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Lin HY, Kao ST, Chen S, Chuang YJ, Lin PJ. Comparing clinical outcomes of Optiwave Refractive Analysis, Lenstar, and surgeon's modified method for intraocular lens power calculation in Asian eyes. Sci Rep 2023; 13:14447. [PMID: 37660153 PMCID: PMC10475043 DOI: 10.1038/s41598-023-41720-2] [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: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023] Open
Abstract
The study aimed to compare the accuracy of intraocular lens (IOL) calculation to predict postoperative refraction by Optiwave Refractive Analysis (ORA), Lenstar LS 900, and the surgeon's Modify method in normal Asian eyes. The IOL power of the Lenstar group was calculated according to Lenstar LS 900, whereas the surgeon's Modify group used topography, axial length (AL) of Lenstar, and Barrett Universal II online formula. Intraoperative aphakic measurements and IOL power calculations were obtained with the ORA system. From the results acquired through Lenstar, Modify, and ORA, the surgeon used his judgment to select the actual IOL power. Postoperative manifest refraction spherical equivalent (MRSE) was obtained 2 months after surgery. The prediction error (PE) was calculated as the difference between the postoperative MRSE and the target refraction proposed by three methods. AL, anterior chamber depth (ACD, measured from corneal endothelium to lens), lens thickness (LT), and ACD + 1/2LT were also included in the survey. In 67 eyes, the average real PE was smaller for the Lenstar (0.06 ± 0.44) and Modify (- 0.05 ± 0.40) than for the ORA group (- 0.25 ± 0.60, p < 0.05). The ORA system demonstrated the best results of IOL power selection in eyes with a normal range of ACD + 0.5 LT (5.2-5.6 mm) in Asian eyes.
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Affiliation(s)
- Hung-Yuan Lin
- Universal Eye Center, Zhong-Li, Taipei City, 10660, Taiwan
- Department of Optometry, Central Taiwan University of Science and Technology, Taichung, 40601, Taiwan
- Department of Ophthalmology, Fujian Medical University, Fuzhou city, 350005, Fujian Sheng, China
| | - Shu-Ting Kao
- Yee-Hong Clinic, New Taipei City, 23447, Taiwan.
| | - Shuan Chen
- Universal Eye Center, Long-Tan, Taipei City, 10660, Taiwan
| | - Ya-Jung Chuang
- Universal Eye Center, Long-Tan, Taipei City, 10660, Taiwan
| | - Pi-Jung Lin
- Universal Eye Center, Long-Tan, Taipei City, 10660, Taiwan
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Lifton J, Burkemper B, Jiang X, Pardeshi AA, Richter G, McKean-Cowdin R, Varma R, Xu BY. Ocular Biometric Determinants of Dark-to-Light Change in Angle Width: The Chinese American Eye Study. Am J Ophthalmol 2022; 237:183-192. [PMID: 34736951 PMCID: PMC9035021 DOI: 10.1016/j.ajo.2021.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/29/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess ocular biometric determinants of dark-to-light change in anterior chamber angle width and identify dynamic risk factors in primary angle closure disease (PACD). DESIGN Population-based cross-sectional study. METHODS Chinese American Eye Study (CHES) participants underwent anterior segment optical coherence tomography imaging in the dark and light. Static dark and light biometric parameters, including angle opening distance, 750 µm (AOD750), anterior chamber width (ACW), lens vault (LV), and pupillary diameter (PD) were measured, and dynamic dark-to-light changes were calculated. Contributions by static and dynamic parameters to dark-to-light changes in AOD750 were assessed using multivariable linear regression models with standardized regression coefficients (SRCs) and semipartial correlation coefficients squared (SPCC2). PACD was defined as ≥3 quadrants of gonioscopic angle closure. RESULTS The analysis included 1011 participants. All biometric parameters differed between dark and light (P < .05). On multivariable regression analysis, change in ACW (SRC = -0.35, SPCC2 = 0.081) and PD (SRC = -0.46, SPCC2 = 0.072) were the strongest determinants of dark-to-light change in AOD750 (overall R2 = 0.40). Dark-to-light increase in AOD750 was less in eyes with than without PACD (0.081 mm and 0.111 mm, respectively; P < .001). ACW increased in eyes with PACD and decreased in eyes without PACD from dark to light (P < .025), whereas change in PD was similar (P = .28). CONCLUSIONS Beneficial angle widening effects of transitioning from dark to light are attenuated in eyes with PACD, which appears related to aberrant dark-to-light change in ACW. These findings highlight the importance of assessing the angle in both dark and light to identify potential dynamic mechanisms of angle closure.
