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Chansangpetch S, Phinyo P, Patumanond J, Choovuthayakorn J, Lin SC. Diagnostic Abilities of Three-Dimensional Anterior Segment Optical Coherence Tomography in Detecting Angle Closure. J Glaucoma 2024; 33:801-807. [PMID: 38780278 DOI: 10.1097/ijg.0000000000002442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
PRCIS Three-dimensional (3D) angle parameters and cutoff values for detecting angle closure were proposed. The 3D parameters demonstrated excellent diagnostic performance. Certain horizontal two-dimensional (2D) parameters [ie, trabecular iris space area (TISA)-750, angle opening distance (AOD)-750, and AOD-500] can attain similar performance to their high-performing 3D counterparts. OBJECTIVE To investigate the diagnostic performance of single horizontal 2D versus 3D angle parameters from swept-source anterior segment optical coherence tomography (CASIA2) in detecting angle closure. MATERIALS AND METHODS The cross-sectional study included 118 phakic patients (59 open angles, 59 closed angles). AOD, angle recess area (ARA), and TISA at 250, 500, and 750 μm from scleral spur were measured in 360-degree radial-scan images. The 3D information of each measurement was analyzed in 2 patterns: (1) average 3D parameter-the averaged value from 360-degree angle values and (2) estimate 3D parameter-the estimation of surface area of circumferential angle inlet (using AOD) or circumferential angle volume (using ARA and TISA). The areas under the receiver operating characteristic curve [areas under the curve (AUCs)] of eighteen 3D parameters were compared with 2D horizontal parameters. RESULTS Among 3D parameters, AOD-500 estimate 3D gave the highest AUC (AUC: 0.950, cutoff: 6.09 mm 2 ), followed by AOD-750 estimate 3D (AUC: 0.948, cutoff: 8.26 mm 2 ). 3D parameters significantly increased the AUC of ARA-250 and TISA-250 (all P < 0.02) compared with the 2D parameters. No significant improvement in AUC was demonstrated for AOD-250 and all parameters at 500 and 750 μm. No significant difference in AUC was found among the 6 maximum AUC parameters, which were AOD-750 horizontal 2D, AOD-500 estimate 3D, TISA-750 horizontal 2D, AOD-500 horizontal 2D, AOD-750 estimate 3D, and TISA-750 average 3D. CONCLUSIONS The 3D-angle parameters had high performance in detecting angle closure. However, comparing a horizontal measurement to 3D parameters, the AUC improvement was mostly insignificant.
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Affiliation(s)
- Sunee Chansangpetch
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok
- Center of Excellence in Glaucoma, Chulalongkorn University, Bangkok
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai
| | - Phichayut Phinyo
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University
| | - Jayanton Patumanond
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai
| | - Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Shan C Lin
- Glaucoma Center of San Francisco, San Francisco, CA
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Guo PY, Zhang X, Li F, Lin C, Nguyen A, Sakata R, Higashita R, Okamoto K, Yu M, Aihara M, Aung T, Lin S, Leung CKS. Diagnostic criteria of anterior segment swept-source optical coherence tomography to detect gonioscopic angle closure. Br J Ophthalmol 2024; 108:1130-1136. [PMID: 38594062 PMCID: PMC11287563 DOI: 10.1136/bjo-2023-323860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/27/2023] [Indexed: 04/11/2024]
Abstract
AIMS To compare the diagnostic performance of 360° anterior segment optical coherence tomography assessment by applying normative percentile cut-offs versus iris trabecular contact (ITC) for detecting gonioscopic angle closure. METHODS In this multicentre study, 394 healthy individuals were included in the normative dataset to derive the age-specific and angle location-specific normative percentiles of angle open distance (AOD500) and trabecular iris space area (TISA500) which were measured every 10° for 360°. 119 healthy participants and 170 patients with angle closure by gonioscopy were included in the test dataset to investigate the diagnostic performance of three sets of criteria for detection of gonioscopic angle closure: (1) the 10th and (2) the 5th percentiles of AOD500/TISA500, and (3) ITC (ie, AOD500/TISA500=0 mm/mm2). The number of angle locations with angle closure defined by each set of the criteria for each eye was used to generate the receiver operating characteristic (ROC) curve for the discrimination between gonioscopic angle closure and open angle. RESULTS Of the three sets of diagnostic criteria examined, the area under the ROC curve was greatest for the 10th percentile of AOD500 (0.933), whereas the ITC criterion AOD500=0 mm showed the smallest area under the ROC (0.852) and the difference was statistically significant with or without adjusting for age and axial length (p<0.001). The criterion ≥90° of AOD500 below the 10th percentile attained the best sensitivity 87.6% and specificity 84.9% combination for detecting gonioscopic angle closure. CONCLUSIONS Applying the normative percentiles of angle measurements yielded a higher diagnostic performance than ITC for detecting angle closure on gonioscopy.
