‘Van Herick Plus’: a modified grading scheme for the assessment of peripheral anterior chamber depth and angle

2018 ◽  
Vol 103 (7) ◽  
pp. 960-965 ◽  
Author(s):  
Ramanjit Sihota ◽  
Neha Kamble ◽  
Ajay K Sharma ◽  
Anju Bhari ◽  
Amisha Gupta ◽  
...  

AimTo evaluate the accuracy of a new, modified grading scheme involving a short vertical slit beam, at the inferior angle for peripheral anterior chamber depth (PAC) and angle estimation and its correlation with anterior segment optical coherence tomography (ASOCT).MethodsA cross-sectional study of consecutive phakic patients, above 40 years of age, was performed. Using a short, vertical slit beam not reaching the pupil, the inferior angle at the sclerolimbal junction was evaluated, photographed and assessed by a ratio of peripheral anterior chamber depth to peripheral corneal thickness (PAC:PCT) and iridocorneal angle (ICA) on ImageJ software. The inferior angle at the same meridian was also recorded on ASOCT.ResultsBased on the PAC:PCT ratio, the subjects were divided into four groups: I (<1/4), II (1/4-1/2), III (>1/2–1) and IV (>1). The clinically assessed angle by short vertical slit beam correlated well with ASOCT values, trabecular-iris angle (TIA) (r=0.918; p<0.001) and scleral spur angle (r=0.903, p<0.001). The mean difference between ICA and TIA on ASOCT was 0.7970; 95% limits of agreement:−5.7670 to 7.3610 (±1.96 SD). For angles graded narrow on ASOCT (TIA <200), using a cut-off of peripheral PAC:PCT <1/4, the area under the curve was 0.918 with a sensitivity of 85.2% and a specificity of 88.2%. There was good agreement between ImageJ parameters with those assessed subjectively on photograph of the slit beam examination by a glaucoma fellow (weighted kappa=0.74) as compared with a general ophthalmologist, where there was moderate agreement (weighted kappa=0.57).ConclusionA short, vertical slit lamp beam evaluation at the inferior angle is an easy and relatively accurate method for both peripheral anterior chamber depth and angle assessment. It correlated well with ASOCT and can be used as a more reliable screening tool to identify eyes with possibly occludable angles.


2016 ◽  
Vol 27 (4) ◽  
pp. 417-422 ◽  
Author(s):  
José Ignacio Fernández-Vigo ◽  
Lucía De-Pablo-Gómez-De-Liaño ◽  
Cristina Fernández-Vigo ◽  
Inés Sánchez-Guillén ◽  
Enrique Santos-Bueso ◽  
...  

Purpose To determine the prevalence of trabecular-iris contact (TIC) and quantify this contact in healthy Caucasian individuals using Fourier-domain optical coherence tomography (FD-OCT). Methods For this cross-sectional study, 2,012 eyes of 1,006 healthy subjects were recruited among individuals undergoing a routine ophthalmologic checkup. In each participant, age, sex, intraocular pressure, and spherical refractive error were first recorded along with anterior chamber depth and volume, central corneal thickness measured with the Pentacam, and axial length with the IOLMaster. Anterior chamber angle variables and the presence of TIC in the horizontal quadrants were determined by anterior segment FD-OCT (RTVue 100®). When TIC was observed, TIC length (TICL) and its percentage in relation to the length of the trabecular meshwork (TICL percentage) were also measured. Results Trabecular-iris contact in the horizontal quadrants was observed in 34 eyes of 25 patients, representing 1.6% of the total number of eyes examined. In this subgroup of individuals, mean age was 55.8 years, 84% were women, and spherical refractive error ranged from -0.25 to 8.25 D. Eyes with TIC showed an angle width of less than 23.2 degrees and axial length shorter than 23.7 mm. Mean TICL was 239 ± 79 μm (103-495 μm) and mean TICL percentage was 46.9% ± 13.9% (17.2%-76.3%). Conclusions The prevalence of TIC was low in this population. Fourier-domain optical coherence tomography emerged as useful to assess its prevalence and quantify the extent of TIC.



