Gonioscopy

Glaucoma ◽  
2012 ◽  
Author(s):  
Morales Jose
Keyword(s):  
Anterior Chamber ◽  
False Negative ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Anterior Chamber Angle ◽  
Negative Results ◽  
Laser Trabeculoplasty ◽  
Chamber Angle

Gonioscopy allows visualization of the anterior chamber angle using special lenses. The anterior chamber angle cannot be visualized by direct observation because of its position in the angle recess and the phenomenon of total internal reflection of the light caused by the cornea. Goniolenses with appropriate optical properties and mirrors or prisms allow adequate visualization of its structures through a “periscope effect” and provide a more favourable reflection angle. Clinical circumstances where gonioscopy is essential or helpful in the diagnosis and management of glaucoma are as follows: • To diagnose primary angle closure and to assess the results of medical, laser, or surgical treatment on angle configuration • The Van Herick method of estimating the peripheral anterior chamber depth with the slit lamp gives a useful but rough estimate and does not replace gonioscopy. It can give false-negative results in patients with plateau iris configuration and false-positive results in patients with moderate anterior chamber depth but an open angle. • To assess the risk of angle closure in patients with shallow anterior chambers before undergoing pupillary dilation • To diagnose and follow treatment of acute angle-closure glaucoma attacks To establish the diagnosis of secondary angle-closure glaucoma • To determine precise anatomic landmarks for accurate laser application during trabeculoplasty • For the evaluation and follow-up of congenital or acquired abnormalities of the anterior chamber angle • To detect and evaluate mass lesions that affect the anterior chamber angle • To evaluate the anatomic angle changes and patency of the ostium after trabeculectomy • To visualize the angle during “angle surgery” • Such as goniotomy, trabectome surgery,or trabecular micro-bypass stent •During laser trabeculoplasty and after laser iridoplasty Three goniolens prototypes have been most used in the past and represent the precursors of newer lenses Their main features are displayed on Table 2.1. Explain the procedure to the patient and its purpose. Reassure him or her that with the use of topical anesthetic the test will not be painful, and request cooperation in terms of avoiding lid squeezing and excessive eye movement during the exam.

scholarly journals Effect of Phacoemulsification on Anterior Chamber Angle in Eyes with Medically Uncontrolled Filtered Primary Angle-Closure Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Chengguo Zuo ◽  
Bing Long ◽  
Xinxing Guo ◽  
Liming Chen ◽  
Xing Liu
Keyword(s):  
Anterior Chamber ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Anterior Chamber Angle ◽  
Iol Implantation ◽  
Anatomical Changes ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Mean ◽  
Chamber Angle

Purpose. To evaluate the effect of phacoemulsification and intraocular lens (IOLs) implantation in eyes with medically uncontrolled primary angle-closure glaucoma (PACG) previously treated with trabeculectomy and to quantify the anatomical changes in the anterior chamber angle by ultrasound biomicroscopy (UBM). Methods. Forty-four eyes of 37 consecutive patients with medically uncontrolled PACG coexisting cataracts with a surgical history of trabeculectomy were included in this study. Each patient underwent phacoemulsification and IOL implantation. Indentation gonioscopy and UBM were performed preoperatively and then again 3 months after surgery. The main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications and anatomical changes in the anterior chamber angle. Results. The mean logarithm of the minimum angle of resolution BCVA significantly improved from 0.52 ± 0.30 preoperatively to 0.26 ± 0.23 postoperatively (p<0.001). The mean IOP significantly decreased from 24.33 ± 9.65 mmHg preoperatively to 18.04 ± 7.86 mmHg postoperatively (p<0.05). 001). The median number of antiglaucoma medications decreased from 2 preoperatively to 1 postoperatively (p<0.001). There was no significant difference in the extent of peripheral anterior synechia after the surgery (p>0.05). Some parameters, including anterior central chamber depth, angle opening distance at 500 μm, trabecular-iris angle, and scleral ciliary process angle, were significantly higher after than before surgery (p<0.001). However, the crystalline lens rise was significantly smaller following the surgery (p<0.001). Conclusions. Phacoemulsification and IOL implantation reduced the IOP and improved vision in eyes with medically uncontrolled filtered PACG. The mechanism underlying the outcomes observed following surgery might be related to the anterior chamber deepening, widened drainage angle, and improved aqueous fluid flow to the trabecular meshwork.