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Affiliation(s)
- Philip Yawen Guo
- Department of Ophthalmology, The University of Hong Kong, Pok Fu Lam, People's Republic of China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Chen Lin
- Shenzhen Aier Eye Hospital, Shenzhen, China
| | - Anwell Nguyen
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | - Rei Sakata
- Ophthalmology, The University of Tokyo, Bunkyo-ku, Japan
| | | | | | - Marco Yu
- Singapore Eye Research Institute, Singapore
| | - Makoto Aihara
- Ophthalmology, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Tokyo, Japan
| | - Tin Aung
- Glaucoma, Singapore National Eye Centre, Singapore
| | - Shan Lin
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
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Shan J, Pardeshi A, Jiang X, Richter GM, McKean-Cowdin R, Varma R, Xu BY. Optimal number and orientation of anterior segment OCT images to measure ocular biometric parameters in angle closure eyes: the Chinese American Eye Study. Br J Ophthalmol 2023; 107:795-801. [PMID: 35063932 PMCID: PMC9529245 DOI: 10.1136/bjophthalmol-2021-319275] [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: 05/03/2021] [Accepted: 12/31/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess the optimal number and orientation of anterior segment optical coherence tomography (AS-OCT) images for accurately measuring ocular biometric parameters in angle closure eyes. METHODS Subjects with angle closure, defined as >3 quadrants of non-visible pigmented trabecular meshwork on static gonioscopy, were selected from the Chinese American Eye Study. Mean angle opening distance (AOD500) was calculated using four images (0°-180°, 45°-225°, 90°-270° and 135°-315° meridians) from one eye per subject. Ten eyes from each quartile of AOD500 measurements were randomly selected for detailed 32-image analysis of 10 biometric parameters, including AOD500, iris curvature (IC), anterior chamber depth (ACD), lens vault (LV), and anterior chamber area (ACA). Mean and range of measurements from 1, 2, 4, 8 or 16 images were compared with 32-image values for all parameters. RESULTS 40 out of 335 eyes with angle closure were selected for 32-image analysis. Deviation from the 32-image mean was between 0.44% and 19.31% with one image, decreasing to 0.08% to 4.21% with two images for all parameters. Deviation from the 32-image range of measurements was between 54.67% to 88.94% with one image, decreasing to <7.00% with eight images for all parameters except ACD and ACA. Orienting the first image analysed along the 25°-205° meridian better approximated the range of measurements when four or fewer images were analysed. CONCLUSIONS Sectoral anatomical variations in angle closure eyes are easily misrepresented based on current AS-OCT imaging conventions. A revised multi-image approach can better capture the mean and range of biometric measurements.
