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Chen H, Ye L, Cheng L, Chen L, Lin J, Li Y, Ye D, Lu P, Huang J. Ocular Biometric Characteristics in Preoperative Diagnosis of Acute Angle Closure With and Without Zonular Laxity. J Glaucoma 2024; 33:195-205. [PMID: 37748092 PMCID: PMC10901222 DOI: 10.1097/ijg.0000000000002307] [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: 02/16/2023] [Accepted: 08/12/2023] [Indexed: 09/27/2023]
Abstract
PRCIS Biometric parameters, including binocular difference of anterior chamber depth (ACD), lens vault (LV) in affected eyes, and binocular difference of the LV, had high efficiency in diagnosing acute angle closure (AAC) with zonular laxity. PURPOSE To investigate the ocular biometric characteristics of eyes with AAC with zonular laxity to further explore the sensitive parameters for preoperative diagnosis. METHODS This study included 50 patients with AAC with zonular laxity and 54 patients with AAC without zonular laxity. Demographic data, ocular examination results, and biometric parameters on ultrasound biomicroscopy images were compared between the affected and fellow eyes in 2 groups. Parameters significant in the multiple linear regression model were included in a regression equation and the diagnostic efficiency was evaluated by area under the curve. RESULTS In patients with AAC with zonular laxity, the binocular difference of central ACD, LV in affected eyes, and binocular difference of the LV were significantly larger than those in patients without zonular laxity respectively and these three parameters were all significant in multiple linear regression analysis (all P <0.001). The area under the curve of binocular difference of ACD, LV in affected eyes, and binocular difference of LV were 0.972, 0.796, and 0.855, respectively, with the cutoff values of 0.23, 1.28, and 0.19 mm. The regression equation containing these three parameters was: ln ( P /(1- P ))=-4.322 + 1.222 [LV in affected eyes (mm)] + 3.657 [binocular difference of LV (mm)] + 6.542 [binocular difference of ACD (mm)], with the accuracy of prediction reaching 94.05%. CONCLUSION Binocular difference of ACD, LV in affected eyes, and binocular difference of LV had high efficiency in diagnosing AAC with zonular laxity.
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Affiliation(s)
- Hailiu Chen
- 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
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou
| | - Litong Ye
- 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
| | - Lu Cheng
- 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
| | - Liming Chen
- 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
| | - Jialiu Lin
- 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
| | - Yangyunhui 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
| | - Dan Ye
- 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
| | - Peng Lu
- 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
- Research Center of Ophthalmic Diseases, Guangxi Academy of Medical Sciences & Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Jingjing Huang
- 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
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Chong YJ, Azzopardi M, Hussain G, Recchioni A, Gandhewar J, Loizou C, Giachos I, Barua A, Ting DSJ. Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review. Diagnostics (Basel) 2024; 14:122. [PMID: 38248000 PMCID: PMC10814678 DOI: 10.3390/diagnostics14020122] [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: 11/20/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Since its introduction, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and has now become an indispensable, noninvasive tool in daily practice. Most ophthalmologists are familiar with its use in the assessment and monitoring of retinal and optic nerve diseases. However, it also has important applications in the assessment of anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris, and has the potential to transform the clinical examination of these structures. In this review, we aim to provide a comprehensive overview of the potential clinical utility of anterior segment OCT (AS-OCT) for a wide range of anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. In addition, the clinical applications of AS-OCT (including epithelial mapping) in preoperative planning and postoperative monitoring for corneal and refractive surgeries are discussed.
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Affiliation(s)
- Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Modality Ophthalmology, Modality Partnership, Birmingham B19 1BP, UK;
| | - Matthew Azzopardi
- Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK;
| | - Gulmeena Hussain
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK;
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Jaishree Gandhewar
- New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK;
| | | | - Ioannis Giachos
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Ankur Barua
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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Xu Q, Zhang Y, Wang L, Chen X, Sun X, Chen Y. The morphology of angle dysgenesis assessed by ultrasound biomicroscopy and its relationship with glaucoma severity and mutant genes in Axenfeld-Rieger syndrome. Quant Imaging Med Surg 2023; 13:6979-6988. [PMID: 37869359 PMCID: PMC10585538 DOI: 10.21037/qims-23-348] [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: 03/17/2023] [Accepted: 08/14/2023] [Indexed: 10/24/2023]
Abstract
Background Axenfeld-Rieger syndrome (ARS), a developmental disorder, involves anterior segment abnormalities and can lead to glaucoma. However, limited research has addressed the ultrasound biomicroscopy (UBM) characteristics of ARS. This study aimed to assess the anterior chamber angle features using UBM in ARS and determine their correlation with glaucoma severity and mutant genes. Methods UBM examination was conducted for 42 patients diagnosed with ARS and glaucoma. The morphology of the anterior chamber angle was classified into 6 types (type A, pure high iris insertion; type B, posterior embryotoxon; type C, iris process; type D, trabecular-iris synechia; type E, peripheral iridocorneal adhesion; type F, goniodysgenesis). Candidate genes were sequenced with next-generation sequencing. Correlations of clinical characteristics with angle dysgenesis types and mutant genes were analyzed. Results Among the 42 patients recruited, 6 eyes were excluded for poor quality UBM images or lack of glaucoma development. The remaining 78 eyes were categorized into 6 groups according to their dominant type of anterior chamber angle (>2 quadrants). There were statistically significant differences in onset age of glaucoma (P<0.001), untreated intraocular pressure (IOP) (P=0.016), vertical cup to disc ratio (P=0.001), and age at surgery (P<0.001) among the groups. Eyes in the type C and D groups developed glaucoma and underwent surgery at an earlier age, while eyes in the type B, E, and F groups developed glaucoma at a relatively later age. Eyes in type A group developed glaucoma and underwent surgery at the latest age, and had the lowest untreated IOP compared to the other groups. Patients with FOXC1 defects were more likely to have angle type B, type C, and type D (accounting for 93.8% of the total), whereas patients with PITX2 defects were more likely to have angle type A, type E, and type F (accounting for 92.1% of the total). Conclusions UBM is powerful for evaluating the anterior segment abnormalities in ARS. Combined with genetic testing results, the morphological classification helps to assess the severity of glaucoma.
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Affiliation(s)
- Qingdan Xu
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Youjia Zhang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Li Wang
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Xueli Chen
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
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Keller MJ, Gast TJ, King BJ. Advancements in high-resolution imaging of the iridocorneal angle. FRONTIERS IN OPHTHALMOLOGY 2023; 3:1229670. [PMID: 38983074 PMCID: PMC11182319 DOI: 10.3389/fopht.2023.1229670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/31/2023] [Indexed: 07/11/2024]
Abstract
High-resolution imaging methods of the iridocorneal angle (ICA) will lead to enhanced understanding of aqueous humor outflow mechanisms and a characterization of the trabecular meshwork (TM) morphology at the cellular level will help to better understand glaucoma mechanics (e.g., cellular level biomechanics of the particulate glaucomas). This information will translate into immense clinical value, leading to more informed and customized treatment selection, and improved monitoring of procedural interventions that lower intraocular pressure (IOP). Given ICA anatomy, imaging modalities that yield intrinsic optical sectioning or 3D imaging capability will be useful to aid in the visualization of TM layers. This minireview examines advancements in imaging the ICA in high-resolution.
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Affiliation(s)
- Matthew J Keller
- School of Optometry, Indiana University, Bloomington, IN, United States
| | - Thomas J Gast
- School of Optometry, Indiana University, Bloomington, IN, United States
| | - Brett J King
- School of Optometry, Indiana University, Bloomington, IN, United States
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Stephen M, Kaliaperumal S, Behera G. Evaluation of changes in anterior segment morphology using Sirius Scheimpflug-Placido disk topographer following laser peripheral iridotomy in primary angle-closure disease. Indian J Ophthalmol 2023; 71:848-852. [PMID: 36872691 PMCID: PMC10229939 DOI: 10.4103/ijo.ijo_993_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 10/26/2022] [Accepted: 12/07/2022] [Indexed: 03/07/2023] Open
Abstract
Purpose To assess the morphological changes in the anterior segment following laser peripheral iridotomy (LPI) in primary angle-closure disease (PACD) using Sirius Scheimpflug-Placido disk corneal topographer. Methods This was a prospective observational study. A total of 52 eyes of 27 patients with PACD who underwent LPI were analyzed for iridocorneal angle (ICA), anterior chamber depth (ACD), anterior chamber volume (ACV), horizontal visible iris diameter (HVID), corneal volume (CV), central corneal thickness (CCT), and horizontal anterior chamber diameter (HACD) 1 week following LPI, using Sirius Scheimpflug-Placido disk corneal topographer. Data analysis was done using Statistical Package for the Social Sciences (SPSS) software version 19.0, and paired t-test was used to assess the statistical significance. Results Laser peripheral iridotomy was performed in 43 eyes with primary angle-closure suspect (PACS), six eyes with primary angle closure (PAC), and three eyes with primary angle-closure glaucoma (PACG). The analysis of the data showed statistically significant changes in anterior segment parameters of ICA, ACD, and ACV. Post-laser increase in ICA from 34.13° ± 2.64° to 34.75° ± 2.84° (P < 0.041), mean ACD increase from 2.21 ± 0.25 to 2.35 ± 0.27 mm (P = 0.01), and mean ACV increase from 98.19 ± 12.13 to 104.15 ± 11.16 mm3 (P = 0.001) were noted. Conclusion Significantly quantifiable short-term changes in the anterior chamber parameters of ICA, ACD, and AC volume were seen after LPI in patients with PACD on Sirius Scheimpflug-Placido disc corneal topographer.