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Asian Race and Primary Open-Angle Glaucoma: Where Do We Stand? J Clin Med 2022; 11:jcm11092486. [PMID: 35566612 PMCID: PMC9099679 DOI: 10.3390/jcm11092486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 01/27/2023] Open
Abstract
Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by irreversible retinal ganglion cell damage and visual field loss. The global POAG prevalence is estimated to be 3.05%, and near term is expected to significantly rise, especially within aging Asian populations. Primary angle-closure glaucoma disproportionately affects Asians, with up to four times greater prevalence of normal-tension glaucoma reported compared with high-tension glaucoma. Estimates for overall POAG prevalence in Asian populations vary, with Chinese and Indian populations representing the majority of future cases. Structural characteristics associated with glaucoma progression including the optic nerve head, retina, and cornea are distinct in Asians, serving as intermediates between African and European descent populations. Patterns in IOP suggest some similarities between races, with a significant inverse relationship between age and IOP only in Asian populations. Genetic differences have been suggested to play a role in these differences, however, a clear genetic pattern is yet to be established. POAG pathogenesis differs between Asians and other ethnicities, and it may differ within the broad classification of the Asian race. Greater awareness and further research are needed to improve treatment plans and outcomes for the increasingly high prevalence of normal tension glaucoma within aging Asian populations.
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Craven ER, Chopra V, Goldberg JL, Marion KM, Chen X, Chang CT, Chen MY. Comparison of Iridocorneal Angle Assessments in Open-Angle Glaucoma and Ocular Hypertension Patients: Anterior Segment Optical Coherence Tomography and Gonioscopy. Clin Ophthalmol 2022; 16:1301-1312. [PMID: 35510274 PMCID: PMC9058653 DOI: 10.2147/opth.s322962] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 03/03/2022] [Indexed: 12/01/2022] Open
Abstract
Purpose To quantitatively compare iridocorneal angle assessments using gonioscopy and anterior segment optical coherence tomography (AS-OCT). Patients US and Chinese patients with open-angle glaucoma (OAG) and/or ocular hypertension (OHT). Methods Analysis was pooled from 2 multicenter, noninterventional studies conducted in the US and China. Gonioscopy Shaffer grade and an AS-OCT method that approximates the angle width relative to local morphologic variations were compared by measuring the same iridocorneal angles. A third, separate, single-center, noninterventional study was conducted to verify results observed from the pooled analysis. Results From the pooled studies, a total of 239 eyes were measured using Shaffer grade and AS-OCT. Of these, 6 were Shaffer grade 2, 37 in Shaffer grade 3, and 196 in Shaffer grade 4. There was a trend of increasing Shaffer grade with increasing AS-OCT angle width. Open iridocorneal angles, Shaffer grade ≥3, had a ~98% sensitivity and 88% positive predictive value for identifying AS-OCT angle width ≥300 µm, using the AS-OCT method. To verify these results, a total of 28 right eyes were imaged for the third study. A trend of increasing Shaffer grade with increasing AS-OCT angle width was observed, and angles with Shaffer grade ≤2 had AS-OCT angle width <300 µm. Conclusion The AS-OCT method can determine the space in the anterior chamber and can potentially identify angles that are the appropriate size for certain glaucoma devices. Information gathered from AS-OCT can provide additional comprehensive and quantitative assessment to gonioscopy.
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Affiliation(s)
- E Randy Craven
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Correspondence: E Randy Craven, 600 N. Wolfe Street, Baltimore, MD, 21287, USA, Tel +1 240-482-1100, Fax +1 240-482-1105, Email
| | | | | | | | - Xiaoming Chen
- West China Hospital Sichuan University, Sichuan, People’s Republic of China
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Rampersad N, Hansraj R. Distribution of anterior chamber angle measurements in South African young adults: an optical coherence tomography study. Int Ophthalmol 2022; 42:1697-1709. [PMID: 34984629 DOI: 10.1007/s10792-021-02164-7] [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: 05/15/2021] [Accepted: 12/18/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Assessment of anterior chamber angle (ACA) variables is important to screen, diagnose and monitor ocular anomalies. Even though data on ACA variables, such as angle-opening distance taken at 500 µm (AOD500) and trabecular-iris angle (TIA), are available in the literature, limited information is available about these variables in African sub-populations. The purpose of this study is to describe the distribution of ACA measurements (AOD500 and TIA) in a South African young adult population. METHODS In this cross-sectional study, 700 young adults were recruited from a university student population using two-stage random sampling. The Optovue iVue 100 optical coherence tomographer was used to measure the ACA variables. The distribution of the AOD500 and TIA measurements was analysed using descriptive and inferential statistics. Data from only the right eyes were analysed because the ACA measurements in the two eyes showed high levels of interocular symmetry. RESULTS The measurements for the nasal and temporal ACAs were asymmetrically distributed (p < 0.001). The median AOD500 measurements in the nasal and temporal angles were 539 µm and 542 µm, respectively. The median TIA measurements were similar (~ 36°) in the two horizontal angles. The temporal ACA measurements were slightly higher than the nasal ACA measurements. Females had higher median ACA measurements than males (p ≥ 0.029). CONCLUSION The ACA measurements in South African young adults resemble non-Gaussian curves. The ACA measurements are different from that reported in other sub-populations worldwide and most participants had ACA measurements associated with non-occludable ACAs.