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Affiliation(s)
- Jing Shan
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
| | - Anmol Pardeshi
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Xuejuan Jiang
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
| | - Grace M Richter
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
| | - Roberta McKean-Cowdin
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Benjamin Y Xu
- Department of Ophthalmology, University of Southern California, Los Angeles, California, USA
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Mirzayev I, Gündüz AK, Aydın Ellialtıoğlu P, Gündüz ÖÖ. Clinical applications of anterior segment swept-source optical coherence tomography: A systematic review. Photodiagnosis Photodyn Ther 2023; 42:103334. [PMID: 36764640 DOI: 10.1016/j.pdpdt.2023.103334] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/25/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Optical coherence tomography (OCT) is a non-invasive method that provides the opportunity to examine tissues by taking cross-sectional images. OCT is increasingly being used to evaluate anterior segment (AS) pathologies. Swept-source (SS) OCT allows greater penetration and achieves better visualization of the internal configuration of AS tissues due to the longer wavelength employed and high scan speeds. We reviewed the utilization of AS SS-OCT in various conditions including glaucoma, ocular surface pathologies, iris tumors, refractive surgery, cataract surgery, and scleral diseases. A systematic literature search was carried out on PubMed, Scopus, and Web of Science databases between January 1, 2008, and September 1, 2022 using the following keywords: AS SS-OCT; dry eye and SS-OCT; ocular surface and SS-OCT; cornea and SS-OCT; dystrophy and SS-OCT; glaucoma and SS-OCT; ocular surface tumors and SS-OCT; conjunctival tumors and SS-OCT; refractive surgery and SS-OCT; cataract and SS-OCT; biometry and SS-OCT; sclera and SS-OCT; iris and SS-OCT; ciliary body and SS-OCT; artificial intelligence and SS-OCT. A total of 221 studies were included in this review. Review of the existing literature shows that SS-OCT offers several advantages in the diagnosis of AS diseases. Exclusive features of SS-OCT including rapid scanning, deeper tissue penetration, and better image quality help improve our understanding of various AS pathologies.
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Affiliation(s)
- Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Halil Şıvgın Çubuk State Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey; Private Eye Clinic, Ankara, Turkey.
| | | | - Ömür Özlenen Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
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Lin S, Hu Y, Ye C, Congdon N, You R, Liu S, Liu C, Lv F, Zhang S. Detecting eyes with high risk of angle closure among apparently normal eyes by anterior segment OCT: a health examination center-based model. BMC Ophthalmol 2022; 22:513. [PMID: 36577987 PMCID: PMC9798562 DOI: 10.1186/s12886-022-02739-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The main barriers keeping individuals with high-risk of angle closure from seeking eye-care service are the absence of both disease awareness and convenient and low-cost access to the ocular health care system. Present study described the efficacy of a health examination center-based screening model designed to detect eyes with high risk of angle closure (HRAC) among healthy individuals using anterior segment optical coherence tomography (AS-OCT). METHODS From March 1 to April 30, 2017, consecutive individuals aged ≥ 40 years undergoing routine physical examinations at a health examination center were invited to enroll. Presenting visual acuity (PVA), intraocular pressure (IOP) measurement, non-mydriatic fundus photography and AS-OCT were performed by three trained nurses. Participants with PVA < 6/12 in the better-seeing eye, IOP ≥ 24 mmHg, or abnormal fundus photography in either eye were referred to the outpatient clinic, but not included in the analysis. Eyes with HRAC were defined as having trabecular-iris angle < 12 degrees in ≥ 3 quadrants. Configuration of the iris was classified into flat, bowing, bombe, thick peripheral iris and mixed mechanism. RESULTS Altogether, 991 participants (77.3%) with readable OCT images (mean age 55.5 ± 9.0 years; 58.4% men) were included. HRAC was diagnosed in 78 eyes (7.9%, 61.3 ± 8.2 years, 41.0% men). The prevalence of HRAC increased with age (p < 0.001) and was much higher among women (11.2%) than men (5.5%) (p = 0.001). The mixed mechanism iris configuration was most common among eyes with HRAC (37/78, 47.4%). CONCLUSION HRAC is prevalent among asymptomatic Chinese adults undergoing routine health screening. Health examination center-based eye screening with AS-OCT administered by non-specialists may be a good model to screen narrow angles in the population at large.
