016/j.preteyeres.2016.12.003] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/18/2016] [Accepted: 12/07/2016] [Indexed: 01/25/2023]
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Mun CY, Park SY, Jung MS. Anterior Segment Changes after Laser Iridotomy for the Treatment and Prevention of Angle-closure Glaucoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.12.1396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Chi Young Mun
- Department of Ophthalmology, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Se Young Park
- Department of Ophthalmology, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Moon Sun Jung
- Department of Ophthalmology, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
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Huang W, Gao X, Zhang X, Zhang X. Limbus-insertion distance of superior rectus in primary angle closure glaucoma: an anterior segment OCT study. Can J Ophthalmol 2016; 51:438-444. [PMID: 27938955 DOI: 10.1016/j.jcjo.2016.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 05/28/2016] [Accepted: 06/06/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To compare the distance from the corneoscleral limbus to the insertion site of the superior rectus of primary angle-closure glaucoma (PACG) patients with normal controls and to identify potential characteristics associated with limbus-insertion distance. DESIGN Cross-sectional study. PARTICIPANTS A total of 92 subjects (eyes) were enrolled in the study: 35 were nonglaucoma controls and 57 were PACG patients. METHODS The limbus-insertion distance of the superior rectus was measured by anterior segment optical coherence tomography (AS-OCT) and intraoperative surgical caliper. The anterior chamber parameters were also measured using AS-OCT to identify potential characteristics associated with limbus-insertion distance. RESULTS The limbus-insertion distance of the superior rectus was 0.40 ± 0.08 mm shorter in the PACG group than in the normal control group (p < 0.001). Anterior segment parameter values, including anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber area (ACA), and anterior chamber volume (ACV), were smaller in the PACG group than in the normal control group, but the lens vault was larger (all p < 0.001). A shorter limbus-insertion distance of the superior rectus was significantly associated with shorter axial length and "crowded" angle (smaller ACD, ACW, ACA, and ACV) (all p < 0.05). CONCLUSIONS This is the first study to demonstrate that the limbus-insertion distance of the superior rectus was shorter in PACG eyes than in normal eyes. The shorter limbus-insertion distance may be another anatomic characteristic of PACG eyes.
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Affiliation(s)
- Wenbin Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xinbo Gao
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xinyu Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China..
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Shi H, Zhang J, Zhu R, Hu N, Lu H, Yang M, Qin B, Shi J, Guan H. Primary Angle Closure and Sequence Variants within MicroRNA Binding Sites of Genes Involved in Eye Development. PLoS One 2016; 11:e0166055. [PMID: 27824919 PMCID: PMC5100968 DOI: 10.1371/journal.pone.0166055] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/21/2016] [Indexed: 01/22/2023] Open
Abstract
Purpose The formation of primary angle closure (PAC) and primary angle closure glaucoma (PACG) is regulated by a tissue remodeling pathway that plays a critical role in eye development. MicroRNAs (miRNAs) are powerful gene expression regulators and may exert their effects on tissue remodeling genes. This study investigated the associations between gene variants (single-nucleotide polymorphism, SNP) in miRNA binding sites in the 3’-UTR region of genes involved in eye development and PAC. Methods The sample consisted of 232 PAC subjects and 306 controls obtained from a population-based cohort in the Funing District of Jiangsu, China. The markers include 9 SNPs in the COL11A1, PCMTD1, ZNRF3, MTHFR, and ALPPL2 genes respectively. SNP genotyping was performed with a TaqMan-MGB probe using an RT-PCR system. Results Of the 9 SNPs studied, the frequency of the minor A allele of COL11A1 rs1031820 was higher in the PAC group than in the control group in allele analysis (p = 0.047). The genotype analysis indicated that MTHFR rs1537514 is marginally associated with PAC (p = 0.014). The CC genotype of rs1537514 was present solely in the PAC group. However, the differences lost significance after Bonferroni correction. Conclusion Our study reveals a possible association of COL11A1 and MTHFR with PAC in the Han Chinese population. These results will contribute to an improved understanding of the genetic basis of PACG.