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Affiliation(s)
- Mary Stephen
- Department of Ophthalmology, JIPMER, Puducherry, India
| | | | - Geeta Behera
- Department of Ophthalmology, JIPMER, Puducherry, India
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Rao A, Khan SM, Mukherjee S. Causes of Immediate and Early IOP Spikes After Circumferential Gonioscopy-Assisted Transluminal Trabeculotomy Using ASOCT. Clin Ophthalmol 2023; 17:313-320. [PMID: 36711260 PMCID: PMC9879041 DOI: 10.2147/opth.s397816] [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: 11/17/2022] [Accepted: 01/05/2023] [Indexed: 01/23/2023] Open
Abstract
Purpose To report the early postoperative causes of intraocular pressure (IOP) spikes after complete circumferential gonioscopy-assisted transluminal trabeculotomy (GATT) using anterior segment optical coherence tomography (ASOCT). Methods This was retrospective interventional case series of patients who underwent circumferential GATT by a single surgeon (APR) from 2021 to 2022 at a tertiary eye care in East India and who developed IOP spikes at 1 day-2 weeks (immediate) or early (>2 weeks-2 months) after GATT. The intraocular pressure (IOP), glaucoma medications, and angle evaluation by ASOCT at 1 week, and 1 month were compared between the two groups. Results Thirty-two eyes of 32 consecutive patients, aged 40±20.1 years (20 exfoliation glaucoma, 9 juvenile open-angle, and 3 developmental glaucoma), that developed IOP spikes between immediate (n=20) or early (n=12) IOP spikes after GATT, were included. Immediate postoperative spikes were seen in 20 eyes due to retained viscoelastic (n=8), hyphema (n=8) in uncontrolled hypertension, and peripheral anterior synechiae (PAS) (n=6) of which only one eye required medication at 2 months. Causes of immediate IOP spikes on ASOCT included an inverted/reattached trabecular shelf, iris strands in eyes with abnormal iris in developmental glaucoma, and PAS in 1-2 quadrants. Causes of early IOP spikes included PAS >3 quadrants (n=8), and hyperreflective fibrotic tissue over TM (n=4) with 50% requiring medications at 2 months. The ASOCT features predicting the need for medications were PAS >3 quadrants (OR=8.4[2.2-14.3], p=0.03) and fibrotic TM closure (OR=5.4, [3.6-10.2], p=0.003). One eye with macrohyphema 3 days after surgery owing to uncontrolled hypertension (owing to the stoppage of medicines), required additional incisional trabeculectomy within 1 month of surgery. Conclusion Immediate IOP spikes are mostly self-resolving as opposed to early IOP spikes >2 weeks that require medications after GATT. Gonioscopic PAS >3 quadrants, and fibrotic TM closure were the main identifiable ASOCT causes predicting the need for medications after GATT.
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Affiliation(s)
- Aparna Rao
- Glaucoma Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, 751024, India,Correspondence: Aparna Rao, Glaucoma Service, LV Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, 751024, India, Tel +91 674 2653001, Fax +91 674 2653130, Email ;
| | - Sardar Mohd Khan
- Glaucoma Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, 751024, India
| | - Sujoy Mukherjee
- Glaucoma Service, LV Prasad Eye Institute, Bhubaneswar, Odisha, 751024, India
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Antonov AA, Khderi K, Bersunkayev MK, Pateyuk LS. [The effect of phacoemulsification of age-related cataract on intraocular pressure and iridocorneal angle parameters in primary open-angle glaucoma]. Vestn Oftalmol 2023; 139:60-68. [PMID: 38235631 DOI: 10.17116/oftalma202313906160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Cataract phacoemulsification with intraocular lens implantation significantly affects the morphology of the anterior chamber angle (ACA) and contributes to a reduction of intraocular pressure (IOP). PURPOSE This study investigates the changes in anterior chamber angle configuration and IOP level before and after cataract surgery in primary open-angle glaucoma (POAG) eyes, and assesses its possible relationship with the axial length of the eye. MATERIAL AND METHODS The study included 38 patients with immature senile cataract and compensated unoperated stage I-II POAG. Patients underwent anterior segment optical coherence tomography (AS-OCT) with measurement of the angle opening distance (AOD750) and trabecular-iris space area (TISA750) before and six weeks after the surgery, as well as axial length and corneal-compensated IOP (IOPcc). RESULTS After the surgery 92.11% of patients showed a decrease in IOPcc an average of 1.84±1.95 mm Hg (by 12.33±10.21% of the baseline); the maximum decrease in the IOPcc level was 8.35 mm Hg (by 40.97% of the baseline). AS-OCT data indicates that cataract phacoemulsification causes an increase in anterior chamber angle width: AOD750 increased from 0.510±0.175 to 0.771±0.156 mm, and TISA750 increased from 0.266±0.090 to 0.494±0.096 mm2. The strongest correlations were found between the axial length, postoperative TISA750 increase (Δ%TISA750) and postoperative IOPcc reduction (Δ% IOPcc). Postoperatively, specific changes could be observed in the trabecular meshwork in 28.95% of cases in the form of elongation and strain of the membrane. CONCLUSIONS Cataract extraction contributes to a significant reduction in IOP due to anterior chamber angle expansion, trabecular meshwork stretching, and improved aqueous outflow.
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Affiliation(s)
- A A Antonov
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - Kh Khderi
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | | | - L S Pateyuk
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
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Ciliochoroidal effusion and its association with the outcomes of micropulse transscleral laser therapy in glaucoma patients: a pilot study. Sci Rep 2022; 12:16403. [PMID: 36180552 PMCID: PMC9525712 DOI: 10.1038/s41598-022-20675-w] [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: 01/09/2022] [Accepted: 09/16/2022] [Indexed: 11/08/2022] Open
Abstract
We investigate the development of ciliochoroidal effusion following micropulse transscleral laser therapy (MPTLT) and evaluate the relationship between the early postoperative ciliochoroidal effusion (ECE) and short-term treatment outcomes. Glaucoma patients who underwent MPTLT were assessed for ciliochoroidal effusion by anterior segment optical coherence tomography (AS-OCT) at postoperative 1, 4, 12 weeks. The subjects were classified based on AS-OCT findings at postoperative 1 week into eyes with and without ECE. The absolute intraocular pressure (IOP), IOP reduction and number of antiglaucoma medications were compared between eyes with and without ECE. A total of 50 eyes were included, of which 23 (46%) developed ciliochoroidal effusion at postoperative 1 week. Almost all effusion resolved at 4 weeks. At 12 weeks, the mean IOP (SD) significantly decreased from 28.5 (12.8) mmHg to 17.8 (10.5) mmHg (p < 0.001), and the mean number of medications (SD) decreased from 4.1 (0.9) to 3.3 (1.1) (p < 0.001). Eyes with ECE had significantly greater IOP reduction (p = 0.009) and lower absolute IOP (p = 0.008) at the 4-week visit. There was no significant difference in number of medications between the groups. In conclusion, ciliochoroidal effusion was commonly observed following MPTLT. Eyes with ECE had overall greater IOP reduction during early post-operation.
