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Abstract #50476 Published in IGR 14-2
Anterior Segment Changes After Pilocarpine and Laser Iridotomy for Primary Angle-Closure Suspects With Scheimpflug Photography
Talajic JC; Lesk MR; Nantel-Battista M; Harasymowycz PJJournal of Glaucoma 2013; 22: 776-779
PURPOSE: To assess changes in Scheimpflug-based measurements of the anterior segment after pilocarpine administration and prophylactic laser peripheral iridotomy (LPI) in narrow anterior chamber angles (ACAs). METHODS: Thirty-seven eyes in 37 patients with occludable angles were included in this prospective interventional case series. Primary angle-closure suspects (iridotrabecular contact in 3 quadrants or more) were enrolled. Patient evaluation included indentation gonioscopy, Goldmann tonometry, and optic nerve examination. The mean of 3 consecutive Pentacam measurements was taken at baseline, 45 minutes after 2% pilocarpine administration, and 1 month after LPI. ACA, anterior chamber volume (ACV), anterior chamber depth (ACD), pupil diameter, central corneal thickness, and intraocular pressure were measured. RESULTS: ACV increased significantly after LPI (94.6 mm±3.6 SEM to 108.8 mm±3.4 SEM, P<0.001), as did the ACA (26.7±0.9 to 28.2 degrees±0.8, P<0.001). Central corneal thickness showed significant thinning after LPI (558.1 μm±5.3 to 552.6±5.7 μm, P=0.018). Central ACD increased slightly after LPI, but this was not statistically significant (2.13 mm±0.05 to 2.15 mm±0.05, P=0.109). Pupil diameter and intraocular pressure also did not change significantly after LPI. After pilocarpine, the ACV decreased significantly (by 4.3±1.3 4 mm, P=0.009), as did the central ACD by (0.1 ±0.02 mm, P<0.001) and the pupil diameter (0.74±0.06 mm, P<0.001). CONCLUSIONS: Scheimpflug photography demonstrates significant anterior segment changes after pilocarpine and after LPI in primary angle-closure suspects.
*Resident in Ophthalmology, University of Montreal ‡Resident in Dermatology, University of Montreal †Department of Ophthalmology, Michel-Mathieu Institute of Excellence in Ophthalmology and Guy-Bernier Research Center, Maisonneuve-Rosemont Hospital, University of Montreal §Montreal Glaucoma Institute, Montreal, QC, Canada.
Full articleClassification:
9.3.4 Primary angle closure suspect (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
11.2 Cholinergic drugs (Part of: 11 Medical treatment)
12.2 Laser iridotomy (Part of: 12 Surgical treatment)
6.8.1 Anterior segment (Part of: 6 Clinical examination methods > 6.8 Photography)