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Affiliation(s)
- Haihong Shi
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Junfang Zhang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Rongrong Zhu
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Nan Hu
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Hong Lu
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Mei Yang
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Bai Qin
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Jian Shi
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
| | - Huaijin Guan
- Eye Institute, Affiliated Hospital of Nantong University, Nantong, China
- * E-mail:
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Rao A, Padhy D, Sarangi S, Das G. Angle Closure Scoring System (ACSS)-A Scoring System for Stratification of Angle Closure Disease. PLoS One 2016; 11:e0160209. [PMID: 27788183 PMCID: PMC5082952 DOI: 10.1371/journal.pone.0160209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/16/2016] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the angle closure scoring system (ACSS) for stratifying primary angle course disease. Methods This observational cross sectional institutional study included patients with primary open angle glaucoma suspects (n = 21) and primary angle closure disease (primary angle closure, PAC, n = 63 and primary angle course glaucoma, PACG, n = 58 (defined by International society of Geographical and Epidemiological Ophthalmology, ISGEO). Two independent examiners blinded to clinical details, graded good quality pre-laser goniophotographs of the patients incorporating quadrants of peripheral anterior synechieae (PAS), non-visibility of posterior trabecular meshwork (PTM) and blotchy pigments (ranging from 1–4 quadrants), iris configuration, angle recess (sum of above depicting ACSSg) and lens thickness/axial length ratio (LT/AL), cup disc ratio and baseline intraocular pressure (IOP) to give total score (ACSSt). Result There were significant differences in ACSSg scores within the same ISGEO stage of PAC and PACG between eyes that required nil or >1medicines after laser iridotomy, p<0.001. The ACSSg was associated with need for >1 medicines in both PAC and PACG eyes, p<0.001. An ACSSg score>12 and 14 in PAC (odds ratio = 2.7(95% CI-1.7–5.9) and PACG (Odds ratio = 1.6(95%CI-1.19–2.2) predicted need for single medicines while ACSSg scores >14 and 19 predicted need for ≥2 medicines in PAC and PACG eyes, respectively. The LT/Al ratio, IOP score or cup disc score did not influence the need for medical treatment independently. Conclusion The ACSS can be a useful clinical adjunct to the ISGEO system to predict need for medicines and prognosticate each stage more accurately.
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Affiliation(s)
- Aparna Rao
- Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, India
- * E-mail:
| | - Debananda Padhy
- Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, India
| | - Sarada Sarangi
- Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, India
| | - Gopinath Das
- Glaucoma Service, LV Prasad Eye Institute, Patia, Bhubaneswar, India
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Gao X, Huang W, Wang W, Zhou M, Wang J, Du S, Chen S, Zhang X. Topographic profile of choroid in eyes after acute primary angle-closure. Can J Ophthalmol 2016; 51:354-361. [PMID: 27769326 DOI: 10.1016/j.jcjo.2016.02.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 12/27/2015] [Accepted: 02/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To characterize and compare the topographic profile of choroid in eyes after acute primary angle-closure (APAC) and in normal controls. DESIGN, SETTING, AND PARTICIPANTS A prospective observational study was conducted. Forty-four consecutive patients who had experienced unilateral APAC that was resolved by treatment were recruited. Seventy age- and sex-matched normal individuals were recruited as controls. METHODS Enhanced depth imaging-optical coherence tomography was used to measure choroidal thickness (CT) in 9 diffuse locations of macular region. The average CT was compared among each location in the APAC and control groups and between the same locations in the 2 groups. RESULTS Variants of CT at different macular locations were found in both groups; it was greatest at subfoveal locations and spread thinner around them, to reach a significant decrease (all p ≤ 0.05) 3 mm away in all directions from the fovea except for the superior direction in normal controls (p = 0.472). Among the 4 directions, the superior had the thickest CT in both groups, followed by the temporal, inferior, and nasal directions in both groups, whereas the APAC had a thicker choroid profile at each location (all p < 0.05). Univariate analysis showed that age, sex, anterior chamber depth, axial length, and spherical equivalent were all associated with the subfoveal choroidal thickness (SFCT) (all p < 0.1). Multivariable linear regression analysis showed that the SFCT was significantly thicker in association with an APAC diagnosis, shorter axial length, greater spherical equivalent refractive error, and younger female subjects (all p ≤ 0.05). CONCLUSIONS APAC eyes have a thicker choroid than normal eyes in the macular region, and the increase in CT in APAC eyes follows topographic distribution as in normal control eyes.
