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Abstract #50392 Published in IGR 14-2
Quantitative evaluation of anterior chamber parameters using anterior segment optical coherence tomography in primary angle closure mechanisms
Shabana N; Aquino MC; See J; Ce Z; Tan AM; Nolan WP; Hitchings R; Young SM; Loon SC; Chew PTClinical and Experimental Ophthalmology 2012; 40: 792-801
BACKGROUND: To evaluate different mechanisms of primary angle closure (PAC) and to quantify anterior chamber (AC) parameters in these mechanisms using anterior segment optical coherence tomography (AS-OCT) in an Asian population. DESIGN: Hospital based cross sectional observational study. PARTICIPANTS: Forty-eight consecutive patients with PAC and PAC glaucoma. METHODS: Patients underwent complete ophthalmic examination and imaging of nasal-temporal angles with AS-OCT. Images were categorized into 4 PAC mechanisms: pupil block (PB), plateau (PL) iris configuration, Thick peripheral iris roll (PIR) and exaggerated lens vault (LV). Parameters computed: AC depth central (ACD(C) ), ACD(1000) and ACD(2000) (ACD at 1000µm and 2000µm anterior to scleral spur respectively), LV, AC area, angle opening distance (AOD), trabecular iris space area and iris thickness (IT). MAIN OUTCOME MEASURE: Anterior chamber parameters and primary angle closure mechanisms. RESULTS: Mean values of (ACD(C) ) (p<0.001), (ACD(2000) ) (p<0.001), (ACD(1000) ) (p<0.001), LV (p<0.001), AC area (p<0.001), AOD (p<0.001) and IT (p<0.001) were significantly different among the four groups. Multivariate analysis showed (ACD(C) ), (ACD(2000) ) and AC area were higher in PL iris and Thick PIR and lower in exaggerated LV (p<0.001) as compared to eyes with PB mechanism. LV was greater in exaggerated LV (p<0.001) and lesser in PL iris and Thick PIR as compared to eyes with PB mechanism. CONCLUSION: Quantitative AC parameters showed significant differences in four PAC mechanisms. ACD(C) , LV and AC area could be used to separate the 4 groups and AS-OCT may be used for evaluation of underlying PAC mechanism(s) in a patient and tailor the treatment accordingly. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.
Department of Ophthalmology, National University Health System, Singapore Moorfields eye hospital, London, United Kingdom.
Full articleClassification:
6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