2021 ◽  
Author(s):  
Xu Zhang ◽  
Huixian Wang ◽  
Yuan Nie ◽  
Wenjing Li

Abstract Background: To evaluate and compare the changes in intraocular pressure and anterior eye segment biometrics,during and after wearing two types of commonly used swimming goggles.Methods: In a cross-sectional study, a total of 40 healthy adults aged between 18 and 60 years old were selected to wear two kinds of common swimming goggles (ocular socket and orbital goggles). Intraocular pressure and anterior segment biometry were evaluated before wearing, at 2 and 5 minutes of wearing, and at 5 minutes after removing the goggles. Intraocular pressure (IOP), corneal front keratometry values (K1, K2, Km), central corneal thickness (CCT), central anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) were measured.Results: The IOP at 2 minutes (21.0±2.2 mmHg) and 5 minutes (21.2±2.3 mmHg) was significantly higher than before wearing goggles (17.7± 2.1 mmHg). The IOP after the goggles were removed and at 5 minutes after the goggles were removed was 18.4±2.3 mmHg and 17.7±2.1 mmHg, respectively. ACV, ACD, and ACA values all decreased while the googles were worn. After the goggles were removed, these changes gradually returned to baseline values, with no significant difference in the values before and after.Conclusion: This study proves that wearing orbital goggles can lead to an acute increase in IOP and a slight decrease in ACV, ACD, and ACA. However, once the goggles are removed, these indicators return to baseline levels, showing that wearing orbital goggles has no significant lasting effect on IOP and anterior segment parameters.



2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Ercan Ozsoy ◽  
Abuzer Gunduz ◽  
Ersin Ersan Demirel ◽  
Tongabay Cumurcu

Purpose. To evaluate anterior segment’s structures by Pentacam in patients with tilted disc syndrome (TDS).Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups.Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (p=0.625,p=0.830,p=0.234, andp=0.850). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (p=0.001,p=0.0001,p=0.003, andp=0.001). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (p=0.130,p=0.910, andp=0.057).Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc.



2021 ◽  
Vol 8 ◽  
Author(s):  
Guihua Xu ◽  
Guanrong Wu ◽  
Zijing Du ◽  
Shanqing Zhu ◽  
Yunxiang Guo ◽  
...  

Purpose: To investigate the distribution of white-to-white (WTW) corneal diameter and anterior chamber depth (ACD) in Chinese myopia patients.Methods: This was a cross-sectional observational study conducted at five ophthalmic centers. Anterior segment biometry was performed in 7,893 eyes of the 7,893 myopic patients using Pentacam, and the WTW and ACD were recorded. The distribution patterns of WTW and ACD were evaluated and the correlation between WTW and ACD was analyzed statistically.Results: There were 4416 (55.95%) males and 3477 (44.05%) females. The age of the study population was 25.14 ± 5.41 years. Distribution of WTW was slightly positively skewed (Skewness = 0.0076, Kurtosis = 0.3944, KS P = 0.020) with a mean of 11.65 ± 0.38 mm and a 95% normal range of 10.91–12.39 mm. A significant difference in WTW was found among different myopia groups (P &lt; 0.001). The ACD was normally distributed (Skewness = 0.899, Kurtosis = 0.027, KS P = 0.086). The mean ACD was 3.25 ± 0.26 mm and the 95% normal range of was 2.74–3.75 mm. A significant difference in ACD was also found among different myopia groups (P = 0.030). There was a significant correlation between WTW and ACD (r = 0.460, P &lt; 0.001).Conclusions: In our study, 95% of the Chinese myopic patients had a WTW within 10.91–12.39 mm and an ACD within 2.74–3.75 mm. ACD and WTW were significantly different among different myopia, gender and age groups. WTW was positively correlated with ACD.



