Water-drinking test in primary angle-closure suspect before and after laser peripheral iridotomy

Purpose: To compare the water-drinking test (WDT) and pharmacologic mydriasis as provocative tests in patients with primary angle closure suspect (PACS). Methods: This observational non-randomized comparative study evaluated changes in intraocular pressure (IOP) in 21 patients with PACS who underwent pharmacologic mydriasis and compared it with IOP changes in 26 patients given the WDT. Ocular biometric and anterior chamber parameters were also assessed. Tests were repeated on the same patient two weeks after performing laser peripheral iridotomy (LPI). Results: The mean age ± standard deviation was 60 ± 7 and 57 ± 9 years in the mydriasis and WDT groups, respectively (P = 0.201). Before LPI, both provocative tests were associated with a significant increase in IOP (mydriasis: 15.1 ± 3.1 to 16.6 ± 3.5 mmHg, P = 0.025; WDT: 16.2 ± 2.8 to 18.5 ± 3.3 mmHg, P < 0.001). However, the IOP changes were not statistically different between groups (P = 0.102). After LPI, only the WDT group showed a continued significant IOP elevation after the test (mydriasis: 16.4 ± 3.3 to 16.7 ± 3.5 mmHg, P = 0.569; WDT: 14.9 ± 3.0 to 17.8 ± 4.1 mmHg, P < 0.001). The post-test IOP change was significantly greater in the WDT than in the mydriasis group (3.0 versus 0.3 mmHg, respectively; P = 0.002). Step-wise multiple regression analysis verified the type of provocative test as the only independent factor affecting the post-test IOP change after LPI (regression coefficient: 2.664; P = 0.002). Conclusion: Pharmacologic mydriasis and the WDT had similar IOP elevation before LPI, but after LPI, IOP elevation was much greater in the WDT group.

Download Full-text

Evaluation of Choroidal Thickness, Intraocular Pressure, and Serum Osmolality After the Water Drinking Test in Eyes With Primary Angle Closure

Investigative Opthalmology & Visual Science ◽

10.1167/iovs.14-15280 ◽

2015 ◽

Vol 56 (4) ◽

pp. 2135 ◽

Cited By ~ 5

Author(s):

Monisha E. Nongpiur ◽

Valencia H. X. Foo ◽

John Mark de Leon ◽

Mani Baskaran ◽

Tin A. Tun ◽

...

Keyword(s):

Intraocular Pressure ◽

Choroidal Thickness ◽

Serum Osmolality ◽

Angle Closure ◽

Water Drinking ◽

Primary Angle Closure ◽

Drinking Test ◽

Water Drinking Test

Download Full-text

Effects of Laser Peripheral Iridotomy in Subgroups of Primary Angle Closure Based on Iris Insertion

Journal of Ophthalmology ◽

10.1155/2015/581719 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Sung-Cheol Yun ◽

Ji Wook Hong ◽

Kyung Rim Sung ◽

Jin Young Lee

Keyword(s):

Anterior Segment ◽

Anterior Chamber Depth ◽

Multivariate Regression Analysis ◽

Angle Closure ◽

Laser Peripheral Iridotomy ◽

Factors Affecting ◽

Primary Angle Closure ◽

Before And After ◽

Qualitative Classification ◽

Peripheral Iridotomy

Purpose. To investigate the effect of laser peripheral iridotomy (LPI) in subgroups of primary angle closure based on iris insertion configuration.Methods. Anterior segment optical coherence tomography (AS-OCT) images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG) and nonbasal insertion group (NBG)) was performed. Anterior chamber depth (ACD), lens vault (LV), iris curvature, iris area, iris thickness (IT750), and angle opening distance (AOD750) 750 microns from scleral spur were calculated. Uni- and multivariate regression analysis was carried out to evaluate factors associated with AOD750before and after LPI.Results. Ninety-two eyes of 92 subjects were categorized as NBG (39 eyes) or BG (53 eyes). The mean change after LPI was not significantly different between two groups in all parameters. In both groups, AOD750was affected by ACD (p<0.001,p=0.044) before LPI. AOD750was affected by LV (p=0.012) in NBG, but by ACD (p<0.001) and IT750(p=0.039) in BG after LPI.Conclusions. The outcomes of LPI are not significantly different between angle closure subgroups with different iris insertions. However, factors affecting AOD750show differences between two subgroups after LPI.

Download Full-text

Biometric Indicators of Anterior Segment Parameters Before and After Laser Peripheral Iridotomy by Swept-Source Optical Coherent Tomography

10.21203/rs.3.rs-1113315/v1 ◽

2021 ◽

Author(s):

Bo Yu ◽

Kang Wang ◽

Xiaoli Xing

Keyword(s):

Anterior Chamber ◽

Anterior Segment ◽

Angle Closure ◽

Laser Peripheral Iridotomy ◽

Swept Source ◽

Optical Coherent Tomography ◽

Primary Angle Closure ◽

Before And After ◽

Anterior Segment Parameters ◽

Peripheral Iridotomy

Abstract Background Primary angle closure glaucoma (PACG) is the most common type of glaucoma in China. Laser peripheral iridotomy (LPI) is the primary choice to treat PAC. We aim to evaluate the changes and to find the biometric indicators of anterior segment parameters before and after laser peripheral iridotomy (LPI) in primary angle closure (PAC) eyes using swept-source optical coherent tomography (OCT). Methods LPI was performed in 52 PAC eyes of 28 participants. The change of intraocular pressure and anterior segment parameters, including angle opening distance (AOD500), AOD500 area, trabecular iris space area (TISA500), TISA500 volume, trabecular iris angle (TIA500), iridotrabecular contact (ITC) index, ITC area, anterior chamber volume (ACV), anterior chamber depth (ACD), lens vault (LV) and lens thickness (LT) before and 1 week after LPI were measured by Tomey CASIA2 anterior segment OCT. We also estimate and analyze potential contributing factors possibly affecting the change of anterior chamber angle parameters. Results No post-laser complications were found. The LV and LT did not change significantly 1 week after LPI. AOD500, AOD500 area, TISA500, TISA500 volume, TIA500, ACV and ACD increased significantly after LPI. There was significant decrease in ITC index and ITC area. LT was positively correlated to the change of ITC index (r=0.411, p=0.002) and ITC area (r=0.384, p=0.005). ACD was negatively correlated to the change of ITC index (r=0.292, p=0.036). Conclusions The anterior segment architecture significantly changed after LPI in PAC spectrum eyes. Crystalline lens measurements remained unchanged before and after LPI. AS-OCT can be used to follow anterior chamber parameter changes in PAC spectrum eyes. Pre-treatment LT and ACD affect the therapeutic effect of LPI.

Download Full-text