scholarly journals Characteristic Manifestations regarding Ultrasound Biomicroscopy Morphological Data in the Diagnosis of Acute Angle Closure Secondary to Lens Subluxation

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Fenglei Wang ◽  
Dabo Wang ◽  
Ling Wang
Keyword(s):  
Clinical Diagnosis ◽  
Risk Ratio ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Morphological Data ◽  
Angle Closure ◽  
Control Group ◽  
Imaging Features ◽  
Lens Subluxation ◽  
Acute Angle Closure

Purpose. To investigate the mechanisms underlying the occurrence of acute angle closure (AAC) and to further explore the sensitive indicators for clinical diagnosis of acute angle closure secondary to lens subluxation (AACSLS) through qualitative and quantitative analysis of ultrasound biomicroscopy (UBM) imaging features of eyes with AAC to provide a theoretical basis for the selection of treatment schemes.Methods. A retrospective analysis was conducted from 2013 to 2018 on 160 eyes (160 patients) with uniocular acute angle closure crisis (AACC) complicated by cataract. The case group consisted of 29 eyes (29 patients) with lens subluxation and the control group consisted of 131 eyes (131 patients) without lens subluxation. Before the operation, computer optometry, best corrected visual acuity, intraocular pressure, slit lamp, gonioscopy, preset lens, A-mode ultrasonography, and UBM were performed. All the enrolled subjects underwent cataract surgery with or without other operations. The pupil was fully dilated, and the position of the lens was recorded before the operation. The zonular rupture and lens subluxation were further confirmed during operation. SPSS version 20.0 was used to analyze UBM imaging data from the lens subluxation group and non-lens subluxation group.Results. The iris span (IS) value in the whole quadrant of the lens subluxation group was significantly higher than that of the non-lens subluxation group (P=0.033, 95%CI 0.01 to 0.31). The iris lens angle (ILA) in the lens subluxation group was significantly lower than that in the non-lens subluxation group in the upper, lower, nasal, temporal, and whole quadrants (P<0.001, 95%CI -8.79 to -2.78; P=0.001, 95%CI -8.36 to -2.27; P<0.001, 95%CI -9.85 to -4.98; P=0.015, 95%CI -6.67 to -0.72; P<0.001, 95%CI -8.74 to -5.83, respectively). However, the ILA of the maximum difference among the four quadrants in the lens subluxation group was significantly higher than that in the non-lens subluxation group (P<0.001, 95%CI 4.74 to 9.86). The ILA and iris lens contact distance (ILCD) showed significant negative correlations in both the lens subluxation group and non-lens subluxation group (Y=20.984-7.251X, R=0.520, and P<0.001; Y=19.923-3.491X, R=0.256, and P<0.001, respectively). The risk ratio of lens subluxation in exposed eyes with ILA=0 in one quadrant at least was significantly higher than that in nonexposed eyes without ILA=0 in all quadrants (X2=87.859, P<0.001, and odds ratio (OR)=79.200, 95% CI 23.063 to 271.983). The risk ratio of zonular rupture in exposed quadrants with ILA=0 was significantly lower than that in nonexposed eyes without ILA=0 (X2=33.884, P<0.001, OR=0.122, and 95% CI 0.053 to 0.278). The risk ratio of zonular rupture in exposed quadrants with nonforward convexity of iris was significantly lower than that in nonexposed quadrants with forward convexity of iris (X2=6.413, P=0.011, and OR=0.381; 95% CI 0.176 to 0.825).Conclusions. ILA=0 and nonforward convexity of iris as UBM sensitive and characteristic indicators for screening lens subluxation and zonular rupture can provide new ideas and hints for clinical diagnosis of acute angle closure secondary to lens subluxation.

scholarly journals Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

2019 ◽  
Author(s):  
Hong-Yang Zhang ◽  
Hong-Liang Lin ◽  
Yong-Jie Qin ◽  
Yu-Lin Zhang ◽  
Yu-Qiao Zhang ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Clinical Characteristics ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure ◽  
Fellow Eye ◽  
Lens Extraction ◽  
Lens Subluxation ◽  
Acute Angle Closure