Evaluation of anterior chamber angle under dark and light conditions in angle closure glaucoma: An anterior segment OCT study

2014 ◽  
Vol 37 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Habibeh Masoodi ◽  
Ebrahim Jafarzadehpur ◽  
Alireza Esmaeili ◽  
Fereshteh Abolbashari ◽  
Seyed Mahdi Ahmadi Hosseini
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Light Conditions ◽  
Anterior Chamber Angle ◽  
Anterior Segment Oct ◽  
Chamber Angle

scholarly journals Anterior chamber angle imaging with swept-source optical coherence tomography: comparison between CASIAII and ANTERION

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Poemen Pui-man Chan ◽  
Gilda Lai ◽  
Vivian Chiu ◽  
Anita Chong ◽  
Marco Yu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Optical Coherence ◽  
Anterior Chamber Angle ◽  
Swept Source ◽  
Scan Pattern ◽  
Chamber Angle

Abstract This study compared the test–retest variabilities and measurement agreement of anterior chamber angle (ACA) dimensions measured by two anterior segment swept-source optical coherence tomography (SS-OCT)—the ANTERION (Heidelberg Engineering, Heidelberg, Germany) and CASIAII (Tomey, Nagoya, Japan). Thirty-eight subjects, 18 patients with primary angle closure and 20 healthy participants with open angles, were included. The mean age was 54.7 ± 15.8 years (range: 26–75 years). One eye of each subject was randomly selected for anterior segment imaging by ANTERION and CASIAII, using the same scan pattern (6 evenly spaced radial scans across the anterior segment for three times) in the same visit. The between- and within-instrument agreement and repeatability coefficients of angle open distance (AOD500), trabecular-iris space area (TISA500), lens vault (LV), scleral spur-scleral spur distance (SSD), anterior chamber depth (ACD), and pupil diameter (PD) were measured. The anterior and posterior boundaries of the cornea, iris, and lens were automatically segmented by the SS-OCT instruments; the scleral spur was manually located by a single masked observer. There were significant differences between ANTERION and CASIAII measurements; the SSD, PD, and ACD were smaller whereas AOD500 and TISA500 were greater in ANTERION compared with CASIAII (P < 0.001). Anterior segment measurements obtained from the two SS-OCT instruments showed strong associations (R2 ranged between 0.866 and 0.998) although the between-instrument agreement was poor; the spans of 95% limits of between-instrument agreement were ≥ 1.5-folds than the within-instrument agreement for either instrument. Whereas both SS-OCT instruments showed low test–retest measurement variabilities, the repeatability coefficients of AOD500, TISA500, ACD, and PD were slightly smaller for CASIAII than ANTERION (P ≤ 0.012).

scholarly journals Evaluation of the Anterior Chamber Angle in Angle-Closure Suspect Patients by Anterior Segment Optical Coherence Tomography (AS-OCT) and Pentacam

2021 ◽  
Author(s):  
Mohamed Salah El-Din Mahmoud ◽  
Nosiba Essam ◽  
Layla Mohamed Hammouda ◽  
Ahmed Shawkat Mohamed
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Chamber ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Angle Closure ◽  
P Value ◽  
Optical Coherence ◽  
Anterior Chamber Angle ◽  
Cross Sectional ◽  
Chamber Angle

Abstract Purpose: The study aims is to detect primary angle-closure glaucoma (PACG) suspects using both anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging. Methods: A prospective cross-sectional observational study on forty PACG suspect patients with a range of ages from 20 to 70 years. Angle imaging by AS-OCT (Optovue Inc., Fairmont, CA) with study parameters in the superior, inferior, nasal, and temporal quadrants were anterior chamber angle (ACA), angle opening distance at 750 µm (AOD750), and trabecular-iris space area at 750 μm (TISA). Also, angle imaging using Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) with study parameters were the anterior chamber angle (ACA), anterior chamber depth (ACD) and, anterior chamber volume (ACV). The angle evaluation was done before and after the mydriatic test.Results: As regarding AS-OCT, after the mydriatic test, we noticed a decrease in all parameters measured, some decreased significantly while others did not. A significant decrease was noticed in ACA (TIA750) in all quadrants (P value<0.001in nasal, 0.001in superior &temporal, 0.003 in inferior) and in TISA750 in the nasal quadrant only (P-value 0.004). AOD750 and TISA750 in the remaining quadrants also decreased but not significantly as ACA. As regarding Pentacam, all parameters decreased after the mydriatic test. ACA (P-value <0.001) and ACD (P-value 0.004) showed significant statistical decrease but ACV showed statistically non-significant decrease (P-value 0.558).Conclusions: AS-OCT and Pentacam are reliable investigations for the detection of PACG suspects which needs more close follow-up for a possible increase in IOP.