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Affiliation(s)
- Xinbo Gao
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Wenbin Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Wei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Minwen Zhou
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jiawei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Shaolin Du
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Shida Chen
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China.
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Li SF, Wu GW, Chen CX, Shen L, Zhang ZB, Gao F, Wang NL. Association between choroidal thickness and anterior chamber segment in eyes with narrow or open-angle. Int J Ophthalmol 2016; 9:1143-7. [PMID: 27588269 DOI: 10.18240/ijo.2016.08.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 07/06/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the relationship between choroidal thickness and anterior chamber segment in subjects with eyes with narrow or open-angle. METHODS The subfoveal choroidal thickness was measured with enhanced depth-imaging optical coherence tomography and anterior chamber parameters were measured with ultrasound biomicroscopy in one eye of 23 subjects with open-angle eyes and 38 subjects with narrow-angle eyes. The mean age was 59.52±7.04y for narrow-angle subjects and 60.76±7.23y for open-angle subjects (P=0.514). Multivariate linear regression analysis was performed to assess the association between choroidal thickness and narrow-angle parameters. RESULTS There were no differences in subfoveal choroidal thickness between open- and narrow-angle subjects (P=0.231). Anterior chamber parameters, including central anterior chamber depth, trabecular iris angle, iris thickness 500 µm from the scleral spur (IT500), and ciliary body thickness at 1 mm and 2 mm from the scleral spur (CBT1, CBT2) showed significant differences between the two groups (P<0.05). Subfoveal choroidal thickness showed negative correlation (β=-0.496, P=0.016) only with anterior chamber depth in the open-angle group and with age (β=-0.442, P=0.003) and IT500 (β=-0.399, P=0.008) in the narrow-angle group. However, subfoveal choroidal thickness was not correlated with trabecular iris angle, anterior chamber depth, ciliary body thickness, or central corneal thickness in the narrow-angle group. CONCLUSION Choroidal thickness does not differ in the two groups and has not correlated with anterior chamber parameters in narrow-angle subjects, suggesting a lack of relationship between choroidal thickness and primary angle-closure glaucoma.
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Affiliation(s)
- Song-Feng Li
- Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ge-Wei Wu
- Department of Ophthalmology, Beijing Shi Jing Shan Hospital, Beijing 100000, China
| | - Chang-Xi Chen
- Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ling Shen
- Department of Ophthalmology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Zhi-Bao Zhang
- Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Fei Gao
- Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ning-Li Wang
- Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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Abstract
PURPOSE The purpose of this study was to compare the ocular biometrics between myopic patients with and without narrow angles. METHODS Patients with a stable myopic refraction (myopia worse than -1.00 D spherical equivalent) were prospectively recruited. Angle status was assessed using gonioscopy and biometric measurements were performed using an anterior segment optical coherence tomography and an IOLMaster. RESULTS A total of 29 patients (58 eyes) were enrolled with 13 patients (26 eyes) classified as having narrow angles and 16 patients (32 eyes) classified as having open angles. Baseline demographics of age, sex, and ethnicity did not differ significantly between the 2 groups. The patients with narrow angles were on average older than those with open angles but the difference did not reach statistical significance (P=0.12). The central anterior chamber depth was significantly less in the eyes with narrow angles (P=0.05). However, the average lens thickness, although greater in the eyes with narrow angles, did not reach statistical significance (P=0.10). Refractive error, axial lengths, and iris thicknesses did not differ significantly between the 2 groups (P=0.32, 0.47, 0.15). CONCLUSIONS Narrow angles can occur in myopic eyes. Routine gonioscopy is therefore recommended for all patients regardless of refractive error.