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Affiliation(s)
- Sigeng Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No.270 Xueyuanxi Street, Lucheng District, Wenzhou, 325027, Zhejiang, China.,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Ying Hu
- Department of Ophthalmology, The Forth People's Hospital of Shenyang, Huanggu District, NO. 20 Huanghenan Street, Shenyang, 110031, Liaoning, China
| | - Cong Ye
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No.270 Xueyuanxi Street, Lucheng District, Wenzhou, 325027, Zhejiang, China.,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.,Orbis International, New York, NY, USA
| | - Ruirong You
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No.270 Xueyuanxi Street, Lucheng District, Wenzhou, 325027, Zhejiang, China.,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Shanshan Liu
- Department of Ophthalmology, The Forth People's Hospital of Shenyang, Huanggu District, NO. 20 Huanghenan Street, Shenyang, 110031, Liaoning, China
| | - Chi Liu
- Department of Ophthalmology, The Forth People's Hospital of Shenyang, Huanggu District, NO. 20 Huanghenan Street, Shenyang, 110031, Liaoning, China.
| | - Fan Lv
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No.270 Xueyuanxi Street, Lucheng District, Wenzhou, 325027, Zhejiang, China.,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Shaodan Zhang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No.270 Xueyuanxi Street, Lucheng District, Wenzhou, 325027, Zhejiang, China. .,Glaucoma Research Institute, Wenzhou Medical University, Wenzhou, China. .,National Clinical Research Center for Ocular Diseases, Wenzhou, China.
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Liu F, Xia F, Niu L, Zhao J, Wang X, Zhou X. Early Assessment of Circumferential Anterior Segment Structures Following Implantable Collamer Lens V4c Implantation Via SS-OCT. Transl Vis Sci Technol 2022; 11:4. [PMID: 36331273 PMCID: PMC9645365 DOI: 10.1167/tvst.11.11.4] [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] [Indexed: 11/06/2022] Open
Abstract
Purpose To explore early changes in circumferential anterior segment structures following Implantable Collamer Lens (ICL) V4c implantation via swept-source optical coherence tomography (SS-OCT). Methods In 103 eyes of 56 myopic patients undergoing ICL V4c surgery, anterior segments were measured via SS-OCT to compute local anterior chamber angle (ACA) parameters on the nasal–temporal (0°–180°), superior–inferior (90°–270°), and superior nasal–inferior temporal (80°–260°) meridians, including angle-opening distance at 500 µm (AOD500), trabecular–iris space area at 500 µm (TISA500), trabecular–iris angle at 500 µm (TIA500), and circumferential ACA parameters, including AOD area at 500 µm (AODA500), trabecular–iris circumference volume at 500 µm (TICV500), and the index and area of iris–trabecular contact (ITC). ACA parameters were compared preoperatively and at 1 week, 1 month, and 3 months postoperatively and compared among quadrants. Mixed-effects model was used to evaluate the parameters correlated with the post-ITC parameters. Results The mean AOD500, TISA500, TIA500, AODA500, and TICV500 were decreased by 65.4% to 71%, 64.1% to 69.3%, 53.8% to 61.5%, 69.9%, and 69.2%, respectively, at 1 week postoperatively. The ITC index and area values rose from 1.436% ± 4.427% and 0.070 ± 0.254 mm2 to 12.343% ± 13.216% and 0.903 ± 1.304 mm2 (all P < 0.05). No further decreases in ACA parameters were observed beyond 1 week postoperatively (all P > 0.05). Significant differences were observed among quadrants, with the narrowest in the superior–nasal quadrant, followed by the superior quadrant. The 3-month vault was significantly correlated with the ITC index and area at 3 months postoperatively. Conclusions Anterior segment structures were significantly shallow at 1 week with no further decreases thereafter. In light of anatomical variability, we recommend circumferential meridian scan to assess angle status, with special attention to the superior–nasal and superior quadrants. Translational Relevance We investigated the early changes in circumferential anterior segment structures following ICL V4c implantation, thus providing a better perspective for understanding anterior segment structural characteristics after ICL V4c surgery.