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Garcia Marin YF, Alonso-Caneiro D, Vincent SJ, Collins MJ. Anterior segment optical coherence tomography (AS-OCT) image analysis methods and applications: A systematic review. Comput Biol Med 2022; 146:105471. [DOI: 10.1016/j.compbiomed.2022.105471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/03/2022]
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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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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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Kyei S, Abowine JBV, Zaabaar E, Boadi-Kusi SB, Assiamah F, Abdul-Kabir M, Asiedu K. Age- and sex-related differences in the measures of anterior segment parameters in a myopic clinical sample using Pentacam Scheimpflug tomography. Int Ophthalmol 2022; 42:1573-1580. [PMID: 35083596 DOI: 10.1007/s10792-021-02192-3] [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: 09/13/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess age-and sex-related differences of anterior segment parameters in a myopic clinical sample. METHODS This clinic-based retrospective study involved eligible subjects grouped into myopia (i.e., low-to-moderate) and high myopia. Demographics and anterior segment parameters measures were recorded and analyzed. RESULTS Some 153 eligible eyes were analyzed-98 myopia and 55 high myopia-comprising 87 males and 66 females. The mean ages and ranges were 28.47 years (SD = 9.59 years), 8-50 years, and 27.82 years (SD = 9.69 years), 10-51 years, for the myopia and the high myopia groups, respectively. The means of the spherical equivalents were - 3.02 D (SD = 1.46 D, range: - 0.50 to - 5.85 D), for the myopia group and - 10.42 D (SD = 5.50 D, range: - 6.00 to - 21.86 D) for the high myopia group. No significant difference was found between degree of myopia and anterior segment measures. Males had larger anterior chamber volume (mean 175.71 ± 26.27, range: 124-225 mm3); (P = 0.007) and deeper anterior chamber depth (3.73 ± 0.27, range: 3.06-4.41 mm) (P = 0.017) than females in the myopia group. Females also had significantly steeper anterior corneal curvature, Km (ant.) but flatter posterior corneal curvature, Km (post.), (- 6.31 ± 0.25, range - 7.00 to - 5.90 D) in both the myopia group [Km (ant.): 44.06 D ± 1.33 D, range: 41.30-47.10; Km (post.): - 6.31 D ± 0.25 D, range: - 7.00 to - 5.90; P = 0.008, P = 0.002, respectively] and the high myopia group [Km (ant.): 43.79 D ± 0.33 D, range: 41.00-47.10; Km (post.): - 6.22 D ± 0.30 D, range: - 6.80 to - 5.60; P = 0.034, P = 0.049, respectively]. Age was not correlated with the anterior segment parameters in both degrees of myopia. CONCLUSION Sex has significant influence on the corneal curvature, anterior chamber volume and anterior chamber depth regardless of the degree of myopia.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, PMB, Cape Coast, Ghana.
| | | | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, PMB, Cape Coast, Ghana
| | - Samuel Bert Boadi-Kusi
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, PMB, Cape Coast, Ghana
| | - Frank Assiamah
- Eye Department, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Mohammed Abdul-Kabir
- Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kofi Asiedu
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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13
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Chen H, Meng J, Lu P, Ye D, Li Y, Cheng L, Li Y, Liang X, Huang W, Huang J. Segmentation Errors in the Measurement of Volumetric Parameters by Swept-Source Anterior Segment Optical Coherence Tomography. Front Med (Lausanne) 2021; 8:761550. [PMID: 34977068 PMCID: PMC8718599 DOI: 10.3389/fmed.2021.761550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the error rate of segmentation in the automatic measurement of anterior chamber volume (ACV) and iris volume (IV) by swept-source anterior segment optical coherence tomography (SS-ASOCT) in narrow-angle and wide-angle eyes.Methods: In this study, fifty eyes from 25 narrow-angle subjects and fifty eyes from 25 wide-angle subjects were enrolled. SS-ASOCT examinations were performed and each SS-ASOCT scan was reviewed, and segmentation errors in the automatic measurement of ACV and IV were classified and manually corrected. Error rates were compared between the narrow-angle and the wide-angle groups, and ACV and IV before and after manual correction were compared.Results: A total of 12,800 SS-ASOCT scans were reviewed. Segmentation error rates of angle recess, iris root, posterior surface of the iris, pupil margin, and anterior surface of the lens were 84.06, 93.30, 13.15, 59.21, and 25.27%, respectively. Segmentation errors of angle recess, iris root, posterior surface of the iris, and pupil margin occurred more frequently in narrow-angle eyes, while more segmentation errors of the anterior surface of the lens were found in wide-angle eyes (all P < 0.001). ACV decreased and IV increased significantly after manual correction of segmentation errors in both groups (all P < 0.01).Conclusion: Segmentation errors were prevalent in the volumetric measurement by SS-ASOCT, particularly in narrow-angle eyes, leading to mismeasurement of ACV and IV.
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Affiliation(s)
- Hailiu Chen
- 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, China
- Department of Ophthalmology, Joint Shantou International Eye Center, Shantou University, Chinese University of Hong Kong, Shantou, China
| | - Jie Meng
- 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, China
| | - Peng Lu
- 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, China
| | - Dan Ye
- 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, China
| | - Yunxuan 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, China
| | - Lu Cheng
- 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, China
| | - Yangyunhui 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, China
| | - Xiaoling Liang
- 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, China
| | - Wenyong Huang
- 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, China
- *Correspondence: Wenyong Huang
| | - Jingjing Huang
- 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, China
- Jingjing Huang
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14
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Wang W, Wang L, Wang T, Wang X, Zhou S, Yang J, Lin S. Automatic Localization of the Scleral Spur Using Deep Learning and Ultrasound Biomicroscopy. Transl Vis Sci Technol 2021; 10:28. [PMID: 34427626 PMCID: PMC8399238 DOI: 10.1167/tvst.10.9.28] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to develop a convolutional neural network (CNN) for automated localization of the scleral spur in ultrasound biomicroscopy (UBM) images of open-angle eyes. Methods UBM images were acquired, and one glaucoma specialist provided reference coordinates of scleral spur locations in all images. A CNN model based on the EfficientNetB3 architecture was developed to detect the scleral spur in each image. The prediction errors and Euclidean distance were used to evaluate localization performance of the CNN model. Trabecular-iris angle 500 (TIA500) and angle-opening distance 500 (AOD500) were measured and analyzed using the scleral spur locations provided by the specialist and predicted by the CNN model. Results The CNN was developed using a training dataset of 2328 images and tested using an independent dataset of 258 images. The mean absolute prediction errors of CNN model were 48.06 ± 45.40 µm for X-coordinates and 30.84 ± 27.03 µm for Y-coordinates. The mean absolute intraobserver variability was 47.80 ± 44.45 µm for X-coordinates and 29.50 ± 25.77 µm for Y-coordinates. The mean Euclidean distance of the CNN was 60.41 ± 49.02 µm and the intraobserver mean Euclidean distance was 59.78 ± 47.12 µm. The mean absolute error in TIA500 was 1.26 ± 1.38 degrees for all test images and in AOD500 was 0.039 ± 0.051 mm. Conclusions A CNN can detect the scleral spur on UBM images of open-angle eyes with performance similar to that of a glaucoma specialist. Translational Relevance Deep learning algorithms for automating scleral spur localization would facilitate the quantitative assessment of the opening of the angle and the risk in angle closure.
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Affiliation(s)
- Wensai Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Lingxiao Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Tao Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Xiaochun Wang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Sheng Zhou
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Jun Yang
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Song Lin
- Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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15
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Rao A, Vupparaboina KK, Padhy D, Raj N, Pradhan A, Goud A, Peguda HK, Jana S, Richariya A. Automated iris volume analysis and trabecular meshwork length using anterior segment optical coherence tomography - Application in pseudoexfoliation and pseudoexfoliation glaucoma. Indian J Ophthalmol 2021; 69:1815-1819. [PMID: 34146036 PMCID: PMC8374829 DOI: 10.4103/ijo.ijo_2403_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: 11/22/2022] Open
Abstract
Purpose: The aim of this study was to evaluate differences in the iris and angle parameters in psuedoexfoliation syndrome (PXF) and pseudoexfoliation glaucoma (PXG) using anterior segment optical coherence tomography (ASOCT). Methods: Patients with PXF or PXG were compared using ASOCT with primary open-angle glaucoma POAG eyes as controls in this noninterventional comparative study conducted at a tertiary eye care center in East India. All angle parameters, TM length, and iris thickness were analyzed from the enhanced depth imaging (EDI) single scans obtained. Quadrant scans were used for the calculation of iris volume using a custom-built in-house software. In particular, the software performs multiple operations including edge detection, connected components, and thresholding to localize and segment the iris. Differences in the iris volume/thickness and TM length in PXF and PXG with POAG were analyzed. Results: A total of 225 eyes were included, which included 75 PXG and 98 PXF cases and 52 POAG with a mean age of 67 ± 9.7 years at presentation. The algorithm repeatability and reproducibility was also established with correlation coefficients more than 99% which was substantiated with Bland-Altman plots. The iris volume (calculated in 197 images of 225 eyes) did not differ significantly in PXF and PXG eyes, although both had significantly greater volume compared to POAG eyes. The iris volume or other angle parameters including TM length did not correlate with clinical variables such as IOP, age, or visual field indices. Conclusion: Iris parameters or TM length do not explain pathogenesis of glaucoma in pseudoexfoliation.