Abstract BackgroundTo compare clinical characteristics of lens subluxation between eyes with or without acute angle closure (AAC).MethodsThis is a retrospective and case control study. Thirty-four cases with lens subluxation were recruited from 2015 to 2017. Patients with acute angle closure were assigned to the AAC group (n=17 eyes) and those without AAC were in the non-AAC group (n=17 eyes). Quantitative anterior segment was evaluated by ultrasound biomicroscopy (UBM). Axial length (AL) was measured with IOL master. All patients underwent lens extraction surgery and were followed up for 6 months. ResultsThe history of blunt trauma was accounted for 11 (64.7%) cases in the AAC group and 14 (82.3%) cases in the non-AAC group. Nine (52.9%) patients in the AAC group had LPI or SPI treatment history, and high intraocular pressure was recurred. The UBM analysis showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than the fellow eyes (2.39 mm, P < 0.05) or both eyes in the non-AAC group (affected eye 3.24mm vs fellow eye 3.81mm). Lens vault and AOD500 also showed a remarkable difference between affected eye than fellow eye (P < 0.001) in the AAC group. The both eyes in the AAC group presented a shorter AL and shallower anterior chamber, comparing with those in the non-AAC group. Besides, the affected eyes in the AAC group presented significantly higher LV. ConclusionsThe crowded anterior chamber structure and shorter AL might be an anatomic basis for the eye with lens subluxation induced AAC. Quantitative evaluation of these ocular structures to identify zonular compromise, increased LV and shorter AL are valuable for the diagnosis of lens subluxation induced AAC.

scholarly journals Comparisons of Ocular Anatomic Differences of Lens-Subluxated Eye with or without Acute Angle Closure: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hong-Liang Lin ◽  
Yong-Jie Qin ◽  
Yu-Lin Zhang ◽  
Yu-Qiao Zhang ◽  
Yong-Yi Niu ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure ◽  
Lens Extraction ◽  
Lens Subluxation ◽  
History Of ◽  
Acute Angle Closure ◽  
Anatomic Basis

Purpose. To compare ocular anatomy differences of lens subluxation between eyes with or without acute angle closure (AAC). Methods. This is a retrospective and case-control study. Sixty cases with mild lens subluxation were recruited. Among them, 30 eyes with acute angle closure were assigned to the AAC group and 30 eyes without AAC were assigned to the non-AAC group. The anterior segment was quantitatively evaluated by ultrasound biomicroscopy (UBM). The axial length (AL) was measured with IOL Master. All patients underwent lens extraction surgery and were followed up for six months. Results. The history of blunt trauma accounted for 22 (73.3%) cases in the AAC group and 21 (70%) cases in the non-AAC group. Fifteen (50%) patients in the AAC group had iridotomy history, and high intraocular pressure recurred. The UBM analysis showed that the average central chamber depth of the affected eyes in the AAC group was 1.82 mm, which was significantly shallower than that in the fellow eyes (2.58 mm, P<0.05) or both eyes in the non-AAC group.Both eyes in the AAC group presented a shorter AL and shallower anterior chamber than the eyes in the non-AAC group. Conclusions. An asymmetrical anterior chamber between bilateral eyes is an important feature in lens subluxation-induced AAC. The crowded anterior chamber and shorter AL might be the anatomic basis for the eye with lens subluxation-induced AAC.

Utility of ultrasound biomicroscopy in the diagnosis of topiramate-associated ciliochoroidal effusions causing bilateral acute angle closure

2014 ◽  
Vol 42 (5) ◽  
pp. 500-501 ◽  
Author(s):  
Gustavo MSM Reis ◽  
Oliver CF Lau ◽  
Chameen Samarawickrama ◽  
Peter Heydon ◽  
Ivan Goldberg
Keyword(s):  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure ◽  
Acute Angle Closure

scholarly journals Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

2019 ◽  
Author(s):  
Xiaoli Xing ◽  
Liangyu Huang ◽  
Fang Tian ◽  
Yan Zhang ◽  
Yingjuan Lv ◽  
...  
Keyword(s):  
Axial Length ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Lens Thickness ◽  
Primary Angle Closure ◽  
Lens Position ◽  
Acute Angle Closure