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Affiliation(s)
- Nishanee Rampersad
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - Rekha Hansraj
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Uejyo C, Henzan IM, Nakamura Y, Ishikawa S, Sakai H, Sawaguchi S, Kumar RS, Iwase A, Tomidokoro A, Araie M. Evaluation of anterior chamber angle by van Herick grading and ultrasound biomicroscopy in light and dark conditions for finding appositional angle closure and plateau iris configuration. Acta Ophthalmol 2021; 99:e86-e95. [PMID: 32567220 DOI: 10.1111/aos.14502] [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: 09/03/2019] [Accepted: 05/17/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate association of the van Herick (VH) grades with the ultrasound biomicroscopic (UBM) parameters, appositional irido-trabecular contact (A-ITC) and plateau iris (PI) in a randomly sampled population. METHODS A 10% random sample of all residents aged 40 or older of the Kumejima study underwent UBM under dark and light conditions in the four quadrants of right eyes. RESULTS Of 301 right eyes with eligible UBM images, 101 (33.6%) and 200 (66.4%) were classified as VH ≤ 2 and VH ≥ 3, respectively. The UBM parameters on angle width and ciliary body configuration were significantly different between VH ≤ 2 and VH ≥ 3 eyes (p < 0.001). A-ITC was found in at least one quadrant in 54.5% and 75.2% of VH ≤ 2 eyes under light and dark conditions, respectively; and 20.5% and 45.5% of VH ≥ 3 eyes. When 'VH ≤ 2' was used to screen eyes with A-ITC in three or more quadrants, the sensitivity and specificity were 74.1% and 75.3%, respectively. A-ITC was significantly associated with shallower anterior chamber (p = 0.018) and higher intraocular pressure (p = 0.044) in VH ≥ 3 eyes. Plateau iris (PI) was found in 15.8% and 6.0% of VH ≤ 2 and VH ≥ 3 eyes, respectively. Plateau iris (PI) was significantly associated with the UBM parameters on angle width and ciliary body configuration. When 'VH ≤ 2' was used to screen eyes with PI, the sensitivity and specificity were 57.1% and 68.9%, respectively. CONCLUSIONS The VH grade of ≤2 and ≥3 showed significant association with UBM angle width and ciliary body configuration parameters. The VH ≤ 2 criterion should be useful for screening of A-ITC and PI.
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Affiliation(s)
- Chiharu Uejyo
- Department of Ophthalmology Faculty of Medicine University of Ryukyu Naha Okinawa Japan
| | | | - Yuko Nakamura
- Department of Ophthalmology Faculty of Medicine University of Ryukyu Naha Okinawa Japan
| | - Shusaku Ishikawa
- Department of Ophthalmology Faculty of Medicine University of Ryukyu Naha Okinawa Japan
| | - Hiroshi Sakai
- Department of Ophthalmology Faculty of Medicine University of Ryukyu Naha Okinawa Japan
| | - Shoichi Sawaguchi
- Department of Ophthalmology Faculty of Medicine University of Ryukyu Naha Okinawa Japan
| | - Rajesh S. Kumar
- Eye Institute Cleveland Clinic Abu Dhabi United Arab Emirates
| | | | | | - Makoto Araie
- Kanto Central Hospital of the Mutual Aid Association of Public School Teachers Setagaya Tokyo Japan
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Jiang Y, Wang W, Wang L, He M. Association of anterior segment parameters and 5-year incident narrow angles: findings from an older Chinese population. Br J Ophthalmol 2020; 105:970-976. [PMID: 32699050 DOI: 10.1136/bjophthalmol-2020-315852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/23/2020] [Accepted: 06/25/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE To assess the association of anterior segment optical coherence tomography (AS-OCT) parameters and 5-year incident narrow angle in China. METHODS This was a prospective cohort study of people aged 50 and older residing in Liwan District, Guangzhou, China. Random clustering sampling was used to identify adults aged 50 years and older in Liwan District, Guangzhou. In 2008 and 2013, this study was repeated and added AS-OCT imaging under dark and light conditions. Customised software (ZAAP) was used to analyse horizontal AS-OCT scans. Angle opening distance (AOD), trabecular iris space area (TISA), anterior chamber volume (ACV) and maximal iris thickness (ITM) were measured. Multiple logistic regression analysis models were used to investigate the associations of the final angle status with baseline AS-OCT parameters. ORs and 95% CIs were calculated. RESULTS Of the 220 subjects with eligible AS-OCT images and gonioscopic results in 2008, the response rate was 77.3%. A total of 27 (15.9%) subjects developed narrow angles and 143 (84.1%) had open angles on gonioscopy in 2013. Subjects developed narrow angles had greater spherical equivalent and shallower anterior chamber depth, smaller angle parameters, thicker IT750 and ITM, smaller anterior chamber parameters, greater lens vault, and smaller dynamic parameters (ΔITM, ΔACA, ΔACV) at baseline. After adjusting confounders, the predictors of incident narrow angles included smaller AOD750, TISA750, ΔACA and greater ITM, ΔIarea. CONCLUSIONS Incident narrow angles were associated with smaller anterior ocular dimensions, thicker iris and smaller light-to-dark changes at baseline. These findings can help in early diagnosis in this population.
