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Abstract #22687 Published in IGR 11-1
Ultrasound biomicroscopic features associated with angle closure in fellow eyes of acute primary angle closure after laser iridotomy
Yao BQ; Wu LL; Zhang C; Wang XOphthalmology 2009; 116: 444-448
PURPOSE: To investigate the frequency of appositional angle closure and related anatomic characteristics in fellow eyes of Chinese subjects with acute primary angle closure (APAC) after laser peripheral iridotomy (LPI). DESIGN: Cross-sectional study. PARTICIPANTS: Consecutive subjects with APAC presenting from April 2006 to September 2006 at the Glaucoma Service of Peking University Eye Center, Peking University Third Hospital. METHODS: Under dark conditions, fellow eyes were divided into 2 groups based on the detection of appositional angle closure by ultrasound biomicroscopy (UBM). For all subjects, UBM parameters were measured to evaluate the different anatomic features between the 2 groups. Darkroom provocative tests (DRPTs) and gonioscopy were performed to investigate the relationship between angle closure and intraocular pressure. MAIN OUTCOME MEASURES: Central anterior chamber depth (ACD); angle opening distance500 (AOD500); angle recess area500 (ARA500); trabecular-iris angle (T-I angle); trabecular-ciliary process distance (TCPD); peripheral iris thickness (IT1); iris-zonule distance (IZD); and the position of the iris insertion. RESULTS: Thirty-four post-LPI fellow eyes of 34 patients with APAC (8 men, 26 women; mean ± standard deviation age 66.3±7.2 years, range 54-83) were included. Peripheral anterior synechiae (PAS) were not observed in any subject. Appositional angle closure was observed in at least 1 quadrant in 13 (38.2%) of the 34 patients. Compared with eyes without appositional closure, eyes with appositional closure showed significantly lower AOD500, ARA500, and T-I angle in 4 quadrants; shorter TCPD in the inferior and temporal quadrants; and thicker IT1 in the superior and nasal quadrants (P<0.05). The DRPT results were positive in 3 (11.1%) of 27 eyes with appositional closure in 0 to 2 quadrants and in 3 (75.0%) of 4 eyes with appositional closure in 3 to 4 quadrants (P = 0.0164). CONCLUSIONS: Under dark conditions, more than one third of fellow eyes of APAC showed appositional angle closure after LPI. The anatomic findings indicate a narrower angle, a more anterior position of the ciliary body, and a thicker peripheral iris in fellow eyes of APAC after LPI may be associated with an increased risk for progressive angle closure.
Dr. B.Q. Yao, Peking University Third Hospital, Peking University Eye Center, Beijing, PR China; Tianjin Medical University General Hospital, Department of Ophthalmology, Tianjin, PR China
Classification:
6.12 Ultrasonography and ultrasound biomicroscopy (Part of: 6 Clinical examination methods)
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
12.2 Laser iridotomy (Part of: 12 Surgical treatment)