Bilateral laser peripheral iridotomy in a co-occurrence of unilateral iridocorneal endothelial syndrome and chronic angle closure glaucoma

2021 ◽  
pp. 112067212110678
Author(s):  
Navjot Singh Ahluwalia ◽  
Rakesh Shakya ◽  
Dhairya Parikh ◽  
Devindra Sood
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Specular Microscopy ◽  
Laser Peripheral Iridotomy ◽  
First Case ◽  
Peripheral Iridotomy ◽  
Iris Atrophy

Purpose To report a case of unilateral Iridocorneal endothelial (ICE) syndrome- Progressive iris atrophy (PIA) with an overlapping chronic angle closure glaucoma (CACG) and to highlight the effect of bilateral Laser peripheral iridotomy (LPI) in such a co-occurrence. Case description A patient presented to us with bilateral gradual painless progressive diminution of vision. Both eyes (BE) had a clear cornea, shallow peripheral anterior chamber depth, grade 2 nuclear sclerosis, raised intraocular pressure and glaucomatous optic neuropathy. In addition, the Left eye (LE) had an irregular anterior chamber, peripheral anterior synechiae (PAS) extending to cornea, patchy iris atrophy, subtle corectopia and a low endothelial cell count on specular microscopy. Indentation gonioscopy led to the diagnoses of CACG BE with ICE syndrome- PIA LE. LPI was performed bilaterally. On Anterior Segment Optical Coherence Tomography (ASOCT), there was evident widening of the angle away from PAS in the Right eye as well as in the LE with PIA post LPI. Conclusion This is a unique case of unilateral PIA with an associated CACG in BE. It is the first case demonstrating the effect of bilateral LPI in such a case scenario. Though not indicated in ICE syndrome, LPI did show short term evidence of significant widening of the angle away from areas of PAS even in the eye with PIA having a limited high PAS and a concurrent primary (chronic) angle closure disease.

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

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
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.

Laser Peripheral Iridotomy Changes Anterior Chamber Architecture

2016 ◽  
Vol 27 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Christian Theinert ◽  
Peter Wiedemann ◽  
Jan D. Unterlauft
Keyword(s):  
Anterior Chamber ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Control Group ◽  
Threshold Values ◽  
Characteristic Analysis ◽  
Laser Peripheral Iridotomy ◽  
Peripheral Iridotomy ◽  
Healthy Eyes

Purpose The pressure gradient between anterior and posterior chamber in acute angle closure (AAC) and primary angle closure suspects is balanced by a sufficient laser peripheral iridotomy (LPI). The anterior chamber changes induced by LPI in patients with unilateral AAC were examined and compared to healthy eyes to define threshold values, which may help to discriminate between healthy and diseased eyes. Methods Using Scheimpflug photography, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), and central corneal thickness (CCT) were measured before and after LPI in both eyes of unilateral AAC cases. These measurements were compared to a group of healthy control eyes to determine threshold values for ACD, ACV, and ACA. Results The ACD, ACV, and ACA increased significantly in the 25 AAC eyes after LPI. The ACD, ACV, ACA, and CCT values in the AAC eyes obtained before LPI were compared to a control group of 59 healthy eyes with wide open chamber angles. The cutoff values revealed by receiver operating characteristic analysis were 2.1 mm for ACD, 90.5 mm2 for ACV, and 27.25° for ACA. Conclusions Our results confirm the significant changes of the anterior segments architecture induced by LPI in AAC eyes. The found threshold values for ACD, ACV, and ACA may help in daily clinical routine to discriminate between healthy eyes and those in need for a prophylactic LPI.

scholarly journals Changes in Anterior Segment Morphology of Iris Bombe before and after Laser Peripheral Iridotomy in Patients with Uveitic Secondary Glaucoma

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Wakako Ikegawa ◽  
Takashi Suzuki ◽  
Koji Namiguchi ◽  
Shiro Mizoue ◽  
Atsushi Shiraishi ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Anterior Chamber Angle ◽  
Laser Peripheral Iridotomy ◽  
Chamber Volume ◽  
Anterior Chamber Volume ◽  
Before And After ◽  
The Mean ◽  
Peripheral Iridotomy

Purpose. To quantify changes in anterior segment (AS) parameters after laser peripheral iridotomy (LPI) using AS-optical coherence tomography (OCT) of iris bombe. Method. AS images of eight eyes were captured before and after iris bombe and more than 2 weeks after LPI (post-LPI) using AS-OCT. We compared the following AS parameters: anterior chamber depth (ACD), anterior chamber volume (ACV), iris curvature (IC), iris thickness at 500 μm from the scleral spur (IT-1) in the middle between the iris root and pupillary margin (IT-2) and 500 μm from the pupillary margin (IT-3) to the anterior chamber angle (ACA) (angle opening distance [AOD750]), and trabecular iris space area. Results. Mean IT-1 and IT-3, but not IT-2, were lower after iris bombe (IT-1, P=0.001; IT-2, P=0.081; and IT-3, P=0.001). There were no significant differences between ACD at pre-LPI and before iris bombe (P=0.096). The mean ACV and AOD750 of iris bombe increased at post-LPI (ACV, P<0.01, and AOD750, P<0.05). The mean IT-1, IT-2, and IT-3 increased at post-LPI (all, P≤0.01). IC decreased at post-LPI (P<0.001), and ACD at post-LPI did not change. Conclusions. The iris extends and becomes thinner during iris bombe. LPI during bombe decreases the IC and increases the ACV and ACA.