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Affiliation(s)
- Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China
| | - Wei Wang
- Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Lanhua Wang
- Department of Preventive Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - Mingguang He
- Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
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Jiang Y, Wang D, Wang W, Chen F, Wang L, Scheetz J, Huang W, Huang S, He M. Five-year changes in anterior segment parameters in an older population in urban southern China: the Liwan Eye Study. Br J Ophthalmol 2019; 104:582-587. [PMID: 31484638 PMCID: PMC7147177 DOI: 10.1136/bjophthalmol-2019-313827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/09/2019] [Accepted: 06/27/2019] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the 5-year changes in static and dynamic anterior segment optical coherence tomography (AS-OCT) parameters and their predictors. Methods This was a prospective, population-based cohort study of people aged 50 years and older residing in the Liwan District, Guangzhou, China. Standardised AS-OCT scans were performed in November 2008 and November 2013 under dark and light conditions. Customised software was used to analyse horizontal AS-OCT images. Parameters in dark and measurements of light-to-dark changes were used for analyses. Results A total of 186 (71.8%) subjects underwent AS-OCT twice, 5 years apart and were included for analyses. The mean age in 2008 was 64.7±7.0 years, and 60.2% were women. The anterior chamber width (ACW) decreased from 11.74±0.44 mm in 2008 to 11.60±0.37 mm in 2013 (p=0.001). There was a trend towards a decrease in dynamic capacity (light-to-dark changes) in the anterior segment, with decreased iris thickness at 750 µm (ΔIT750), ΔACW, Δ anterior chamber area (ACA) and Δ pupil diameter at 5 years (all p<0.05). After adjusting for age and sex, the following baseline parameters were associated with a greater decrease rate in trabecular iris space area at 500 µm (TISA500) at 5 years: TISA500, IT750 and ACA in dark (p<0.001 for all). Conclusions Anterior chamber angle width decreased and the amount of light-to-dark changes declined during 5-year follow-up. Subjects with greater height, wider angle width and thicker iris at baseline have greater angle narrowing at follow-up.
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Affiliation(s)
- Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-senUniversity, Guangzhou, China
| | - Decai Wang
- Department of Preventive Ophthalmology, ZhongshanOphthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-senUniversity, Guangzhou, China
| | - Feng Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-senUniversity, Guangzhou, China
| | - Lanhua Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-senUniversity, Guangzhou, China
| | - Jane Scheetz
- Department of Ophthalmology and Surgery, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Wenyong Huang
- Department of Preventive Ophthalmology, ZhongshanOphthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shengsong Huang
- Department of Preventive Ophthalmology, ZhongshanOphthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-senUniversity, Guangzhou, China .,Department of Ophthalmology and Surgery, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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Siguan-Bell CS, Chansangpetch S, Perez CI, Kutzscher A, Wang D, He M, Oldenburg C, Hee MR, Lin SC. Anterior Segment Parameters of Filipino-Americans Compared to Chinese-Americans and Caucasian Americans Using Anterior Segment Optical Coherence Tomography. Transl Vis Sci Technol 2019; 8:11. [PMID: 30972232 PMCID: PMC6450640 DOI: 10.1167/tvst.8.2.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/18/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose We compare anterior segment characteristics of Filipino- versus Chinese- and Caucasian-Americans to describe the differences in risk factors among each ethnic group. Methods A cross-sectional study was conducted among Filipino, Chinese, and Caucasian subjects without glaucoma who underwent a standardized set of ocular examinations and anterior segment optical coherence tomography (Visante ASOCT) imaging. Zhongshan Angle Assessment Program (ZAAP) 4 was used for ASOCT image analysis. The following quantitative parameters wereobtained from ZAAP: (1) angle opening distance (AOD500, AOD750), angle recess area at 750 μm (ARA), and trabecular-iris space area at 500 and 750 μm (TISA500, TISA750); (2) iris parameters, including iris thickness at 750 μm from the scleral spur (IT750), iris area (IArea), iris curvature or convexity (ICurv), and pupil diameter; 3) anterior chamber parameters; and (4) lens vault. Results The Filipino (122 eyes), Chinese (121 eyes), and Caucasian (111 eyes) subject groups were similar in terms of demographic and clinical characteristics. We reported pairwise comparisons of Filipino parameter values to Chinese or Caucasian values, represented as B-coefficients and P values. In multivariate analysis, Filipinos had narrower angles than Caucasians (AOD750, TISA 500, TISA 750, ARA, P < 0.001). Filipinos had thicker and more convex irises than Caucasians (IT750, IT 2000, ICurv P < 0.003). Angle and iris parameters were similar overall for Filipino and Chinese. Conclusions Filipinos appear to have more convex and thicker irises, smaller lens vault and narrower angles compared to Caucasians. Filipino eyes closely resembled Chinese eyes with similar iris and angle parameters. Translational Relevance The anatomic angle parameters of Filipinos may contribute to angle closure risk among this population, thus ASOCT and thorough angle analysis is recommended in this population.