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Affiliation(s)
- Fang Liu
- Department of Ophthalmology and Optometry, Eye and 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 Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fei Xia
- Department of Ophthalmology and Optometry, Eye and 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 Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Eye and 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 Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye and 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 Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye and 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 Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and 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 Research Center of Ophthalmology and Optometry, Shanghai, China
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Relationship Between Optical Coherence Tomography and Anterior Chamber Depth After Pupillary Dilation in Primary Angle Closure Suspects. J Glaucoma 2022; 31:915-919. [PMID: 35882041 DOI: 10.1097/ijg.0000000000002085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 06/24/2022] [Indexed: 02/04/2023]
Abstract
PRCIS Anterior chamber depth (ACD) change after pupillary dilation is correlated with lens vault (LV) and anterior chamber width (ACW), as observed by swept-source optical coherence tomography (SS-OCT) at both horizontal and vertical scans in patients with primary angle closure suspect and cataract. PURPOSE The purpose of this study is to evaluate the association between ACD and other anterior chamber parameters after pharmacological dilation in patients with primary angle closure suspect and cataract. PATIENTS AND METHODS SS-OCT was performed for 78 patients at baseline and 1 hour after pharmacological dilation. Measurements were taken at 8 evenly spaced axes at 250, 500, and 750 μm from the scleral spur. Pearson correlation coefficient (ρ) was used to evaluate the relationship between averaged ACD change and other SS-OCT parameters. Multivariable regression analyses were performed to determine the parameters that predict ACD change. RESULTS Across all 14 dimension and angle parameters, 12 parameters at the 270-degree axis and 10 parameters at the 0-degree axis yielded significant correlations with ACD change (ρ=0.24-0.55, P <0.05). Angle parameters were most significantly correlated to ACD change 750 µm from the scleral spur. The prediction model for ACD change after pharmacological dilation at 0 degree included decreased LV, wider ACW, and increased trabecular iris space area (all P ≤0.001). The prediction model for ACD change at 270 degrees included: decreased LV, wider ACW, larger change in anterior chamber volume, larger baseline anterior chamber volume, and smaller baseline angle opening distance (all P ≤0.03). CONCLUSIONS LV and ACW, as measured in both vertical and horizontal scans, were found to be determinants of the ACD change after pharmacological pupillary dilation. Examination of these parameters may help identify patients at higher risk of developing angle-closure disease.
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Xie Q, Ma P, Jutima P, Saifee M, Yonamine S, Yu Y, Ying GS, Yang Y, Han Y, Li S. Anterior Segment OCT in Primary Angle Closure Disease Compared With Normal Subjects With Similar Shallow Anterior Chamber. J Glaucoma 2022; 31:84-90. [PMID: 34366393 PMCID: PMC8795465 DOI: 10.1097/ijg.0000000000001915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/02/2021] [Indexed: 02/03/2023]
Abstract
PRCIS Compared with normal subjects with similar shallow anterior chamber depth (ACD), patients with primary angle closure disease (PACD) had narrower angle structures measured by swept-source optical coherence tomography (SS-OCT) at 250 μm from scleral spur (very root of iris), especially along oblique and vertical axis. PURPOSE To examine anterior segment structures in normal subjects whose ACD was shallow on slit-lamp examination but did not meet the diagnostic criteria of PACD, and to compare them with PACD patients with similar ACD. MATERIALS AND METHODS Patients were recruited from glaucoma clinic at Zhongshan Ophthalmic Center. A total of 40 eyes from 29 PACD patients and 40 eyes from 34 normal subjects received full ophthalmic examination and CASIA SS-1000 OCT tests. PACD eyes and control eyes were 1:1 matched for ACD at 0 degree of scan. Generalized linear model that accounted for inter-eye correlation was used to compare differences between the 2 groups for intraocular pressure and SS-OCT parameters. P-values were adjusted for multiple comparisons using the Bonferroni method. RESULTS The PACD and control groups had similar age, but the PACD group had a significantly higher intraocular pressure (18.4 vs. 14.0 mm Hg, P=0.005). Angle parameters, representative of angle area, such as angle recess area and trabecular iris space area measured at 250 μm along axes of 90, 135, 225, and 315 degrees were significantly smaller in PACD group than those of control group (adjusted P<0.05), while most of angle parameters at 500 and 750 μm, volume parameters, and anterior chamber parameters, were similar (adjusted P>0.05). CONCLUSIONS In PACD patients compared with normal subjects with similar anterior chamber shallowing, OCT findings measured at the iris root 250 μm from the scleral spur, especially in the oblique and vertical axes, including angle recess area and trabecular iris space area, may match gonioscopic findings more closely and provide further insight into mechanisms of PACD.