2020 ◽  
Author(s):  
Qin Luo ◽  
Wenwen Xue ◽  
Yin Yuan ◽  
Chaowei Fu ◽  
Jiangnan He ◽  
...  

Abstract Background To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening. Methods Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results 2528 adults participated in the study with 91 patients diagnosed with PACD. 2463 subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04±0.46 (range 0.11-2.93) CT and 0.87±0.41 (range 0.12-2.96) CT respectively (t=-4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P<0.0001) per diopter of SE and was 0.19 CT (P<0.0001) shallower in women than in men (r2=0.1304, P<0.0001). Peripheral ACD performed best in screening for PACD. Conclusions Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.



2021 ◽  
Author(s):  
Fatih Akıncı ◽  
Abdullah Arslan ◽  
Muammer Özcimen

Abstract Purpose: In this study the acute effects of 1 session of hyperbaric oxygen therapy on eye anterior segment morphology and on intraocular pressure was evaluated.Materials and methods: 30 patients taking hyperbaric oxygen therapy for different indications were included in this prospective study. Only the right eye per patient was included in the study. The refractive errors were measured with autorefractometry, intraocular pressures were measured with pneumatic tonometry; anterior segment parameters pachymetry, keratometry, anterior chamber depth and iridocorneal angle values were measured with corneal topography prior to and 24 hours after 1 session of hyperbaric oxygen therapy.Results: In this study 30 eyes from a total of 30 patients were evaluated; 19 men (% 64) and 11 women (% 36). Median age was 44.33 ±16.12 (Age range 18-80 years). Mean intraocular pressure was 13.7 ±4,16 mmHg (milimetermercuries), mean central corneal thickness was 531.9 ±28.24 μm, mean anterior chamber depth was 3.30 ±0.375 mm, mean iridocorneal angle value was 35.3± 6.61 degrees before hyperbaric oxygen therapy. The mean intraocular pressure was 12.66±4,54 mmHg, mean central corneal thickness was 529.43± 26.68 μm, mean anterior chamber depth was 3.28±0.372 mm, mean iridocorneal angle value was 34.5±6.42 degrees after HBOT. A statistically significant decrease in these values were recorded. No statistically significant changes were found in spheric equivalent and keratometry values of the patients before and after HBOT.Conclusions: After one session of HBOT a decrease in intraocular pressure, central corneal thickness, anterior chamber depth and iridocorneal angles of patients were observed; keratometry and spheric equivalent values remained unchanged. More studies are needed in order to use the effects of HBOT on anterior segment morphology and on intraocular pressure for situations like glaucoma, corneal edema etc.



2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yue Zhou ◽  
Xiao Bo Huang ◽  
Qi Cai ◽  
Jun Jie Li ◽  
Yao Jia Xiong ◽  
...  

Purpose. To investigate the influences of atropine on changes in anterior segment geometry, as measured by ultrasound biomicroscopy in children. Methods. A prospective observational study was performed. Anterior segment parameters were obtained by UBM before and after the instillation of 1% atropine. Univariate linear regression was performed to identify the variables contributing to the changes in the trabecular meshwork-iris angle (TIA). Results. The study included 21 boys and 37 girls with a mean age of 10.79 ± 2.53 years. Anterior chamber parameters including the central anterior chamber depth, TIA, angle opening distance at 500 μm from the scleral spur, iris thickness 750 μm and 1500 μm from the scleral spur, trabecular-ciliary angle (TCA), trabecular-ciliary process distance, sclera-iris angle (SIA), and sclera-ciliary process angle significantly increased after cycloplegia ( P < 0.05 ). In contrast, the lens vault, iris cross-sectional area, and maximum ciliary muscle thickness significantly decreased after cycloplegia. Univariate analysis identified the change in TCA and the change in SIA and the TIA before mydriasis as determinants of the change in TIA. Conclusions. Atropine causes statistically significant changes in various anterior segment parameters in children. The change in anterior chamber angle is associated with the change in TCA and the change in SIA and the TIA before mydriasis.