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Hong JW, Yun SC, Sung KR, Lee JE. Clinical and Anterior Segment Anatomical Features in Primary Angle Closure Subgroups Based on Configurations of Iris Root Insertion. KOREAN JOURNAL OF OPHTHALMOLOGY 2016; 30:206-13. [PMID: 27247520 PMCID: PMC4878981 DOI: 10.3341/kjo.2016.30.3.206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 07/27/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the clinical and anterior segment anatomical features in primary angle closure sub-groups based on configurations of iris root insertion. Methods Primary angle closure patients were imaged using anterior segment optical coherence tomography. Anterior chamber depth, iris curvature, iris thickness (IT) at the scleral spur and 500, 750, and 1,500 µm from the scleral spur (IT0, IT500, IT750, and IT1500), lens vault, iris area, angle opening distance (AOD500), angle recess area (ARA750), and trabecular iris space area (TISA750) were measured. Iris root insertion was categorized into a non-basal insertion group (NBG) and basal insertion group (BG). Results In total, 43 eyes of 39 participants belonged to the NBG and 89 eyes of 53 participants to the BG. The mean age of participants was greater in the NBG than the BG (62.7 ± 5.7 vs. 59.8 ± 7.3 years, p = 0.043), and the baseline intraocular pressure was higher in the BG than the NBG (16.4 ± 4.4 vs. 14.9 ± 3.3 mmHg, p = 0.037). The BG showed a greater IT0 (0.265 ± 0.04 vs. 0.214 ± 0.03 mm, p < 0.001) and iris area (1.59 ± 0.24 vs. 1.52 ± 0.27 mm2, p = 0.045), lower ARA750 (0.112 ± 0.08 vs. 0.154 ± 0.08 mm2, p = 0.017) and AOD500 (0.165 ± 0.07 vs. 0.202 ± 0.08 mm, p = 0.014) compared to the NBG. Conclusions The BG had a narrower anterior chamber angle, thicker peripheral iris, and higher pretreatment intraocular pressure.
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Affiliation(s)
- Ji Wook Hong
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Rim Sung
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Eun Lee
- Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea
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Laser peripheral iridotomy changes anterior chamber architecture. Eur J Ophthalmol 2016; 27:49-54. [PMID: 27198636 DOI: 10.5301/ejo.5000804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE The pressure gradient between anterior and posterior chamber in acute angle closure (AAC) and primary angle closure suspects is balanced by a sufficient laser peripheral iridotomy (LPI). The anterior chamber changes induced by LPI in patients with unilateral AAC were examined and compared to healthy eyes to define threshold values, which may help to discriminate between healthy and diseased eyes. METHODS Using Scheimpflug photography, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and central corneal thickness (CCT) were measured before and after LPI in both eyes of unilateral AAC cases. These measurements were compared to a group of healthy control eyes to determine threshold values for ACD, ACV, and ACA. RESULTS The ACD, ACV, and ACA increased significantly in the 25 AAC eyes after LPI. The ACD, ACV, ACA, and CCT values in the AAC eyes obtained before LPI were compared to a control group of 59 healthy eyes with wide open chamber angles. The cutoff values revealed by receiver operating characteristic analysis were 2.1 mm for ACD, 90.5 mm2 for ACV, and 27.25° for ACA. CONCLUSIONS Our results confirm the significant changes of the anterior segments architecture induced by LPI in AAC eyes. The found threshold values for ACD, ACV, and ACA may help in daily clinical routine to discriminate between healthy eyes and those in need for a prophylactic LPI.