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Affiliation(s)
- Qinghong Xie
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | - Ping Ma
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
- Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Patlidanon Jutima
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | - Murtaza Saifee
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | - Sean Yonamine
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | - Yinxi Yu
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Yangfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ying Han
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
- Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | - 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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9
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Ma P, Wu Y, Oatts J, Patlidanon J, Yu Y, Ying GS, Kline B, Tun TA, He M, Aung T, Li S, Yang Y, Han Y. Evaluation of the Diagnostic Performance of Swept-Source Anterior Segment Optical Coherence Tomography in Primary Angle Closure Disease. Am J Ophthalmol 2022; 233:68-77. [PMID: 34283974 DOI: 10.1016/j.ajo.2021.06.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/11/2021] [Accepted: 06/25/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE To evaluate the diagnostic performance of swept-source anterior segment optical coherence tomography (SS-OCT) in differentiating eyes with primary angle closure disease (PACD) from eyes of control subjects, as well as eyes with PAC and PAC glaucoma (PACG) from eyes with PAC suspect (PACS) disease. DESIGN Multicenter cross-sectional study. METHODS Chinese patients were classified into control, PACS, and PAC/PACG groups. The area under the receiving operating characteristic curve (AUC) from logistic regression models was used to evaluate discriminating ability. Sensitivity and specificity were calculated, and performance of the models was validated using an independent dataset. RESULTS A total of 2928 SS-OCT images from 366 eyes of 260 patients were recruited to develop diagnostic models. The validation dataset included 1176 SS-OCT images from 147 eyes of 143 patients. For distinguishing PACD from control eyes, average anterior chamber depth had the highest AUC (0.94). With a cutoff of 2.2 mm for average anterior chamber depth, the sensitivity and specificity were 90.2% and 85.2% in the training set. For distinguishing PAC/PACG from PACS, a multivariate model had an AUC of 0.83, with sensitivity and specificity of 82.0% and 62.8% in the training set. The validation set confirmed the findings. CONCLUSIONS SS-OCT of the anterior segment showed excellent diagnostic performance distinguishing PACD from normal eyes and moderate diagnostic ability distinguishing eyes with PAC/PACG from eyes with PACS. ACD alone may provide a simple and effective way to diagnose PACD from control subjects. As ACD can be obtained using other more available modalities, this has implications for the early diagnosis of PACD.
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Affiliation(s)
- Ping Ma
- From the Department of Ophthalmology (P.M., J.O., P.J., K.B., T.A.), University of California, San Francisco, San Francisco, Caliornia, USA; Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yanyan Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Julius Oatts
- From the Department of Ophthalmology (P.M., J.O., P.J., K.B., T.A.), University of California, San Francisco, San Francisco, Caliornia, USA
| | - Jutima Patlidanon
- From the Department of Ophthalmology (P.M., J.O., P.J., K.B., T.A.), University of California, San Francisco, San Francisco, Caliornia, USA
| | - Yinxi Yu
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brad Kline
- From the Department of Ophthalmology (P.M., J.O., P.J., K.B., T.A.), University of California, San Francisco, San Francisco, Caliornia, USA
| | - Tin A Tun
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;; Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - 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
| | - Shuning Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Yangfan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;.
| | - Ying Han
- From the Department of Ophthalmology (P.M., J.O., P.J., K.B., T.A.), University of California, San Francisco, San Francisco, Caliornia, USA; From the Department of Ophthalmology (P.M., J.O., P.J., K.B., T.A.), University of California, San Francisco, San Francisco, Caliornia, USA; Ophthalmology Section, Surgical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA..
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