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Affiliation(s)
- Christine S Siguan-Bell
- Department of Ophthalmology, University of California, San Francisco, CA, USA.,Department of Ophthalmology and Visual Sciences, University of the Philippines-Philippine General Hospital, Manila, Philippines.,Department of Ophthalmology, Cebu Institute of Medicine, Cebu Velez General Hospital, Cebu City, Philippines
| | - Sunee Chansangpetch
- Department of Ophthalmology, University of California, San Francisco, CA, USA.,Glaucoma Research Unit, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok, Thailand
| | - Claudio I Perez
- Department of Ophthalmology, University of California, San Francisco, CA, USA.,Fundacion oftalmologica los Andes, Universidad de los Andes, Santiago, Chile
| | - Anne Kutzscher
- Department of Ophthalmology, University of California, San Francisco, CA, USA.,Georgetown University School of Medicine, Washington, D.C., USA
| | - Dandan Wang
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Mingguang He
- Centre of Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Catherine Oldenburg
- Department of Ophthalmology, University of California, San Francisco, CA, USA.,Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | | | - Shan C Lin
- Department of Ophthalmology, University of California, San Francisco, CA, USA.,Glaucoma Center of San Francisco, San Francisco, CA, USA
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Chansangpetch S, Tran B, Perez CI, Siguan-Bell C, Lau K, Nguyen AH, Thai A, He M, Wang D, Nguyen N, Lin SC. Comparison of Anterior Segment Optical Coherence Tomography Parameters Among Vietnamese, Chinese, and Whites. Am J Ophthalmol 2018; 195:72-82. [PMID: 30081013 DOI: 10.1016/j.ajo.2018.07.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the difference in anterior segment optical coherence tomography (AS-OCT) parameters among ethnic Vietnamese, Chinese, and whites. DESIGN Cross-sectional study. METHODS We prospectively recruited phakic nonglaucomatous participants (based on intraocular pressure < 21 mm Hg, normal optic nerve head and retinal nerve fiber, and cup-to-disc ratio < 0.6) of 3 ethnic groups-Vietnamese, Chinese, and white. AS-OCT parameters including angle (angle opening distance, trabecular-iris space area, and angle recess area), iris (iris thickness, iris area, and iris curvature [Icurv]), and anterior chamber parameters (anterior chamber depth, width [ACW], area, and lens vault [LV]) were obtained. A linear regression model with adjustment for age, sex, axial length, and pupillary diameter was used for analysis. Subgroup analysis was performed in closed- and open-angle subgroups, which were defined in eyes with gonioscopically visible posterior trabecular meshwork for less than 2 quadrants (closed) and equal to or more than 2 quadrants (open). RESULTS Data were obtained from 126 Vietnamese, 124 Chinese, and 112 white participants. Mean (standard deviation) age of participants was 60.2 (11.8) years. Among overall subjects, Vietnamese had significantly smaller values in all angle and anterior chamber parameters than Chinese and white subjects (all P ≤ .001) except LV. Vietnamese had significantly higher Icurv than Chinese (B -0.065, P < .001) and white subjects (B -0.073, P < .001). In the open-angle subgroup, Vietnamese had significantly smaller angle and anterior chamber dimensions (P ≤ .001) and thicker iris (P < .001) than whites, whereas there was no significant difference in all parameters compared to Chinese except for smaller ACW in Vietnamese (P < .001). In the closed-angle subgroup, Vietnamese possessed smaller angle, smaller anterior chamber dimensions, and higher Icurv than Chinese and white subjects (P < .001). Vietnamese had significantly greater LV compared to Chinese (B -204.8, P = .001). CONCLUSION Vietnamese subjects had more of the anatomic characteristics associated with risk for angle closure, including small anterior chamber dimension, high iris curvature, and high lens vault, compared to the other 2 ethnicities.
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Dastiridou A, Marion K, Niemeyer M, Francis B, Sadda S, Chopra V. Pilot Study of the Effects of Ambient Light Level Variation on Spectral Domain Anterior Segment OCT-Derived Angle Metrics in Caucasians versus Asians. Curr Eye Res 2018; 43:955-959. [PMID: 29641953 DOI: 10.1080/02713683.2018.1464192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To investigate the effects of ambient light level variation on spectral domain anterior segment optical coherence tomography (SD-ΟCT)-derived anterior chamber angle metrics in Caucasians versus Asians. MATERIALS AND METHODS Caucasian (n = 24) and Asian participants of Chinese ancestry (n = 24) with open angles on gonioscopy had one eye imaged twice at five strictly controlled, ambient light levels. Ethnicity was self-reported. Light levels were strictly controlled using a light meter at 1.0, 0.75, 0.5, 0.25, and 0 foot candle illumination levels. SD-OCT 5-line raster scans at the inferior 270° irido-corneal angle were measured by two trained, masked graders from the Doheny Image Reading Center using customized Image-J software. Schwalbe's line-angle opening distance (SL-AOD) and SL-trabecular iris space area (SL-TISA) in different light meter readings (LMRs) between the two groups were compared. RESULTS Baseline light SL-AOD and SL-TISA measured 0.464 ± 0.115mm/0.351 ± 0.110mm2 and 0.344 ± 0.118mm/0.257 ± 0.092mm2, respectively, in the Caucasian and the Asian group. SL-AOD and SL-TISA in each LMR were significantly larger in the Caucasian group compared to the Asian group (p < 0.05). Despite this difference in angle size between the groups, there were no statistically significant differences in the degree of change in angle parameters from light to dark (% changes in SL-AOD or SL-TISA between the two groups were statistically similar with all p-values >0.3). CONCLUSION SL-based angle dimensions using SD-OCT are sensitive to changes in ambient illumination in participants with Caucasian and Asian ancestry. Although Caucasian eyes had larger baseline angle opening under bright light conditions, the light-to-dark change in angle dimensions was similar in the two groups.