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Affiliation(s)
- Aparna Rao
- LV Prasad Eye Institute, Patia, Bhubaneswar, Orissa, India
| | | | | | - Niranjan Raj
- LV Prasad Eye Institute, Patia, Bhubaneswar, Orissa, India
| | - Amiya Pradhan
- LV Prasad Eye Institute, Patia, Bhubaneswar, Orissa, India
| | - Abilash Goud
- LV Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Soumya Jana
- LV Prasad Eye Institute, Hyderabad, Telangana, India
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16
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Chen YY, Sun YC, Tsai CY, Chu HS, Wu JH, Chang HW, Chen WL. Spectral-domain optical coherence tomography for evaluating palisades of Vogt in ocular surface disorders with limbal involvement. Sci Rep 2021; 11:12502. [PMID: 34127762 PMCID: PMC8203687 DOI: 10.1038/s41598-021-91999-2] [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: 02/06/2021] [Accepted: 05/17/2021] [Indexed: 12/03/2022] Open
Abstract
Spectral-domain optical coherence tomography (SD-OCT) has been used to observe the morphology of the palisades of Vogt (POV) with satisfactory resolutions. In this study, we used SD-OCT to examine the microstructure of the POV in ocular surface disorders with limbal involvement. We detect subclinical limbal pathologies based on five parameters, including (1) decreased epithelial thickness, (2) loss of the sharp stromal tip, (3) loss of the smooth epithelial-stromal interface, (4) dilated stromal vessels, and (5) decreased POV density. Eighteen eyes of 10 patients with advancing wavelike epitheliopathy (AWE) and 15 eyes of 9 patients with phlyctenular keratitis/ocular rosacea were recruited. SD-OCT could detect abnormal changes in the POV in 100% of the lesion sites. In presumed-healthy areas of the diseased eyes diagnosed by slit-lamp biomicroscopy, SD-OCT detected abnormal changes in the POV in 100% of the eyes in both groups. In patients with unilateral disease, abnormal changes in the POV were detected by SD-OCT in 50% and 100% of presumed-healthy eyes diagnosed by slit-lamp biomicroscopy in the AWE group and phlyctenular keratitis/ocular rosacea group, respectively. SD-OCT is powerful in detecting POV changes in ocular surface disorders and can provide useful information that cannot be provided by slit-lamp biomicroscopy.
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Affiliation(s)
- Ying-Yi Chen
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Yi-Chen Sun
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.,Department of Ophthalmology, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chia-Ying Tsai
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Fu-Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Hsiao-Sang Chu
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Jo-Hsuan Wu
- Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Huai-Wen Chang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. .,Advanced Ocular Surface and Corneal Nerve Research Center, National Taiwan University Hospital, Taipei, Taiwan. .,Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan.
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17
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Potop V, Coviltir V, Schmitzer S, Dragosloveanu CDM, Ionescu CI, Burcel MG, Corbu MC, Dăscălescu DMC. Ultrasound biomicroscopy in glaucoma assessment. Rom J Ophthalmol 2021; 65:114-119. [PMID: 34179574 PMCID: PMC8207866 DOI: 10.22336/rjo.2021.24] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 12/12/2022] Open
Abstract
Ultrasound biomicroscopy (UBM) is an important tool in the diagnosis, evaluation and follow up of glaucoma patients. Even if we are dealing with a primary angle closure glaucoma (PACG) or a primary open angle glaucoma (POAG) patient, the mechanism of angle closure can be revealed by performing an UBM. The device can help differentiate between the two types of glaucoma even in patients with opaque corneas when gonioscopy cannot be performed. Knowing the type of glaucoma is vital, especially regarding an individualized treatment, since each patient is unique and needs to be treated accordingly, in order to prevent glaucomatous optic neuropathy and visual field loss. Abbreviations: AC = anterior chamber, ICE = iridocorneal endothelial syndrome, IOP = intraocular pressure, NTG = normal tension glaucoma, PACG = primary angle closure glaucoma, PC = posterior chamber, PEX = pseudoexfoliation syndrome, POAG = primary open angle glaucoma, UBM = ultrasound biomicroscopy.
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Affiliation(s)
- Vasile Potop
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | - Valeria Coviltir
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | - Speranţa Schmitzer
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | - Christiana Diana Maria Dragosloveanu
- Ophthalmology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
| | | | | | - Maria Cristina Corbu
- Ophthalmology Department, Clinical Hospital of Ophthalmologic Emergencies, Bucharest, Romania
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18
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Anterior Chamber Angle Assessment Techniques: A Review. J Clin Med 2020; 9:jcm9123814. [PMID: 33255754 PMCID: PMC7759936 DOI: 10.3390/jcm9123814] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 12/16/2022] Open
Abstract
Assessment of the anterior chamber angle (ACA) is an essential part of the ophthalmological examination. It is intrinsically related to the diagnosis and treatment of glaucoma and has a role in its prevention. Although slit-lamp gonioscopy is considered the gold-standard technique for ACA evaluation, its poor reproducibility and the long learning curve are well-known shortcomings. Several new imaging techniques for angle evaluation have been developed in the recent years. However, whether these instruments may replace or not gonioscopy in everyday clinical practice remains unclear. This review summarizes the last findings in ACA evaluation, focusing on new instruments and their application to the clinical practice. Special attention will be given to the comparison between these new techniques and traditional slit-lamp gonioscopy. Whereas ultrasound biomicroscopy and anterior segment optical coherence tomography provide quantitative measurements of the anterior segment’s structures, new gonio-photographic systems allow for a qualitative assessment of angle findings, similarly to gonioscopy. Recently developed deep learning algorithms provide an automated classification of angle images, aiding physicians in taking faster and more efficient decisions. Despite new imaging techniques made analysis of the ACA more objective and practical, the ideal method for ACA evaluation has still to be determined.
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Bleb Morphology Using Anterior-Segment Optical Coherence Tomography after Ahmed Glaucoma Valve Surgery with Tenon Capsule Resection. J Ophthalmol 2020; 2020:8386135. [PMID: 33149944 PMCID: PMC7603617 DOI: 10.1155/2020/8386135] [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: 06/24/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To evaluate the internal morphology of blebs using anterior-segment optical coherence tomography (AS-OCT) and the surgical outcomes of Ahmed glaucoma valve (AGV) surgery with Tenon capsule resection compared to conventional AGV surgery in patients with refractory glaucoma. Patients and Methods. This randomised prospective study included 30 eyes from 30 patients (age range: 42-55 y) with refractory glaucoma from March 2018 to February 2020. The study included two groups: AGV with the Tenon capsule resection group (n = 15) and the conventional AGV surgery group (n = 15). Follow-up continued until 6 months after surgery. The primary outcome was intraocular pressure (IOP) and its association with the number of postoperative glaucoma medications, best corrected visual acuity, visual field, and postoperative complications. The internal morphology of the blebs in both groups was evaluated at 1-day, 1-week, 1-month, 3-month, and 6-month follow-up using AS-OCT in terms of the consequent changes in bleb wall thickness, bleb wall reflectivity, and bleb cavity morphology throughout the 6-month follow-up period. Results A significant reduction in IOP was found in both groups, with a greater reduction in group I, where the mean IOP decreased from 32.73 ± 2.12 mmHg in the preoperative period to 13.33 ± 1.59 mmHg after 6 months, whereas in group II, the mean IOP decreased from 33.2 ± 2.21 mmHg in the preoperative period to 14.27 ± 1.44 mmHg after 6 months (p value <0.05). The difference between the 2 groups in terms of the decrease in IOP was insignificant except at 1 and 3 months, where there was a significant difference (p value = 0.016 and 0.01 at 1 and 3 months, respectively). The bleb analysis revealed a significant reduction in the wall thickness in both groups at 1 and 3 months, which was mostly associated with the hypertensive phase. In group I, the bleb wall thickness decreased from 754.67 ± 53.93 μm in the first postoperative day to 684 ± 81.66 μm and 671.6 ± 69.48 μm at 1 and 3 months, respectively, while in group II, the bleb wall thickness decreased from 707.13 ± 31.7 μm in the first postoperative day to 499.53 ± 99.1 μm and 506 ± 76.91 μm at 1 and 3 months, respectively. There was a significant reduction in AS-OCT, and bleb reflectivity was insignificant throughout the follow-up period (p value >0.05). Regarding postoperative complications, the hypertensive phase occurred more frequently in group II (6 eyes, 40%) than in group I (2 eyes, 13.3%). Other complications were also reported more frequently in group II such as hypotony, shallow anterior chamber (AC), and tube exposure. Conclusion AS-OCT was beneficial in the analysis of bleb morphology after AGV surgery where there were more diffuse functioning multicystic blebs and less thinning in the bleb wall thickness during the hypertensive phase after resection of the Tenon capsule, which might be related to the less incidence of fibrosis around the surgical site.