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Seo S, Lee CE, Kim YK, Lee SY, Jeoung JW, Park KH. Factors affecting refractive outcome after cataract surgery in primary angle-closure glaucoma. Clin Exp Ophthalmol 2016; 44:693-700. [DOI: 10.1111/ceo.12762] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/03/2016] [Accepted: 04/08/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Sam Seo
- Department of Ophthalmology; Cheil Eye Hospital; Daegu Korea
- Department of Ophthalmology; Seoul National University Hospital, Seoul National University College of Medicine; Seoul Korea
| | - Chong Eun Lee
- Department of Ophthalmology; Keimyung University Dongsan Medical Center; Daegu Korea
- Department of Ophthalmology; Seoul National University Hospital, Seoul National University College of Medicine; Seoul Korea
| | - Young Kook Kim
- Department of Ophthalmology; Seoul National University Hospital, Seoul National University College of Medicine; Seoul Korea
| | - Sang Yoon Lee
- Department of Ophthalmology; Jeju National University Hospital; Jeju Korea
- Department of Ophthalmology; Seoul National University Hospital, Seoul National University College of Medicine; Seoul Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology; Seoul National University Hospital, Seoul National University College of Medicine; Seoul Korea
| | - Ki Ho Park
- Department of Ophthalmology; Seoul National University Hospital, Seoul National University College of Medicine; Seoul Korea
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Effects of Laser Peripheral Iridotomy in Subgroups of Primary Angle Closure Based on Iris Insertion. J Ophthalmol 2015; 2015:581719. [PMID: 26351573 PMCID: PMC4550797 DOI: 10.1155/2015/581719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/07/2015] [Accepted: 04/07/2015] [Indexed: 11/20/2022] Open
Abstract
Purpose. To investigate the effect of laser peripheral iridotomy (LPI) in subgroups of primary angle closure based on iris insertion configuration. Methods. Anterior segment optical coherence tomography (AS-OCT) images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG) and nonbasal insertion group (NBG)) was performed. Anterior chamber depth (ACD), lens vault (LV), iris curvature, iris area, iris thickness (IT750), and angle opening distance (AOD750) 750 microns from scleral spur were calculated. Uni- and multivariate regression analysis was carried out to evaluate factors associated with AOD750 before and after LPI. Results. Ninety-two eyes of 92 subjects were categorized as NBG (39 eyes) or BG (53 eyes). The mean change after LPI was not significantly different between two groups in all parameters. In both groups, AOD750 was affected by ACD (p < 0.001, p = 0.044) before LPI. AOD750 was affected by LV (p = 0.012) in NBG, but by ACD (p < 0.001) and IT750 (p = 0.039) in BG after LPI. Conclusions. The outcomes of LPI are not significantly different between angle closure subgroups with different iris insertions. However, factors affecting AOD750 show differences between two subgroups after LPI.
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Waldman CW, Waldman SD, Waldman RA. A practical approach to ocular pain for the non-ophthalmologist. Pain Manag 2015; 4:413-26. [PMID: 25494693 DOI: 10.2217/pmt.14.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pain involving the eye has numerous etiologies and is a feared challenge of many clinicians. Between a fear of the patient losing vision and a lack of familiarity with the ophthalmic equipment necessary to diagnose the problem, working up eye pain can be a daunting task. While the ophthalmologist can be indispensable in challenging cases of eye pain, this article will help clarify the unique clinical features of each etiology that can help clinicians narrow down the differential and arrive at a diagnosis.