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Affiliation(s)
- Anna Dastiridou
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA
| | - Kenneth Marion
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA
| | - Moritz Niemeyer
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA
| | - Brian Francis
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA.,b Department of Ophthalmology , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - Srinivas Sadda
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA.,b Department of Ophthalmology , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
| | - Vikas Chopra
- a Doheny Image Reading Center , Doheny Eye Institute , Los Angeles , CA , USA.,b Department of Ophthalmology , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA
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Abstract
PURPOSE OF REVIEW The aim of the present review was to summarize the new developments in anterior segment optical coherence tomography (AS-OCT) for glaucoma. RECENT FINDINGS Recent years have demonstrated significant advances in the measurement of glaucoma through the use of AS-OCT. Furthermore, a more widespread use of AS-OCT in the clinical study of various glaucomas warrants review, which includes angel assessment, trabecular meshwork and Schlemm's canal assessment, and assessment of the filtering bleb and tube. SUMMARY AS-OCT was recently developed and has become a crucial tool in glaucoma clinical practice. AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. In this review, the author will discuss the various clinical applications of AS-OCT for glaucoma disease, such as angle assessment, trabecular meshwork and Schlemm's canal assessment, or assessment of the filtering bleb and tube.
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Wu SC, Lee YS, Wu WC, Chang SHL. Anterior chamber depth and angle-closure glaucoma after central retinal vein occlusion. BMC Ophthalmol 2016; 16:68. [PMID: 27245223 PMCID: PMC4886398 DOI: 10.1186/s12886-016-0256-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 05/26/2016] [Indexed: 12/30/2022] Open
Abstract
Background The purpose of this study was to report the anterior chamber (AC) depth and the attack of angle-closure glaucoma (ACG) in eyes with the recent onset of central retinal vein occlusion (CRVO). Methods This retrospective case series included 24 patients with recent onset of CRVO (within one month of attack) from July 2001 to December 2002. The mean follow-up period of the patients was 46 months (range: 3 to 92 months). AC depth was measured using an ultrasound biomicroscopy. Clinical data, including systemic disorders, intraocular pressure, and visual outcomes were recorded. The main outcome measures were AC depth in the diseased eye and the fellow eye of the same patient and the attack of ACG after CRVO. Results The mean AC depth in the diseased eyes was significantly shallower than in the unaffected fellow eyes (2.43 ± 0.45 mm vs. 2.55 ± 0.46 mm; p < 0.001). Four patients (17 %) developed ACG after the onset of CRVO within one month of the CRVO attack. In these four patients, the mean AC depth in the diseased eyes was 1.91 ± 0.21 mm, which was much shallower than the eyes without ACG attack (2.53 ± 0.40 mm). Conclusions AC depth is significantly shallower following the onset of CRVO. ACG can occur in patients after the onset of CRVO.
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Affiliation(s)
- Shiu-Chen Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, 5 Fu-Hsin Rd., Kweishan, 333, Taoyuan, Taiwan.,Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yung-Sung Lee
- Department of Ophthalmology, Chang Gung Memorial Hospital, 5 Fu-Hsin Rd., Kweishan, 333, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, 5 Fu-Hsin Rd., Kweishan, 333, Taoyuan, Taiwan.,Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Shirley H L Chang
- Department of Ophthalmology, Chang Gung Memorial Hospital, 5 Fu-Hsin Rd., Kweishan, 333, Taoyuan, Taiwan. .,Chang Gung University, College of Medicine, Taoyuan, Taiwan.