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20
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Makashova NV, Kolosova OY. [Methods of assessing the condition of filtering bleb after glaucoma surgery]. Vestn Oftalmol 2020; 136:93-99. [PMID: 33084285 DOI: 10.17116/oftalma202013606193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Currently, there is a need to assess the condition of structures at the surgery site after glaucoma intervention due to the necessity to decide further treatment tactics after performed operations, as well as the possibility of developing more advanced methods of surgical treatment of glaucoma. Despite the fact that there are several methods of examining the filtration bleb (FB), some of them have both clear advantages and significant disadvantages. This article reviews the possibilities of using optical coherence tomography (OCT), ultrasound biomicroscopy (UBM), thermography, confocal microscopy, and the Hyperemia-3 program for assessing the structural and functional state of the FB.
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21
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Pham TH, Devalla SK, Ang A, Soh ZD, Thiery AH, Boote C, Cheng CY, Girard MJA, Koh V. Deep learning algorithms to isolate and quantify the structures of the anterior segment in optical coherence tomography images. Br J Ophthalmol 2020; 105:1231-1237. [PMID: 32980820 DOI: 10.1136/bjophthalmol-2019-315723] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/14/2020] [Accepted: 08/03/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Accurate isolation and quantification of intraocular dimensions in the anterior segment (AS) of the eye using optical coherence tomography (OCT) images is important in the diagnosis and treatment of many eye diseases, especially angle-closure glaucoma. METHOD In this study, we developed a deep convolutional neural network (DCNN) for the localisation of the scleral spur; moreover, we introduced an information-rich segmentation approach for this localisation problem. An ensemble of DCNNs for the segmentation of AS structures (iris, corneosclera shell adn anterior chamber) was developed. Based on the results of two previous processes, an algorithm to automatically quantify clinically important measurements were created. 200 images from 58 patients (100 eyes) were used for testing. RESULTS With limited training data, the DCNN was able to detect the scleral spur on unseen anterior segment optical coherence tomography (ASOCT) images as accurately as an experienced ophthalmologist on the given test dataset and simultaneously isolated the AS structures with a Dice coefficient of 95.7%. We then automatically extracted eight clinically relevant ASOCT measurements and proposed an automated quality check process that asserts the reliability of these measurements. When combined with an OCT machine capable of imaging multiple radial sections, the algorithms can provide a more complete objective assessment. The total segmentation and measurement time for a single scan is less than 2 s. CONCLUSION This is an essential step towards providing a robust automated framework for reliable quantification of ASOCT scans, for applications in the diagnosis and management of angle-closure glaucoma.
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Affiliation(s)
- Tan Hung Pham
- Department of Biomedical Engineering, National University of Singapore, Singapore.,Singapore Eye Research Institute, Singapore
| | | | - Aloysius Ang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zhi-Da Soh
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore
| | - Alexandre H Thiery
- Statistics and Applied Probability, National University of Singapore, Singapore
| | - Craig Boote
- Optometry and Vision Sciences, Cardiff University, Cardiff, South Glamorgan, UK
| | - Ching-Yu Cheng
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore
| | - Michael J A Girard
- Ophthalmic Engineering and Innovation Laboratory (OEIL), Singapore Eye Research Institute, Singapore
| | - Victor Koh
- Department of Ophthalmology, National University Hospital, Singapore
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22
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Pinazo-Durán MD, Muñoz-Negrete FJ, Sanz-González SM, Benítez-Del-Castillo J, Giménez-Gómez R, Valero-Velló M, Zanón-Moreno V, García-Medina JJ. The role of neuroinflammation in the pathogenesis of glaucoma neurodegeneration. PROGRESS IN BRAIN RESEARCH 2020; 256:99-124. [PMID: 32958217 DOI: 10.1016/bs.pbr.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The chapter is a review enclosed in the volume "Glaucoma: A pancitopatia of the retina and beyond." No cure exists for glaucoma. Knowledge on the molecular and cellular alterations underlying glaucoma neurodegeneration (GL-ND) includes innovative and path-breaking research on neuroinflammation and neuroprotection. A series of events involving immune response (IR), oxidative stress and gene expression are occurring during the glaucoma course. Uveitic glaucoma (UG) is a prevalent acute/chronic complication, in the setting of chronic anterior chamber inflammation. Managing the disease requires a team approach to guarantee better results for eyes and vision. Advances in biomedicine/biotechnology are driving a tremendous revolution in ophthalmology and ophthalmic research. New diagnostic and imaging modalities, constantly refined, enable outstanding criteria for delimiting glaucomatous neurodegeneration. Moreover, biotherapies that may modulate or inhibit the IR must be considered among the first-line for glaucoma neuroprotection. This review offers the readers useful and practical information on the latest updates in this regard.
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Affiliation(s)
- Maria D Pinazo-Durán
- Ophthalmic Research Unit "Santiago Grisolía"/FISABIO and Cellular and Molecular Ophthalmo-biology Group of the University of Valencia, Valencia, Spain; Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain.
| | - Francisco J Muñoz-Negrete
- Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain; Ophthalmology Department at the University Hospital "Ramón y Cajal" (IRYCIS) and Surgery Department at the Faculty of Medicine, University Alcala de Henares, Madrid, Spain
| | - Silvia M Sanz-González
- Ophthalmic Research Unit "Santiago Grisolía"/FISABIO and Cellular and Molecular Ophthalmo-biology Group of the University of Valencia, Valencia, Spain; Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain
| | - Javier Benítez-Del-Castillo
- Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain; Department of Ophthalmology at the Hospital of Jerez, Jerez de la Frontera, Cádiz, Spain
| | - Rafael Giménez-Gómez
- Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain; Department of Ophthalmology at the University Hospital "Reina Sofia", Córdoba, Spain
| | - Mar Valero-Velló
- Ophthalmic Research Unit "Santiago Grisolía"/FISABIO and Cellular and Molecular Ophthalmo-biology Group of the University of Valencia, Valencia, Spain
| | - Vicente Zanón-Moreno
- Ophthalmic Research Unit "Santiago Grisolía"/FISABIO and Cellular and Molecular Ophthalmo-biology Group of the University of Valencia, Valencia, Spain; Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain; International University of Valencia, Valencia, Spain
| | - José J García-Medina
- Ophthalmic Research Unit "Santiago Grisolía"/FISABIO and Cellular and Molecular Ophthalmo-biology Group of the University of Valencia, Valencia, Spain; Researchers of the Spanish Net of Ophthalmic Research "OFTARED" of the Institute of Health Carlos III, Net RD16/0008/0022, Madrid, Spain; Department of Ophthalmology at the University Hospital "Morales Meseguer" and Department of Ophthalmology at the Faculty of Medicine, University of Murcia, Murcia, Spain
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Ragab IT, Abdelkader AME, Kishk HM, Elshal AA. Assessment of Post-Operative Pseudophakic Glaucoma by Ultrasound Biomicroscopy. Clin Ophthalmol 2020; 14:1495-1501. [PMID: 32581506 PMCID: PMC7276325 DOI: 10.2147/opth.s255626] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/19/2020] [Indexed: 12/25/2022] Open
Abstract
Purpose Pseudophakic glaucoma is a secondary glaucoma in which intra-ocular pressure is elevated following cataract removal. The current study aimed to evaluate the role of ultrasound biomicroscopy (UBM) in assessing post-operative pseudophakic glaucoma. Patients and Methods This is a case series, prospective, observational and analytical study. It included 29 eyes of 29 patients with post-operative pseudophakic glaucoma. The patients were evaluated by medical history, detailed ophthalmologic examination and UBM. Results UBM examination has unmasked different causes of pseudophakic glaucoma. The detected causes were classified into 3 main groups, including intraocular lens (IOL)-related causes, lens remnants and intra-ocular inflammation. Haptic-related causes were present in 9 eyes, while 6 eyes had decentered or tilted IOLs. Soemmering's ring was the main cause in 3 eyes while in one eye the cause was lens particle in the anterior chamber (AC). Silicone oil in AC with seclusio pupillae was the main cause in one eye. Peripheral anterior synechiae were detected in 8 eyes while, posterior synechiae were evident in 7 eyes. Uveitis induced by anterior chamber IOL (ACIOL) was found in 3 eyes and one eye had peripheral anterior synechiae due to neovascular glaucoma. Conclusion UBM is a helpful diagnostic tool to evaluate causes of pseudophakic glaucoma through adequate visualization of different angle structures.