Abstract Background: To compare the anterior biometry of eyes with secondary acute angle closure induced by occult lens subluxation (LS), misdiagnosed as acute primary angle closure (APAC) at the first visit, APAC, chronic primary angle closure glaucoma (CPACG), cataract. Methods: This retrospective case study included 17 eyes with PAC due to occult LS, who were misdiagnosed as APAC on their first visit, 56 eyes diagnosed as APAC, 54 eyes diagnosed as CPACG, and 56 eyes diagnosed as cataract. Axial length (AL), Central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Results: The patients in the LS group had a longer ocular axial length than those with acute angle closure and CPACG. Corneal thickness in the LS group was not significantly different from that in the APAC group, but was significantly different from those of the CPACG and cataract group. The APAC group had the smallest ACD, while the LS group had the smallest AD. The LS group exhibited significantly shallower ACD (P<0.01). The LS group had the largest lens thickness. Conclusions: This study revealed that LS secondary PAC patients had a shallower ACD, thicker CCT and lens thickness comparing to those of APAC, CPACG and cataract patients. A short depth (< 1.25 mm) and a thick lens thickness (> 5.13 mm) are crisis of lens subluxation in our data. LP and CLP can be helpful for differential diagnosis. Trial registration: NCT03752710, retrospectively registered.

scholarly journals Biometric indicators of eyes with occult lens subluxation inducing secondary acute angle closure

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaoli Xing ◽  
Liangyu Huang ◽  
Fang Tian ◽  
Yan Zhang ◽  
Yingjuan Lv ◽  
...  
Keyword(s):  
Acute Angle ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Acute Angle Closure

scholarly journals Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

2019 ◽  
Author(s):  
Xiaoli Xing ◽  
Liangyu Huang ◽  
Fang Tian ◽  
Yan Zhang ◽  
Yingjuan Lv ◽  
...  
Keyword(s):  
Axial Length ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Lens Thickness ◽  
Primary Angle Closure ◽  
Lens Position ◽  
Acute Angle Closure

Abstract Background : To compare the anterior biometry of eyes with secondary acute angle closure induced by occult lens subluxation (LS), misdiagnosed as acute primary angle closure (APAC) (ASAC-LS ) at the first visit, APAC, chronic primary angle closure glaucoma (CPACG), cataract. Methods : This retrospective case study included 17 eyes with primary angel closure(PAC)due to occult LS, who were misdiagnosed as APAC on their first visit, 56 eyes diagnosed as APAC, 54 eyes diagnosed as CPACG, and 56 eyes diagnosed as cataract. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD) , aqueous depth (AD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of ocular biometry. Results: The patients in the ASAC-LS group had a longer ocular axial length than those with acute angle closure and CPACG. Corneal thickness in the ASAC-LS group was not significantly different from that in the APAC group, but was significantly different from those of the CPACG and cataract group. The APAC group had the smallest ACD, while the ASAC-LS group had the smallest AD. The ASAC-LS group exhibited significantly shallower AD (P<0.01). The ASAC-LS group had the largest lens thickness. According to ROC curve analysis,RLP, ACD, AD, LP, CLP, CCT were high power of discrimination. Conclusions: This study revealed that LS secondary PAC patients had a shallower AD, thicker CCT comparing to those of APAC, CPACG and cataract patients. LP and CLP can be helpful for differential diagnosis.

scholarly journals Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

2019 ◽  
Author(s):  
Xiaoli Xing ◽  
Liangyu Huang ◽  
Fang Tian ◽  
Yan Zhang ◽  
Yingjuan Lv ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Axial Length ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Lens Thickness ◽  
Primary Angle Closure ◽  
Lens Position ◽  
Acute Angle Closure

Abstract Background : To compare the anterior biometricsof eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), which were misdiagnosed at the first visit withacute primary angle closure (APAC), chronic primary angle closure glaucoma (CPACG), or cataracts. Methods: This retrospective case series ncluded 17 eyes with angle closure due to occult LS which were misdiagnosed with APAC at the first visit, 56 APACeyes, 54 CPACGeyes, and 56 cataracteyes. The axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD), and lens thickness (LT) were recorded. The lens position (LP), relative lens position (RLP), and corrected lens position (CLP) were calculated. Quantitative data were subject to a one-way analysis of variance and correlation analysis. Categorical data were analysed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cut-off value for ocular biometrics. Results: The ASAC-LSpatients had a longer ocular AL than the APACand CPACGpatients. The CCTinthe ASAC-LS patientsdid not significantly differ from that in the APAC patientsbut did significantly differ from that of the CPACG and cataract patients.The APAC patientshad the smallest ACD, while the ASAC-LS patientshad the smallest AD. The ASAC-LS patientshad the thickest lenses. According to the ROC curve analysis, the RLP, ACD, AD, CLP, and LP hada high power of discrimination. Conclusions: This study revealed that ASAC-LS patients had a shallower AD and thicker CCT compared to APAC, CPACG, and cataract patients. Biometric parameters ACD, ADwere characteristic of lens subluxation according to our data. The calculated parameters RLP,CLP, LP can be helpful in the differential diagnosis between ASAC-LSand APAC, CPACG, Cataract. Trial registration: NCT03752710, retrospectively registered. Keywords:Lens subluxation; Acute angle-closure; Biometry; Anterior chamber depth; Lens thickness; Axial length