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Affiliation(s)
- Corey W Waldman
- Sinai Hospital, Krieger Eye Institute, Baltimore, MD 21215, USA
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Dada T, Rathi A, Angmo D, Agarwal T, Vanathi M, Khokhar SK, Vajpayee RB. Clinical outcomes of clear lens extraction in eyes with primary angle closure. J Cataract Refract Surg 2015; 41:1470-7. [DOI: 10.1016/j.jcrs.2014.10.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/20/2014] [Accepted: 10/06/2014] [Indexed: 11/28/2022]
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Postiridotomy ultrasound biomicroscopy features in the fellow eye of Chinese patients with acute primary angle-closure and chronic primary angle-closure glaucoma. J Glaucoma 2015; 24:233-7. [PMID: 25055211 DOI: 10.1097/ijg.0000000000000086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the features of postiridotomy ultrasound biomicroscopy (UBM) in Chinese patients with acute primary angle-closure (aPAC) and with chronic primary angle-closure (cPAC) glaucoma. PATIENTS AND METHODS Consecutive cases were classified into acute and chronic groups. The acute group included 77 patients with unilateral aPAC. The chronic group included 57 patients with unilateral advanced cPAC glaucoma. In both the groups, the patients' fellow eye underwent a laser iridotomy and was studied. The main outcome measures included qualitative UBM parameters such as a plateau iris, anterior iris insertion, and an anteriorly rotated ciliary process and quantitative UBM parameters such as central anterior chamber depth (ACD), basal iris thickness (IT500), and scleral ciliary process angle (SCPA). RESULTS For the qualitative parameters, more eyes in the chronic group had a plateau iris (P=0.046), an anterior iris insertion (P=0.222), and an anteriorly rotated ciliary process (P=0.090) than those in the acute group. For the quantitative parameters, the eyes in the chronic group had a deeper ACD (P<0.001), thicker IT500 (P<0.001), and smaller SCPA (P<0.001) than those in the acute group. CONCLUSIONS The UBM features of Chinese patients with cPAC include a more plateaued iris, a thicker basal iris, and a smaller SCPA, whereas patients with aPAC may have a shallower ACD. For Chinese patients, a nonpupillary block component may play a more important role in asymptomatic cPAC than in aPAC.
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Huang W, Gao X, Li X, Wang J, Chen S, Wang W, Du S, He M, Zhang X. Anterior and posterior ocular biometry in healthy Chinese subjects: data based on AS-OCT and SS-OCT. PLoS One 2015; 10:e0121740. [PMID: 25799207 PMCID: PMC4370611 DOI: 10.1371/journal.pone.0121740] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 02/14/2015] [Indexed: 01/23/2023] Open
Abstract
Background To measure the anterior and posterior ocular biometric characteristics concurrently and to determine the relationship between the iris and choroid in healthy Chinese subjects. Methods A total of 148 subjects (270 eyes) were enrolled in this cross-section study. The anterior and posterior ocular biometric characteristics were measured simultaneously by anterior segment optical coherence tomography (AS-OCT) and swept-source optical coherence tomography (SS-OCT). Results Compared with male eyes, female eyes had narrower anterior biometric parameters that presented with smaller anterior segment parameters [including anterior chamber depth (ACD), width (ACW), area (ACA), and volume (ACV); (all p<0.001)], narrower anterior chamber angle parameters [including angle opening distance (AOD750), trabecular–iris space area (TISA750), and angle recess area (ARA); (all p<0.001)], higher iris curvature (ICURV) (p = 0.003), and larger lens vaults (LV) (p = 0.019). These anterior ocular biometric parameters were correlated with increasing age (p<0.01). Iris thickness (IT750) and iris area (IAREA) were associated with age, ACW, and pupil diameter (all p<0.05), while choroidal thickness (CT) was associated with age, gender, and axial length (all p<0.05). Univariate regression analysis showed that greater CT was significantly associated with smaller IAREA (p = 0.026). Conclusion Compared with male eyes, female eyes had narrower anterior biometric parameters that correlated with increasing age, which would be helpful in explaining the higher prevalence of angle closure rates in the female gender and in aging people. Increased CT might be associated with smaller iris area; however, this possibility needs to be investigated in future studies before this conclusion is made.