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Affiliation(s)
- Islam Taher Ragab
- Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Hanem Mohammad Kishk
- Ophthalmology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Automatic Anterior Chamber Angle Measurement for Ultrasound Biomicroscopy Using Deep Learning. J Glaucoma 2020; 29:81-85. [PMID: 31790065 DOI: 10.1097/ijg.0000000000001411] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To develop a software package for automated measuring of the trabecular-iris angle (TIA) using ultrasound biomicroscopy. METHODS Ultrasound biomicroscopy images were collected and the TIA was manually measured by specialists. Different models were used as the convolutional neural network for the automatic TIA measurement. The root-mean-squared error, explained variance, and mean absolute percentage error were used to evaluate the performance of these models. The interobserver reproducibility, coefficient of variation, and intraclass correlation coefficient were calculated to evaluate the consistency between the manual measured and the model predicted values. RESULTS ResNet-18 had the best performance in root-mean-squared error, explained variance, and mean absolute percentage error among all 5 models. The average difference between the angles measured manually and by the model is -0.46±3.97 degrees for all eyes, -1.67±5.19 degrees for open angles, and 0.75±1.43 degrees for narrow angles. The coefficient of variation, intraclass correlation coefficient, and reproducibility of the total TIA measurements are 6.8%, 0.95, and 6.1 degrees for all angles; 6.4%, 0.99, and 7.7 degrees for open angles; and 8.8%, 0.93, and 4 degrees for narrow angles, respectively. CONCLUSIONS Preliminary results show that this fully automated anterior chamber angle measurement method can achieve high accuracy and have good consistency with the manual measurement results, this has great significance for future clinical practice.
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Henriquez MA, Mejías JA, Rincon M, Izquierdo L, Binder PS. Correlation between lens thickness and lens density in patients with mild to moderate cataracts. Br J Ophthalmol 2020; 104:1350-1357. [PMID: 31949096 DOI: 10.1136/bjophthalmol-2019-314171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 10/17/2019] [Accepted: 12/19/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE To determine the relationships between lens thickness (LT), lens density and anterior segment parameters in patients with mild to moderate cataracts. SETTING Oftalmosalud Instituto de Ojos, Lima, Perú. DESIGN Prospective, single-centre, cross-sectional study. METHODS 169 eyes with age-related mild to moderate cataracts had lens density assessed using the Lens Opacification Classification System III, the built-in Pentacam HR Nucleus Staging software and ImageJ software. LT and axial length (AL) were measured with the IOLMaster 700, and angle parameters were measured using anterior segment optical coherence tomography. Pearson correlation coefficients and Kruskal-Wallis tests were used for statistical analyses. RESULTS Nuclear colour score was the only clinical parameter with a weak significant correlation with LT (r=0.24, p=0.003) after accounting for age, AL, gender and anterior chamber depth (ACD). The maximum value of average lens density and the mean nuclear density were significantly correlated with LT (r=0.24, p=0.003 and -0.17, p=0.03, respectively) after controlling for the same factors. Central LT greater than 4.48 mm was present in 54.5% of the eyes with a nuclear opalescence grade 1. CONCLUSIONS LT is independent of lens density in mild to moderate cataracts after accounting for age, AL, ACD and gender contrary to previous studies.
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Affiliation(s)
| | | | - Mirel Rincon
- Research Department, Oftalmosalud Instituto de Ojos, Lima, Peru
| | - Luis Izquierdo
- Research Department, Oftalmosalud Instituto de Ojos, Lima, Peru
| | - Perry S Binder
- Department of Ophthalmology, Gavin Herbert Eye Institute, Irvine, California, USA
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Shi G, Jiang Z, Deng G, Liu G, Zong Y, Jiang C, Chen Q, Lu Y, Sun X. Automatic Classification of Anterior Chamber Angle Using Ultrasound Biomicroscopy and Deep Learning. Transl Vis Sci Technol 2019; 8:25. [PMID: 31448182 PMCID: PMC6703191 DOI: 10.1167/tvst.8.4.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/22/2019] [Indexed: 12/12/2022] Open
Abstract
Purpose To develop a software package for automated classification of anterior chamber angle of the eye by using ultrasound biomicroscopy. Methods Ultrasound biomicroscopy images were collected, and the trabecular-iris angle was manually measured and classified into three categories: open angle, narrow angle, and angle closure. Inception v3 was used as the classifying convolutional neural network and the algorithm was trained. Results With a recall rate of 97% in the test set, the neural network's classification accuracy can reach 97.2% and the overall area under the curve was 0.988. The sensitivity and specificity were 98.04% and 99.09% for the open angle, 96.30% and 98.13% for the narrow angle, and 98.21% and 99.05% for the angle closure categories, respectively. Conclusions Preliminary results show that an automated classification of the anterior chamber angle achieved satisfying sensitivity and specificity and could be helpful in clinical practice. Translational Relevance The present work suggests that the algorithm described here could be useful in the categorizing of anterior chamber angle and screening for subjects who are at high risk of angle closure.
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Affiliation(s)
- Guohua Shi
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu Province, China
| | - Zhenying Jiang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Guohua Deng
- Department of Ophthalmology, the Third People's Hospital of Changzhou, Changzhou, Jiangsu Province, China
| | - Guangxing Liu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu Province, China
| | - Yuan Zong
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Chunhui Jiang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Qian Chen
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xinhuai Sun
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College of Fudan University, Shanghai, China.,Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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Choi W, Lee MW, Kang HG, Lee HS, Bae HW, Kim CY, Seong GJ. Comparison of the trabecular meshwork length between open and closed angle with evaluation of the scleral spur location. Sci Rep 2019; 9:6857. [PMID: 31048724 PMCID: PMC6497692 DOI: 10.1038/s41598-019-43315-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
This study analysed the trabecular meshwork (TM) length in open and closed angle patients and presented a better method for locating the scleral spur using Schwalbe’s line method in anterior segment optical coherence tomography (AS-OCT). Patients who underwent AS-OCT at Yonsei University Gangnam Severance Hospital we enrolled; 58 and 57 open and closed angle eyes, respectively. We measured the distance from the scleral spur to Schwalbe’s line as the TM length and compared it between open and closed angle patients, and to previous studies. TM length was applied to locate the scleral spur using Schwalbe’s line method. Mean TM lengths were 811 ± 83 μm and 575 ± 96 μm in the open and closed angle groups, respectively (p < 0.001). Comparing the actual TM heights using Schwalbe’s line method with an updated reference distance significantly increased accuracy to locate the scleral spur (open: 811 μm, closed: 575 μm) when compared with the 1000 μm reference distance (p < 0.001). TM length was significantly different between open and closed angle patients. Further, the reference distance for Schwalbe’s line method should be distinguished according to open and closed angle eyes in order that the scleral spur can be located properly.
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Affiliation(s)
- Wungrak Choi
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Min Woo Lee
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung Won Bae
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Yun Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Gong Je Seong
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
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Characterization of deeply embedded corneal foreign bodies with anterior segment optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2019; 257:1247-1252. [PMID: 31001669 DOI: 10.1007/s00417-019-04309-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 03/08/2019] [Accepted: 03/21/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of the study was to describe findings demonstrated by anterior segment spectral domain optical coherence tomography (AS-OCT) in various types of deeply embedded corneal foreign bodies. METHODS In this experimental study, an ex vivo model of calf eyes was used and seven different foreign bodies were deeply embedded in the cornea, consisting of five different materials: glass, plastic, metal, wood, and pencil graphite. The eyes were photographed and then scanned by AS-OCT. The images were analyzed to determine distinguishing characteristics for each material. RESULTS Various materials presented unique characteristics in AS-OCT. The opaque materials (pencil graphite, metals, and wood) demonstrated a hyper-reflective anterior border, whereas the posterior border signal could not be clearly identified due to the shadowing effect. Moreover, a chain of signals was characteristic of both pencil graphite and metals though a "mirroring effect" was unique for metals. Wood, as an opaque material, appears as a hyper-reflective mass with a spectrum of penetrability depending on the degree of concentration. Transparent materials demonstrated hyper-reflective sharp borders when surrounded by air or fluid, as opposed to when being embedded purely in the corneal stroma. CONCLUSIONS This study shows that AS-OCT was used to systematically define a novel set of distinguishing characteristics specific to various materials extruding from the cornea, fully embedded in the cornea, and intruding into the anterior chamber. Hopefully, the described characteristics of each material can aid clinicians in diagnosing the type of the material embedded and the depth of its involvement in ocular injury.