2020 ◽  
Author(s):  
Qin Luo ◽  
Wenwen Xue ◽  
Yin Yuan ◽  
Chaowei Fu ◽  
Jiangnan He ◽  
...  

Abstract Background To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening. Methods Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results 2528 adults participated in the study with 91 patients diagnosed with PACD. 2463 subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04±0.46 (range 0.11-2.93) CT and 0.87±0.41 (range 0.12-2.96) CT respectively (t=-4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P<0.0001) per diopter of SE and was 0.19 CT (P<0.0001) shallower in women than in men (r2=0.1304, P<0.0001). Peripheral ACD performed best in screening for PACD. Conclusions Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.



2021 ◽  
Author(s):  
Yanzhen Xue ◽  
Yonghong Guo ◽  
Ruibo Zhao

Abstract Purpose: To determine patient preoperative anatomical features and the parameters of implantable collamer lenses (ICLs) relevant in explaining vault variability.Setting: Ophthalmology Xi’an Aier Gucheng Eye hospital , Xi’an China.Design: Retrospective case series.Methods:This study comprised 88 eyes of 45 patients implanted with myopic or toric ICLs between May 2021 and August 2021.Pentacam imaging was used for assessing white-to-white (WTW) diameter, central keratometry, anterior chamber depth(ACD), central corneal thickness and vault. Anterior-segment optical coherence tomography(AS-OCT) was used to measure the horizontal anterior chamber angle distance (ATA). Ultrasound biomicroscopy (UBM) was used to measure horizontal and vertical sulcus to sulcus(vSTS). According to different ACD,we divide ACD into shallow group(2.8 to 3.2 mm),medium group(3.2 to 3.5 mm),and deep group(>3.5mm).Results: Linear regression analysis found significant correlation between WTW diameters and ATA diameters( y= 0.9605x+0.1491,R² = 0.9148),with a coefficient of determinant of 0.9148 (P<0.01). Linear regression analysis found significant correlation between hSTS and vSTS(y=0.9855x-0.0178,R²=0.1979),with a coefficient of determinant of 0.1979 (P<0.01). WTW diameters showed statistically significant difference in shallow and medium ACD (t=-3.28,P<0.01 ), significant difference in shallow and deep ACD (t=-4.69,P<0.01 ),there was no correlation in medium and deep ACD(t=-1.41,P>0.05 ). There was a statistically significant correlation between WTW diameters and hSTS diameters when the ACD was less than 3.5 mm (t=-0.451, P=0.000) (t=1.406, P=0.026),but weak correlation when the ACD was bigger than 3.5 mm(t=1.594, P=0.051). ATA and WTW with a mean difference close to zero(-0.66 mm). Despite the relatively high correlation (intraclass correlation co-efficient =0.689), the range of agreement is quite broad (1.33 mm).Conclusions:ATA measured with AS-OCT can not be used interchangeably with WTW obtained with Pentacam. WTW diameters and hSTS diameters have a statistically significant correlation when the ACD was less than 3.5 mm. WTW, ATA, hSTS and vSTS all should be considered during design the size of lens and regulating the vault after surgery.



2020 ◽  
Author(s):  
Wenwen Xue ◽  
Qin Luo ◽  
Yin Yuan ◽  
Chaowei Fu ◽  
Jiangnan He ◽  
...  

Abstract Purpose To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters (peripheral ACD, spherical equivalent [SE], intraocular pressure [IOP]) for primary angle closure disease (PACD) screening in an elderly Chinese community. Methods Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results 2528 adults participated in the study with 91 patients diagnosed with PACD. 2463 subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04±0.46 (range 0.11-2.93) CT and 0.87±0.41 (range 0.12-2.96) CT respectively (t=-4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P<0.0001) per diopter of SE and was 0.19 CT (P<0.0001) shallower in women than in men (r2=0.1304, P<0.0001). Peripheral ACD performed best in screening for PACD. Conclusions Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.



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