scholarly journals Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

2019 ◽  
Author(s):  
Xiaoli Xing ◽  
Liangyu Huang ◽  
Yan Zhang ◽  
Yingjuan Lv ◽  
Wei Liu ◽  
...  
Keyword(s):  
Axial Length ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Lens Thickness ◽  
Primary Angle Closure ◽  
Lens Position ◽  
Acute Angle Closure

Abstract Background: To compare the anterior biometry of eyes with secondary acute angle closure induced by occult lens subluxation (LS), misdiagnosed as acute primary angle closure (APAC) at the first visit, APAC, chronic primary angle closure glaucoma (CPACG), cataract. Methods: This retrospective case study included 17 eyes with PAC due to occult LS, who were misdiagnosed as APAC on their first visit, 56 eyes diagnosed as APAC, 54 eyes diagnosed as CPACG, and 56 eyes diagnosed as cataract. Axial length (AL), Central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Results: The patients in the LS group had a longer ocular axial length than those with acute angle closure and CPACG. Corneal thickness in the LS group was not significantly different from that in the APAC group, but was significantly different from those of the CPACG and cataract group. The APAC group had the smallest ACD, while the LS group had the smallest AD. The LS group exhibited significantly shallower ACD (P<0.01). The LS group had the largest lens thickness. Conclusions: This study revealed that LS secondary PAC patients had a shallower ACD, thicker CCT and lens thickness comparing to those of APAC, CPACG and cataract patients. A short depth (< 1.25 mm) and a thick lens thickness (> 5.13 mm) are crisis of lens subluxation in our data. LP and CLP can be helpful for differential diagnosis. Trial registration: NCT03752710, retrospectively registered.

scholarly journals Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

2020 ◽  
Author(s):  
Xiaoli Xing ◽  
Liangyu Huang ◽  
Fang Tian ◽  
Yan Zhang ◽  
Yingjuan Lv ◽  
...  
Keyword(s):  
Axial Length ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Acute Angle ◽  
Angle Closure ◽  
Lens Subluxation ◽  
Lens Thickness ◽  
Primary Angle Closure ◽  
Lens Position ◽  
Acute Angle Closure

Abstract Background: To compare the anterior biometrics of eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), misdiagnosed as acute primary angle closure (APAC) at the first visit with APAC, chronic primary angle closure glaucoma (CPACG), and cataract. Methods : This retrospective case study included 17 eyes with angel closure due to occult LS, who were misdiagnosed as APAC on their first visit, 56 APAC eyes, 54 CPACG eyes, and 56 cataract eyes. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD) , aqueous depth (AD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test.Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of ocular biometrics. Results: The ASAC-LS patients had a longer ocular axial length than APACand CPACGpatients. Central corneal thickness ofthe ASAC-LSpatientswas not significantly different from APAC patients, but was significantly different from CPACG and cataract patients. The APAC patientshad the smallest ACD, while the ASAC-LS patientshad the smallest AD. The ASAC-LS patientshad the largest lens thickness. According to ROC curve analysis, RLP, ACD, AD, CLP, LP hadhigh power of discrimination. Conclusions: This study revealed that LS secondary PAC patients had a shallower AD, thicker CCT comparing to those of APAC, CPACG and cataract patients.LP and CLP can be helpful for differential diagnosis. Trial registration: NCT03752710, retrospectively registered. Keywords: Lens subluxation; Acute angle-closure; Biometry; Anterior chamber depth; Lens thickness; Axial length

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