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Avetisov SE, Petrov SY, Volzhanin AV. [Optical coherence tomography for examination of glaucoma surgery site]. Vestn Oftalmol 2018; 134:250-256. [PMID: 30499525 DOI: 10.17116/oftalma2018134051250] [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] [Indexed: 11/18/2022]
Abstract
The article reviews the results of using optical coherence tomography (OCT) - a non-invasive non-contact examination method for obtaining a tomographic slice image of the site of glaucoma surgery. The method helped reveal the functional relationships between the newly created outflow pathways and various parameters of the filtering bleb such as its linear dimensions, wall structure, presence of microcysts, position of drainage, etc. Due to its high resolution and noninvasiveness, OCT can be reliably used to examine the structure of aqueous outflow pathways in different postoperative periods with accuracy close to morphometric. The amount of data that had been obtained with the method has allowed the creation of new classifications and clarification of OCT-relevant prognostic signs for glaucoma surgery site.
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Affiliation(s)
- S E Avetisov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow Medical University, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991
| | - S Yu Petrov
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - A V Volzhanin
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
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30
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Le Q, Cordova D, Xu J, Deng SX. In Vivo Evaluation of the Limbus Using Anterior Segment Optical Coherence Tomography. Transl Vis Sci Technol 2018; 7:12. [PMID: 30112250 PMCID: PMC6082326 DOI: 10.1167/tvst.7.4.12] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/12/2018] [Indexed: 12/20/2022] Open
Abstract
Purposes To investigate the limbal structure using anterior segment optical coherence tomography (AS-OCT) and compare the difference between a Chinese Han population and a Caucasian population. Methods Sixty healthy Chinese Han subjects (109 eyes, Chinese group) and 32 healthy Caucasian subjects (51 eyes, Caucasian group) were included in this comparative cross-sectional study. The central cornea and the superior, inferior, nasal, and temporal limbal regions of each subject underwent Fourier-domain AS-OCT. The following parameters were measured: corneal epithelial thickness (CET), maximum limbal epithelial thickness (LET), the mean LET, the width of limbus, distance between scleral spur and the location where limbal epithelium was the thickest (S-T), and limbal epithelial area between scleral spur and the end of Bowman's layer (LEA). Results CET was similar in both groups (P = 0.577). The width of limbus was more than 32.8% greater in all limbal quadrants in the Caucasian group (range, 1.25–2.20 mm) than in the Chinese group (range, 0.81–1.40 mm). S-T and LEA were also significantly higher in all limbal quadrants in the Caucasian group (all P < 0.001). The maximum LET and mean LET were 7.8% and 6.9% thicker at the nasal limbus and 8.1% and 8.7% thicker in the temporal limbus in Caucasian subjects than in Chinese subjects. Conclusions The limbal structures can be visualized using AS-OCT and differ significantly between the Caucasian and Chinese eyes. Translational Relevance Research of the limbus and surgeons performing procedures involving the limbal area should take into consideration of the anatomic differences especially when limbus is used as an anatomic reference.
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Affiliation(s)
- Qihua Le
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Daniel Cordova
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jianjiang Xu
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Sophie X Deng
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Razeghinejad MR, Myers JS. Contemporary approach to the diagnosis and management of primary angle-closure disease. Surv Ophthalmol 2018; 63:754-768. [PMID: 29777727 DOI: 10.1016/j.survophthal.2018.05.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 04/19/2018] [Accepted: 05/07/2018] [Indexed: 12/19/2022]
Abstract
The primary angle-closure disease spectrum varies from a narrow angle to advanced glaucoma. A variety of imaging technologies may assist the clinician in determining the pathophysiology and diagnosis of primary angle closure, but gonioscopy remains a mainstay of clinical evaluation. Laser iridotomy effectively eliminates the pupillary block component of angle closure; however, studies show that, in many patients, the iridocorneal angle remains narrow from underlying anatomic issues, and increasing lens size often leads to further narrowing over time. Recent studies have further characterized the role of the lens in angle-closure disease, and cataract or clear lens extraction is increasingly used earlier in its management. As a first surgical step in angle-closure glaucoma, lens extraction alone often effectively controls the pressure with less risk of complications than concurrent or stand-alone glaucoma surgery, but may not be sufficient in more advanced or severe disease. We provide a comprehensive review on the primary angle-closure disease nomenclature, imaging, and current laser and surgical management.
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Affiliation(s)
- M Reza Razeghinejad
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA; Poostchi Ophthalmology Research Center, Shiraz University of Medcial Sciences, Shiraz, Iran.
| | - Jonathan S Myers
- Glaucoma Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
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Associated factors of acute primary angle closure glaucoma in a sub-group of Chinese people: comparison between attack eyes and normal controls. Sci Rep 2017; 7:14885. [PMID: 29097742 PMCID: PMC5668270 DOI: 10.1038/s41598-017-14685-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/10/2017] [Indexed: 01/18/2023] Open
Abstract
Acute primary angle closure glaucoma (APACG) is an ophthalmic emergency that may lead to irreversible blindness. Although efforts were made to control intraocular pressure, disease progression still existed. Anterior segment optical coherence tomography (AS OCT) may provide a new insight into mechanism of APACG. In order to seek out associated factors by AS OCT, We compared anterior segment parameters between 74 APACG and 48 normal eyes. Analysis of variance, principle component analysis and logistic regression were used. APACG group had more women (75.7% vs 47.9%, p = 0.002), smaller anterior chamber (anterior chamber depth, ACD; anterior chamber area, ACA; all p = 0.001), narrower angle (AOD500, AOD750, angle opening distance at 500um and 750um; TISA500, TISA750, trabecular-iris space area at 500um and 750um; ARA500, ARA750, angle recess area at 500um and 750um; all p < 0.001), thinner iris (iris thickness at 750um, IT750; maximum of iris thickness, ITMAX; all p < 0.001), larger iris area (IA, p < 0.001) and lens vault (LV, p = 0.005). Principle component extracted were AOD500, AOD750, TISA500, TISA750, ARA500, ARA750, IA, PD (pupillary diameter), ACD, ACA and IT750. After adjusting for confounding factors, AOD750 (b = 12.40 ± 2.56, p < 0.001), IT750 (b = 10.50 ± 3.45, p = 0.002) and IA (b = −1.56 ± 0.77, p = 0.044) were significantly associated with occurrence of APACG.
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Effect of Lateral Decubitus Body Posture on Anterior Chamber Angle in Healthy Subjects: An Anterior Segment Optical Coherence Tomography Study. J Glaucoma 2017; 26:608-612. [PMID: 28369003 DOI: 10.1097/ijg.0000000000000678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the effect of the lateral decubitus (LD) position on the anterior chamber (AC) angle in healthy subjects. MATERIALS AND METHODS Twenty-three healthy young subjects were included in this prospective observational study. We measured AC angle parameters in the sitting and the left LD positions using anterior segment optical coherence tomography (Visante OCT): trabecular-iris angle (TIA), angle opening distance (AOD500), trabecular-iris space area (TISA500), anterior chamber width, lens vault, and anterior chamber depth. The Wilcoxon signed-rank test was used to compare the parameters between different body positions. Interobserver reproducibility of AC angle measurements was assessed by intraclass correlation coefficients. RESULTS Postural alterations from sitting to the left LD position significantly reduced the AC angle on the temporal side in right eyes (TIA: 39.53±2.38 to 38.31±3.47 degrees; AOD500: 0.72±0.13 to 0.65±0.08; TISA500: 0.25±0.06 to 0.22±0.04; all P<0.05), whereas no significant changes were noted on the nasal side. Contrastingly, a significant decrease in the AC angle on the nasal side was noted for left eyes (TIA: 39.49±2.24 to 38.17±2.76 degrees; AOD500: 0.68±0.09 to 0.64±0.10; TISA500: 0.23±0.04 to 0.21±0.03; all P<0.05). Anterior chamber width and anterior chamber depth were unaffected by postural alterations, but lens vault significantly was reduced following a shift to the left LD position. CONCLUSIONS The AC angle parameters on the nondependent side of the eye in the LD position were significantly reduced compared with those in the sitting position. Therefore, postural shift from sitting to the LD position may induce alterations in the AC angle.