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14
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Lee RY, Lin SC, Chen RI, Barbosa DT, Lin SC. Association between light-to-dark changes in angle width and iris parameters in light, dark and changes from light-to-dark conditions. Br J Ophthalmol 2016; 100:1274-9. [DOI: 10.1136/bjophthalmol-2015-307393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/26/2015] [Indexed: 11/04/2022]
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15
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Zhang X, Wang W, Aung T, Jonas JB, Wang N. Choroidal physiology and primary angle closure disease. Surv Ophthalmol 2015; 60:547-56. [DOI: 10.1016/j.survophthal.2015.06.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 06/12/2015] [Accepted: 06/12/2015] [Indexed: 12/22/2022]
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16
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Comparison of Physiologic versus Pharmacologic Mydriasis on Anterior Chamber Angle Measurements Using Spectral Domain Optical Coherence Tomography. J Ophthalmol 2015; 2015:845643. [PMID: 25878896 PMCID: PMC4386293 DOI: 10.1155/2015/845643] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To compare the effects of physiologic versus pharmacologic pupil dilation on anterior chamber angle (ACA) measurements obtained with spectral domain optical coherence tomography (SD-OCT). Methods. Forty eyes from 20 healthy, phakic individuals with open angles underwent anterior segment OCT imaging under 3 pupillary states: (1) pupil constricted under standard room lighting, (2) physiologic mydriasis in a darkened room, and (3) postpharmacologic mydriasis. Inferior angle Schwalbe's line-angle opening distance (SL-AOD) and SL-trabecular-iris-space area (SL-TISA) were computed for each eye and pupillary condition by masked, certified Reading Center graders using customized grading software. Results. SL-AOD and SL-TISA under pupillary constriction to room light were 0.87 ± 0.31 mm and 0.33 ± 0.14 mm(2), respectively; decreased to 0.75 ± 0.29 mm (P < 0.01) and 0.29 ± 0.13 mm(2) (P < 0.01), respectively, under physiologic mydriasis; and increased to 0.90 ± 0.38 mm (P < 0.01) and 0.34 ± 0.17 mm(2) (P = 0.06) under pharmacologic mydriasis compared to baseline. Conclusions. Using SD-OCT imaging, pharmacologic mydriasis yielded the widest angle opening, whereas physiologic mydriasis yielded the most angle narrowing in normal individuals with open iridocorneal angles. Accounting for the state of the pupil and standardizing the lighting condition would appear to be of importance for future studies of the angle.
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He Y, Baskaran M, Narayanaswamy AK, Sakata LM, Wu R, Liu D, Nongpiur ME, He M, Friedman DS, Aung T. Changes in anterior segment dimensions over 4 years in a cohort of Singaporean subjects with open angles. Br J Ophthalmol 2015; 99:1097-102. [PMID: 25680618 DOI: 10.1136/bjophthalmol-2014-305816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 01/25/2015] [Indexed: 11/04/2022]
Abstract
AIM To evaluate quantitative changes in anterior segment optical coherence tomography (AS-OCT) parameters at 4 years in subjects with open angles on gonioscopy at baseline. METHODS 339 gonioscopically open-angle subjects aged >50 years underwent AS-OCT imaging (Visante, Carl Zeiss Meditec, Dublin, California, USA) at baseline and at 4 years. Customised software was used to analyse images. Linear regression was performed to assess baseline predictors of change in mean trabecular iris space area (TISA). RESULTS Of the 339 subjects, 204 (61%) had good images for analysis. The mean age at baseline was 60 (SD 6.42) years; 55.4% were women and 87.7% were Chinese. Overall, there was a decrease in anterior chamber depth (ACD), anterior chamber area (ACA), anterior chamber volume (ACV) and angle opening distance at 500/750 µm, TISA 500/750 µm, iris thickness at 2000 µm and iris area in both nasal and temporal quadrants (p<0.05) at 4 years. There was an increase in iris curvature (ICURV) and lens vault (LV) (p<0.05). With univariate analysis, shorter axial length (AxL), shallower ACD, greater LV, smaller ACA/ACV and larger mean ICURV at baseline were associated with less change in TISA750 at follow-up. On multivariate analysis, only baseline mean ICURV and shorter AxL were predictive of less change in TISA750 at 4 years. CONCLUSIONS Angle width significantly decreased; ICURV and LV increased in subjects with gonioscopically open angles followed at 4 years. Eyes with shorter AxL and greater ICURV at baseline had lesser decrease in angle width.
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Affiliation(s)
- Yingke He
- Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
| | - Mani Baskaran
- Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Arun K Narayanaswamy
- Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
| | - Lisandro M Sakata
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore Federal University of Parana, Curitiba, Brazil
| | - Renyi Wu
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
| | - Dianna Liu
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Monisha E Nongpiur
- Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - David S Friedman
- Wilmer Eye Institute, Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tin Aung
- Duke-NUS Graduate Medical School, Singapore, Singapore Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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18
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Abstract
PURPOSE OF REVIEW Recent developments in anterior segment imaging enable high-resolution imaging with higher speeds than previous systems. This review will focus on advances in optical coherence tomography (OCT) imaging of the anterior segment with an emphasis on angle evaluation. RECENT FINDINGS Anterior segment imaging with OCT is possible with both time domain and Fourier domain devices, and with light sources of different wavelengths. Recent studies have identified new risk factors for angle closure and prediction models incorporating quantitative angle width parameters have been developed for detection of gonioscopically defined angle closure. Swept source OCT is a variation of Fourier domain OCT that allows three-dimensional imaging of the angle analogous to gonioscopy and novel quantitative parameters have been described for angle measurement with this technology. Fourier domain OCT devices have higher resolution and sampling density than time domain OCT and enable visualization of more angle structures such as the Schwalbe's line and Schlemm's canal. SUMMARY OCT technology is expanding our understanding of angle closure disease. Although it does not replace gonioscopy in angle evaluation, it may help us identify predictors of progression along the angle closure disease spectrum such that treatment may be better targeted.
