scholarly journals Ocular Manifestations of Acute Secondary Angle Closure Associated With Lens Subluxation

2022 ◽  
Vol 8 ◽  
Author(s):  
Qinghe Jing ◽  
Tianhui Chen ◽  
Zexu Chen ◽  
Lina Lan ◽  
Chen Zhao ◽  
...  
Keyword(s):  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Strongly Correlated ◽  
Corneal Curvature ◽  
Roc Curve Analysis ◽  
Trauma History ◽  
Lens Subluxation ◽  
Ocular Manifestations ◽  
Intraindividual Comparison ◽  
Diagnostic Potential

Purpose:To evaluate the clinical characteristics and ocular features of patients with acute secondary angle closure, associated with lens subluxation (ASAC-LS).Methods:We performed a retrospective study at the EENT Hospital of Fudan University, Shanghai, China. A total of 41 affected eyes from 41 patients were enrolled in this study. Furthermore, 20 affected eyes were part of the ASAC-LS cohort and 21 affected eyes were included in the acute primary angle closure (APAC) cohort. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), minimum corneal curvature (K1), maximum corneal curvature (K2), and anterior chamber depth (ACD) were measured and compared between the 2 cohorts. In addition, inter-eye (intraindividual) comparison was performed.Results:The ASAC-LS cohort exhibited younger ages, more frequent trauma history (35%), lower IOP (27.43 ± 13.86 mmHg vs. 41.27 ± 10.36 mmHg), longer AL (23.96 ± 2.60 vs. 22.49 ± 0.77 mm), shallower ACD (1.28 ± 0.38 vs. 1.58 ± 0.23 mm), and bigger ACD differences (0.99 ± 0.52 vs. 0.15 ± 0.19 mm), as compared with the APAC cohort (all p < 0.05). Moreover, eyes from the lens subluxation cohort experienced worse BCVA, higher IOP, and shallower ACD than their matched unaffected eyes (all p < 0.05). Although longer AL, shallower ACD, and bigger ACD differences were strongly correlated with lens subluxation in a univariate logistic regression analysis, only the ACD difference remained significant in the multivariate model (p = 0.004, OR = 1,510.50). Additionally, according to the receiver operating characteristic (ROC) curve analysis, both ACD and ACD differences had greater value in the differential diagnosis of ASAC-LS and APAC, with a cut-off value of 1.4 and 0.63 mm, respectively.Conclusions:Shallower ACD and larger ACD differences provide the promising diagnostic potential for patients with ASAC-LS.

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

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

scholarly journals Polypharmacy-associated potential contraindications of drug prescriptions in patients with primary angle closure disease in a real-world setting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Fumiaki Tanaka ◽  
Naoki Shibatani ◽  
Kazumi Fujita ◽  
Hiroaki Ikesue ◽  
Satoru Yoshimizu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Japanese Patients ◽  
Median Number ◽  
Angle Closure ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Number Of Patients ◽  
Multiple Drugs

Abstract Background Primary angle closure disease (PACD) is a type of glaucoma in which the intraocular pressure (IOP) is increased because of the blockage of the anterior chamber angle. Medications contraindicated for patients with PACD, such as anticholinergics, cause mydriasis, and can elevate IOP. However, anticholinergics are currently contraindicated only for primary angle closure glaucoma (PACG) in Japanese package inserts. In this study, we investigated the prescription status of medications contraindicated for PACD, such as anticholinergics, in patients with PACD scheduled for eye surgeries. Methods Forty-three Japanese patients diagnosed with PACD at Kobe City Eye Hospital, Japan, and scheduled hospitalization for eye surgeries between December 2017 and July 2018, were included. Data, including sex, age, diagnosis, IOP, anterior chamber depth, and patients’ regular medications prior to hospitalization, were collected for each patient from the electronic medical records. Results The number of patients with chronic primary angle closure (CPAC) and acute primary angle closure (APAC) was 35 (81.4%) and 8 (18.6%), respectively. Among all the 43 patients with PACD, 8 (18.6%) received 15 medications that are potentially contraindicated for PACD by non-ophthalmologist. According to medication categories, benzodiazepine hypnotics were the most commonly prescribed. Among the 8 patients with APAC, 2 (25.0%) had routinely received medications contraindicated for PACD. The median number of all kinds of prescriptions on the day of hospitalization was significantly higher for patients who received medications contraindicated for PACD than for those who did not receive them (p = 0.010). Conclusions About 20% of patients with PACD received medications potentially contraindicated for PACD, such as anticholinergics. Attention should be paid to patients prescribed multiple drugs for adverse events, such as increase in intraocular pressure.

Comparison of the Scanning Peripheral Anterior Chamber Depth Analyzer and the Modified van Herick Grading System in the Assessment of Angle Closure

Ophthalmology ◽  
2007 ◽  
Vol 114 (3) ◽  
pp. 501-506 ◽  
Author(s):  
Mani Baskaran ◽  
Francis T.S. Oen ◽  
Yiong-Huak Chan ◽  
Sek-Tien Hoh ◽  
Ching-Lin Ho ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Chamber Depth ◽  
Angle Closure ◽  
Grading System

scholarly journals Delayed diagnosis of homocystinuria presenting as bilateral congenital lens subluxation

2017 ◽  
Vol 145 (9-10) ◽  
pp. 513-515
Author(s):  
Marija Jelic-Vukovic ◽  
Suzana Matic ◽  
Josip Barac ◽  
Tomislav Novinscak ◽  
Mirna Belovari ◽  
...  
Keyword(s):  
Intraocular Lens ◽  
Delayed Diagnosis ◽  
Vitreoretinal Surgery ◽  
Ectopia Lentis ◽  
Lens Subluxation ◽  
Ocular Manifestations ◽  
Methionine Restriction ◽  
Sulcus Fixation ◽  
Pars Plana Lensectomy ◽  
Pars Plana

Introduction. Homocystinuria is an autosomal recessively inherited defect leading to hyperhomocysteinemia and associated with ocular manifestations, mainly myopia and ectopia lentis. Case outline. A 26-year-old male with secondary glaucoma due to bilateral lens subluxation was admitted to the Department of vitreoretinal surgery. Horizontal nystagmus, bilateral lens subluxation, and bilateral amblyopia were first discovered at the age of three years. Preoperative laboratory workup revealed elevated levels of homocysteine. Bilateral pars plana lensectomy and vitrectomy followed by a sulcus fixation of the intraocular lens (ALCON MA60 Acrysof IOL) were performed. The patient was prescribed folic acid, methionine, and pyridoxine, and was urged to maintain a methionine-low diet. After a bilateral lensectomy and sulcus fixation of the intraocular lens and a methionine restriction therapy combined with vitamin B6, B9, and B12 supplementation, his condition improved greatly. Conclusion. In this report of a rare case we emphasize the importance of examining differential diagnoses of lens subluxation, since early intervention can prevent serious complications.

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