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Dong ZM, Wollstein G, Schuman JS. Clinical Utility of Optical Coherence Tomography in Glaucoma. Invest Ophthalmol Vis Sci 2017; 57:OCT556-67. [PMID: 27537415 PMCID: PMC4991023 DOI: 10.1167/iovs.16-19933] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Optical coherence tomography (OCT) has established itself as the dominant imaging modality in the management of glaucoma and retinal diseases, providing high-resolution visualization of ocular microstructures and objective quantification of tissue thickness and change. This article reviews the history of OCT imaging with a specific focus on glaucoma. We examine the clinical utility of OCT with respect to diagnosis and progression monitoring, with additional emphasis on advances in OCT technology that continue to facilitate glaucoma research and inform clinical management strategies.
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Affiliation(s)
- Zachary M Dong
- University of Pittsburgh Medical Center (UPMC) Eye Center Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States
| | - Gadi Wollstein
- University of Pittsburgh Medical Center (UPMC) Eye Center Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States 2Departmen
| | - Joel S Schuman
- University of Pittsburgh Medical Center (UPMC) Eye Center Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Ophthalmology and Visual Science Research Center, Pittsburgh, Pennsylvania, United States 2Departmen
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Diagnostic Imaging of the Anterior Segment in Glaucoma: An Update. Int Ophthalmol Clin 2017; 57:125-136. [PMID: 28590286 DOI: 10.1097/iio.0000000000000173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lin J, Wang Z, Chung C, Xu J, Dai M, Huang J. Dynamic changes of anterior segment in patients with different stages of primary angle-closure in both eyes and normal subjects. PLoS One 2017; 12:e0177769. [PMID: 28542344 PMCID: PMC5436810 DOI: 10.1371/journal.pone.0177769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 05/03/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare changes in anterior segment parameters under light and dark (light-to-dark) conditions among eyes with chronic primary angle-closure glaucoma (CPACG), fellow eyes with confirmed or suspect primary angle-closure (PAC or PACS), and age-matched healthy eyes. Methods Consecutive patients with CPACG in one eye and PAC/PACS in the fellow eye, as well as age-matched healthy subjects were recruited. Anterior segment optical coherence tomography measurements were conducted under light and dark conditions, and anterior chamber, lens, and iris parameters compared. Demographic and biometric factors associated with light-to-dark change in iris area were analyzed by linear regression. Results Fifty-seven patients (mean age 59.6±8.9 years) and 30 normal subjects matched for age (60.6±9.3 years) and sex ratio were recruited. In regards to differences under light–to-dark conditions, angle opening distance at 500 μm (AOD500μm) and iris area during light-to-dark transition were smaller in CPACG eyes than fellow PACS/PAC eyes and normal eyes (P<0.017). Pupil diameter change was largest in normal eyes, and larger in PACS/PAC eyes than CPACG eyes (P<0.017). There was an average reduction of 0.145 mm2 in iris area for each millimeter of pupil diameter increase in CPACG eyes, 0.161 mm2 in fellow PAC/PACS eyes, and 0.165 mm2 in normal eyes. Larger iris curvature in the dark and diagnosis of PACG were significantly associated with less light-to-dark iris area changes. Conclusions Dynamic changes in iris parameters with light-to-dark transition differed significantly among CPACG eyes, fellow PAC/PACS eyes, and normal eyes. Greater iris curvature under dark conditions was correlated with reduced light-to-dark change in iris area and pupil diameter, which may contribute to disease progression.
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Affiliation(s)
- Jialiu Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhonghao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chuchen Chung
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jianan Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Miaomiao Dai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jingjing Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- * E-mail:
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Mannino G, Abdolrahimzadeh B, Calafiore S, Anselmi G, Mannino C, Lambiase A. A review of the role of ultrasound biomicroscopy in glaucoma associated with rare diseases of the anterior segment. Clin Ophthalmol 2016; 10:1453-9. [PMID: 27536058 PMCID: PMC4975163 DOI: 10.2147/opth.s112166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Ultrasound biomicroscopy is a non-invasive imaging technique, which allows high-resolution evaluation of the anatomical features of the anterior segment of the eye regardless of optical media transparency. This technique provides diagnostically significant information in vivo for the cornea, anterior chamber, chamber angle, iris, posterior chamber, zonules, ciliary body, and lens, and is of great value in assessment of the mechanisms of glaucoma onset. The purpose of this paper is to review the use of ultrasound biomicroscopy in the diagnosis and management of rare diseases of the anterior segment such as mesodermal dysgenesis of the neural crest, iridocorneal endothelial syndrome, phakomatoses, and metabolic disorders.
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Affiliation(s)
- Giuseppe Mannino
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | | | - Silvia Calafiore
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | - Gianmario Anselmi
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | - Cristina Mannino
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | - Alessandro Lambiase
- Department of Sense Organs, Ophthalmology Unit, University of Rome "Sapienza", Rome, Italy
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Choy BNK, Chan JCH, Chien CPY, Lai JSM. Recurrent acute angle-closure attack due to plateau iris syndrome after cataract extraction with or without argon laser peripheral iridoplasty: a case report. BMC Ophthalmol 2016; 16:64. [PMID: 27230214 PMCID: PMC4880974 DOI: 10.1186/s12886-016-0244-y] [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: 10/05/2015] [Accepted: 05/19/2016] [Indexed: 11/21/2022] Open
Abstract
Background We describe two cases of recurrent acute angle-closure attack in patients with plateau iris syndrome after cataract extraction. Argon laser peripheral iridoplasty and cataract extraction have been used to reduce the occurrence of acute angle-closure attack in plateau iris syndrome although the risk cannot be completely eliminated. There is no consensus on the long term management of plateau iris syndrome. This is, as far as we know, the first case report of recurrent acute angle-closure attack in plateau iris syndrome after cataract extraction. Case presentation We report two cases of recurrent acute angle-closure attack in 2 Chinese patients with plateau iris syndrome. The first patient was a 69 year-old woman who received bilateral argon laser peripheral iridoplasty and cataract extraction 2 years prior to the latest acute angle-closure with right eye intraocular pressure 48 mmHg. The attack was aborted medically. Peripheral iridotomy was patent and argon laser peripheral iridoplasty marks were mostly at peripheral 2/3 of the iris. Anterior segment optical coherence tomography confirmed bilateral plateau iris configuration. Use of long term pilocarpine or repeated argon laser peripheral iridoplasty to prevent recurrent angle-closure attack was discussed but she opted for observation. The second patient was a 64 year-old man presented with acute angle-closure after cataract extraction despite placement of laser peripheral iridotomy. Plateau iris syndrome was confirmed by anterior segment optical coherence tomography and he received argon laser peripheral iridoplasty. Conclusions Acute angle-closure due to plateau iris syndrome can still occur despite previous cataract extraction and argon laser peripheral iridoplasty. These are the first reported cases of recurrent acute angle-closure attack due to plateau iris syndrome following cataract extraction, with or without previous argon laser peripheral iridoplasty. Repeated treatment with argon laser peripheral iridoplasty or pilocarpine could be considered although the long term efficacy is questionable. Argon laser peripheral iridoplasty should be applied as peripheral as possible so as to open up the drainage angle effectively.
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Affiliation(s)
- Bonnie Nga Kwan Choy
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Room 301, Block B, Cyberport 4, Hong Kong, People's Republic of China.
| | - Jonathan Cheuk Hung Chan
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Room 301, Block B, Cyberport 4, Hong Kong, People's Republic of China
| | - Carol Pui Yang Chien
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong, People's Republic of China
| | - Jimmy Shiu Ming Lai
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Room 301, Block B, Cyberport 4, Hong Kong, People's Republic of China
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Rivero V. Use of optical coherence tomography and ultrasound biomicroscopy in the diagnosis of iridociliary cysts. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2016; 91:300. [PMID: 27021799 DOI: 10.1016/j.oftal.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Affiliation(s)
- V Rivero
- Clínica Oftalmológica Suárez-Leoz, Madrid, España.
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