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Lee RY, Kasuga T, Cui QN, Huang G, He M, Lin SC. Comparison of anterior segment morphology following prophylactic laser peripheral iridotomy in Caucasian and Chinese eyes. Clin Exp Ophthalmol 2013; 42:417-26. [PMID: 24119221 DOI: 10.1111/ceo.12243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 09/16/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND To compare anterior segment biometric parameters between Caucasians and Chinese before and after laser peripheral iridotomy. DESIGN Prospective clinical cohort study. PARTICIPANTS Caucasian and Chinese primary angle-closure suspects. METHODS Anterior segment optical coherence tomography images captured before and after laser peripheral iridotomy were analysed to measure anterior segment biometric parameters. Paired Student's t-tests were used for within-ethnic group comparisons. Univariate and linear mixed-effect regression models were used for between-ethnic group comparisons. MAIN OUTCOME MEASURES Angle opening distance, angle recess area, iris thickness, iris curvature, anterior chamber area, anterior chamber volume and anterior chamber width. RESULTS Caucasians had significantly greater preoperative angle recess area, anterior chamber width, and iris curvature and lower preoperative iris thickness compared to Chinese (P < 0.05). Significant postoperative increases in angle opening distance, angle recess area, anterior chamber area, anterior chamber volume, and anterior chamber width along with significant postoperative decrease in iris curvature were observed within both ethnic groups (P < 0.05). However, the amount of laser peripheral iridotomy-induced changes in angle opening distance, angle recess area, anterior chamber area, anterior chamber volume, anterior chamber width, and iris curvature did not differ between the two ethnic groups (P < 0.05). CONCLUSION Both Caucasian and Chinese demonstrated opening of anterior chamber angle width, expansion of anterior chamber dimensions, and flattening of iris convexity after laser peripheral iridotomy. Although certain aspects of anterior segment anatomy differed between Caucasians and Chinese preoperatively, they did not translate into significant ethnic differences in the amount of laser peripheral iridotomy-induced changes in the anterior segment biometric parameters.
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Affiliation(s)
- Roland Y Lee
- Department of Ophthalmology, University of California, San Francisco, California, USA
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Rho S, Kang SY, Hong S, Seong GJ, Jung JJ, Kim CY. Long-term results of deep sclerectomy with small collagen implant in Korean. KOREAN JOURNAL OF OPHTHALMOLOGY 2013; 27:34-8. [PMID: 23372377 PMCID: PMC3550309 DOI: 10.3341/kjo.2013.27.1.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 03/12/2012] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To describe the long-term results of deep sclerectomy with collagen implant (DSCI) with or without adjuvant mitomycin C in Korean patients with primary or secondary open-angle glaucoma (OAG). METHODS This retrospective review was comprised of 65 Korean patients who received DSCI with or without adjuvant mitomycin C due to primary or secondary OAG. Patients were followed for 72 months after surgery. Complete success was defined as intraocular pressure (IOP) <21 mmHg without medication and qualified success was defined as IOP <21 mmHg with or without medication. RESULTS Mean postoperative follow-up period was 53.0 ± 16.2 months. Mean IOP was 30.5 ± 11.7 mmHg preoperatively, 8.4 ± 4.3 mmHg at postoperative day one and 13.4 ± 3.8 mmHg 60 months after surgery. The mean number of glaucoma medications was decreased from 3.6 ± 1.1 to 1.6 ± 1.3 at 60 months after the operation. Complete and qualified success rates were 36.7% and 79.6% at postoperative 60 months, respectively (Kaplan-Meier survival curve). No shallow or flat anterior chamber, endophthalmitis, or surgery-induced significant cataract was observed. CONCLUSIONS The results of DSCI in Korean patients presented here seem reasonably excellent with qualified success rates of over 70% at six years with negligible complications.
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Affiliation(s)
- Seungsoo Rho
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Lee RY, Kasuga T, Cui QN, Huang G, Wang SY, Lin SC. Ethnic differences in intraocular pressure reduction and changes in anterior segment biometric parameters following cataract surgery by phacoemulsification. Clin Exp Ophthalmol 2012; 41:442-9. [PMID: 23146132 DOI: 10.1111/ceo.12032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 10/27/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Roland Y Lee
- Department of Ophthalmology; University of California; San Francisco; California; USA
| | | | - Qi N Cui
- Department of Ophthalmology; University of California; San Francisco; California; USA
| | | | - Sophia Y Wang
- Department of Ophthalmology; University of California; San Francisco; California; USA
| | - Shan C Lin
- Department of Ophthalmology; University of California; San Francisco; California; USA
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