scholarly journals Evaluation of Anterior Chamber Depth and Anterior Chamber Angle Changing After Phacoemulsification in the Primary Angle Close Suspect Eyes

2019 ◽  
Vol 7 (24) ◽  
pp. 4297-4300
Author(s):  
Anh Tuan Vu ◽  
Van Anh Bui ◽  
Hai Long Vu ◽  
Do Quyet ◽  
Than Van Thai ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Intraocular Lens ◽  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Control Group ◽  
Anterior Chamber Angle ◽  
Interventional Study ◽  
Primary Angle Closure ◽  
Shallow Anterior Chamber ◽  
Chamber Angle

BACKGROUND: Phacoemulsification surgery has the ability to deeply alter the segment anterior morphology, especially in eye with shallow anterior chamber (AC), narrow anterior chamber angle (ACA). However, the changes of anterior chamber depth (ACD) and ACA on the close angle suspect eyes after phacoemulsification have not been mentioned in many studies. So, we conduct this research. AIM: To evaluate the alteration in the ACA and ACD after phacoemulsification in the close angle suspect eyes. METHODS: Interventional study with no control group. Subjects were the primary angle closure suspect (PACS) eyes, that were operated by phacoemulsification with intraocular lens (IOL) at Glaucoma Department of VNIO from December 2017 to October 2018. RESULTS: 29 PACS eyes with cataract were operated by phacoemulsification with intraocular lens. After 3 months of monitoring, the average ACD augmented from 2.082 ± 0.244 to 3.673 ± 0.222 mm. AOD500 increase from 0.183 ± 0.088 to 0.388 ± 0.132 μm, AOD750 increased from 0.278 ± 0.105 to 0.576 ± 0.149 μm. The TISA500 enlarged from 0.068 ± 0.033 to 0.140 ± 0.052 mm2, TISA750 enlarged from 0.125 ± 0.052 to 0.256 ± 0.089 mm2 at the third month (p < 0.01). CONCLUSION: Phacoemulsification surgery increases the ACD and enlarged the angle in the PACS eyes.

REVIEW CLINICAL CHARACTERISTICS AND TREATMENT OUTCOME OF PRIMARY ANGLE CLOSURE GLAUCOMA BY USED ND: YAG LASER PERIPHERAL IRIDOTOMY

2012 ◽  
pp. 18-24
Author(s):  
Huu Quoc Nguyen Nguyen ◽  
Nam Trung Nguyen
Keyword(s):  
Anterior Chamber ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Anterior Chamber Angle ◽  
Yag Laser ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Low Levels ◽  
Angle Width ◽  
Chamber Angle

Objectives: To review the clinical characteristics of primary angle closure glaucoma and the outcome of Nd: YAG laser peripheral iridoctom. Materials and Methods: Prospective study of 46 eyes underwent iridotomy, evaluation of the intraocular pressure and the anterior chamber angle within 2 weeks, 1 month, 3 months & 6 months after treatment. Results: The majority of subjects were females 73.33%, over 60 years of age (80%), blurred vision and decrease visual acuity when the patient were hospitalized (43.48%), 19.65% eye pain, physical symptoms are mainly shallow anterior chamber or pupillary reflexes relaxing lazy. Embryonic glaucoma and chronic angle glaucoma distribution percentage 69.57%. Mean IOP after 2 weeks X = 18.17 ± 1.37 mmHg, 7.66 mmHg lower than before treatment. Anterior chamber angle width increased significantly after 2 weeks of treatment. And no significant changer after 1 month, 3 months & 6 months. There was a precise inverse relation between anterior chamber angle width before treatment with low levels of IOP after treatment, and there was a precise proportional relation between the low levels of IOP with the increase of chamber angle width after treatment. Conclusion: Nd: YAG laser iridotomy is effective in widening the anterior chamber angle and lowering intraocular pressure in primary angle closure glaucoma.

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