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Affiliation(s)
- Wenbin Huang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xinbo Gao
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xingyi Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Jiawei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Shida Chen
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Wei Wang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Shaolin Du
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Mingguang He
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Xiulan Zhang
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- * E-mail:
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Chen YY, Chu D, Chou P. Enhancing the early differential diagnosis of plateau iris and pupillary block using a-scan ultrasonography. PLoS One 2015; 10:e0118811. [PMID: 25689856 PMCID: PMC4331545 DOI: 10.1371/journal.pone.0118811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 01/06/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose To distinguish the frequently misdiagnosed plateau iris eyes from pupillary block group and normal group, we compared the ocular biometrical parameters of them by A-scan ultrasongraphy. Methods In total, we retrospectively reviewed general characteristics and ocular findings including ocular biometric measurements of 71 normal, 39 plateau iris, and 83 pupillary block eyes. Results The normal controls, plateau iris group and pupillary block group were significantly different in age, but not in gender. The anterior chamber depth tended to decrease and the lens thickness tended to increase from normal to plateau iris to pupillary block eyes. Compared to those of plateau iris group, the pupillary block group had significantly shallower anterior chamber depth (2.90mm vs. 2.33mm; p<0.001), thicker lens (4.77mm vs. 5.11mm; p<0.001), shorter axial length (23.16mm vs. 22.63mm; p<0.001), smaller relative lens position (2.28 vs. 2.16; p<0.001) and larger lens/axial length factor (2.06 vs. 2.26; p<0.001). However, when comparing plateau iris and normal eyes, only axial length and lens/axial length factor were significantly different (23.16 vs. 23.54; p<0.05 and 2.06 vs. 1.96; p<0.05). Conclusions Measured by A-scan ultrasonography, the ocular biometrics of plateau iris were significantly different from those of pupillary block eyes. However, our A-scan ultrasongraphy generally found no significant biometric differences between plateau iris and normal eyes. These findings suggest that while A-scan ultrasonography might be used as a practical tool for differentiating plateau iris and papillary block eyes, a more meticulous gonioscopy and other assessments may be necessary to distinguish plateau iris from normal eyes.
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Affiliation(s)
- Yu-Yen Chen
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Department of Ophthalmology, Yang-Ming University Hospital, Ilan County, Taiwan
| | - Dachen Chu
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan
| | - Pesus Chou
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Sakurada Y, Mabuchi F. Advances in glaucoma genetics. PROGRESS IN BRAIN RESEARCH 2015; 220:107-26. [DOI: 10.1016/bs.pbr.2015.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Arimura S, Takamura Y, Takihara Y, Matsumura T, Tomomatsu T, Inatani M. Determinants of anterior chamber angle narrowing after mydriasis in the patients with cataract. Graefes Arch Clin Exp Ophthalmol 2014; 253:307-12. [PMID: 25311654 DOI: 10.1007/s00417-014-2817-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 07/25/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To identify the determinants of anterior chamber angle narrowing after mydriasis by quantitative assessment of the anterior chamber components using anterior segment optical coherence tomography (AS-OCT). METHODS In this intervention study, anterior chamber angle analysis was performed using AS-OCT in patients with cataract before pharmacological pupillary dilation and 30 min afterwards. Angle narrowing was quantified by the change of angle opening distance 500 after mydriasis (ΔAOD500). Multivariate linear regression and stepwise selection regression were used to identify which parameters in AS-OCT significantly determined ΔAOD500. RESULTS One hundred and two Japanese patients (age, mean ± standard deviation, 71.9 ± 11.2 years) were enrolled. Multivariate analysis indicated that smaller ΔAOD500 were significantly associated with larger lens vault (LV; P < 0.001), larger iris area (IA; P = 0.003), and posterior corneal arch distance (PCAL; P = 0.01). Stepwise linear regression analysis revealed that smaller ΔAOD500 was independently associated with larger LV (partial R (2) = 0.232, P < 0.001), larger IA (partial R (2) = 0.080, P = 0.001), and smaller PCAL (partial R (2) = 0.066, P = 0.002) before mydriasis. These three factors explained 37.7 % of the decrease in ΔAOD500. CONCLUSION Larger LV, larger IA, and smaller PCAL contribute considerably to anterior chamber angle narrowing after mydriasis in patients with cataract.
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Affiliation(s)
- Shogo Arimura
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui, 23-3, Shimoaizuki, Eiheiji, Yoshida, Fukui, 910-1193, Japan
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