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

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.

scholarly journals Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy

2017 ◽  
Vol 11 (3) ◽  
pp. 86-91 ◽  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Normal Subjects ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Ciliary Process ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma

ABSTRACT Aim To evaluate the configuration of the anterior chamber angle quantitatively and study the morphological changes in the eye with ultrasound biomicroscopy (UBM) in primary angle closure glaucoma (PACG) patients after laser peripheral iridotomy (LPI). Materials and methods A total of 185 eyes of 185 PACG patients post-LPI and 126 eyes of 126 normal subjects were included in this prospective study. All subjects underwent complete ophthalmic evaluation, A-scan biometry, and UBM. The anterior segment and angle parameters were measured quantitatively and compared in both groups using Student's t-test. Results The PACG patients had shorter axial length, shallower central anterior chamber depth anterior chamber depth (ACD), and anteriorly located lens when compared with normal subjects. Trabecular iris angle (TIA) was significantly narrow (5.73 ± 7.76°) in patients with PACG when compared with normal subjects (23.75 ± 9.38°). The angle opening distance at 500 μm from scleral spur (AOD 500), trabecular—ciliary process distance (TCPD), iris—ciliary process distance (ICPD), and iris—zonule distance (IZD) were significantly shorter in patients with PACG than in normal subjects (p < 0.0001). The iris lens angle (ILA), scleral—iris angle (SIA), and scleral—ciliary process angle (SCPA) were significantly narrower in patients with PACG than in normal subjects (p < 0.0001). The iris—lens contact distance (ILCD) was greater in PACG group than in normal (p = 0.001). Plateau iris was seen in 57/185 (30.8%) of the eyes. Anterior positioned ciliary processes were seen in 130/185 eyes (70.3%) of eyes. Conclusion In PACG patients, persistent apposition angle closure is common even after LPI, which could be due to anterior rotation of ciliary body and plateau iris and overcrowding of anterior segment due to shorter axial length and relative anterior lens position. How to cite this article Mansoori T, Balakrishna N. Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy. J Curr Glaucoma Pract 2017;11(3):86-91.

scholarly journals Predictive Equation for Angle Opening Distance at 750 μm After Laser Peripheral Iridotomy in Primary Angle Closure Suspects

2021 ◽  
Vol 8 ◽  
Author(s):  
Xinbo Gao ◽  
Yuying Zhou ◽  
Chengguo Zuo ◽  
Liming Chen ◽  
Jiawei Ren ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Ciliary Body ◽  
Anterior Segment ◽  
Prediction Equation ◽  
Angle Closure ◽  
Laser Peripheral Iridotomy ◽  
Ciliary Process ◽  
Primary Angle Closure ◽  
Body Parameters ◽  
Peripheral Iridotomy

Aim: The aim of this study was to investigate the changes in anterior segment parameters as assessed by ultrasound biomicroscopy (UBM) after laser peripheral iridotomy (LPI) and to propose a prediction equation for the width of the angle after LPI.Design: This was a prospective study.Participants: The participants included 100 subjects with primary angle closure suspect (PACS).Methods: Anterior segment UBM parameters were measured, whereas AOD750 was chosen to indicate the width of the angle associated with gonioscopic angle closure, as found in a prior study.Main Outcome Measures: Angle parameters, iris parameters, anterior chamber parameters and ciliary body parameters.Results: All angle parameters increased after LPI, including the mean angle opening distance at 750 μm (AOD750), mean angle opening distance at 500 μm from the scleral spur (AOD500), mean angle opening distance at 750 μm from the scleral spur (AOD750), and mean angle recess area at 750 μm from the scleral spur (ARA750). Among iris parameters and ciliary body parameters, the iris thickness at 2,000 μm (IT2000), iris curvature (IC), and trabecular-ciliary process distance (ICPD) were reduced after LPI. The final equation consisted of four parameters: anterior chamber depth (ACD), iris thickness at 750 μm from the scleral spur (IT750), AOD750, and lens vault (LV). This equation explained 42.7% of the variability in the angle opening indicator AOD750 after LPI, whereas in the plateau iris configuration subgroup, the accuracy of the prediction equation reached the highest a maximum of 68.6%.Conclusions: There was an increase in angle opening and iris flattening after LPI. An equation involving four angle parameters was constructed, this equation which could explained 42.7% of the variability in the angle opening indicator AOD750 after LPI whereas in the plateau iris configuration subgroup, the accuracy of the prediction equation reached a maximum of 68.6%.

Changes in Anterior Segment Morphology After Laser Peripheral Iridotomy in Acute Primary Angle Closure

2016 ◽  
Vol 166 ◽  
pp. 133-140 ◽  
Author(s):  
Sasan Moghimi ◽  
Rebecca Chen ◽  
Mohammadkarim Johari ◽  
Faezeh Bijani ◽  
Massood Mohammadi ◽  
...  
Keyword(s):  
Anterior Segment ◽  
Angle Closure ◽  
Laser Peripheral Iridotomy ◽  
Acute Primary Angle Closure ◽  
Primary Angle Closure ◽  
Peripheral Iridotomy
Sign in / Sign up

Export Citation Format

Share Document