scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

scholarly journals Iridoplasty for plateau iris syndrome: a systematic review

2019 ◽  
Vol 4 (1) ◽  
pp. e000340
Author(s):  
Hugo Bourdon ◽  
Vittoria Aragno ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Systematic Review ◽  
Intraocular Pressure ◽  
Retrospective Studies ◽  
Scientific Evidence ◽  
Argon Laser ◽  
Angle Closure ◽  
Current Evidence ◽  
Iridocorneal Angle

Plateau iris syndrome (PIS) is a frequent cause of angle closure. Argon laser peripheral iridoplasty (ALPI) has been proposed in PIS to widen the iridocorneal angle. The objective of the present study was to perform a systematic review of the available studies evaluating the efficacy of ALPI on intraocular pressure (IOP), iridocorneal angle opening and the number of medications in patients with chronic angle-closure associated with PIS. One prospective and seven retrospective studies with a minimum 1 month of follow-up were included. Although ALPI seemed to lower IOP, to decrease the number of topical antiglaucoma medications and widen the iridocorneal angle shortly after the procedure, there is no current evidence of long-term efficacy. To date, there is no robust scientific evidence to advocate ALPI as a treatment for chronic angle-closure caused by PIS.

scholarly journals Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study

2017 ◽  
Vol 11 (3) ◽  
pp. 113-119 ◽  
Author(s):  
Joobin Hooshmand ◽  
James CY Leong ◽  
Jeremy O'Connor ◽  
Ghee S Ang ◽  
Anthony P Wells
Keyword(s):  
Optical Coherence Tomography ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Final Visit ◽  
Optical Coherence ◽  
Medium Term ◽  
Primary Angle Closure

ABSTRACT Aim To evaluate by anterior segment optical coherence tomography (AS-OCT) the medium-term (mean duration 3.2 years) anatomical changes in the anterior chamber angle (ACA) after laser peripheral iridoplasty. Materials and methods This is a longitudinal, retrospective case series of 31 eyes of 31 patients with primary angle-closure suspicion, primary angle closure (PAC), or primary angle-closure glaucoma (PACG) who underwent laser peripheral iridoplasty. All patients had persistent iridotrabecular contact (ITC) despite the presence of a patent peripheral iridotomy (PI). An AS-OCT was performed in dark conditions before and after laser iridoplasty. Quadrants of ITC, intraocular pressure (IOP), and the AS-OCT parameters of the temporal and nasal ACAs were measured and analyzed. Results Prior to iridoplasty, the average number of quadrants of ITC was 3.3. At the first postiridoplasty visit (mean duration 6.8 weeks), this reduced to 1.7 quadrants but increased to 1.9 by the final follow-up visit (mean duration 3.2 years). Twenty-five patients (80.1%) had less ITC at the first postlaser visit increasing to 27 (87.1%) patients by the final visit. Two (6.5%) required a second iridoplasty, while 3 (9.7%) required cataract surgery. All parameters of angle width showed a statistically significant increase in magnitude. All patients maintained IOP ≤ 21 mm Hg throughout the follow-up period. Conclusion Iridoplasty is a useful adjunct in widening the ACA, particularly in those with persistent angle closure after iridotomy but with no cataract. While not successful in all patients, it can act as a temporizing measure to widen the drainage angle until such time that cataract surgery can be performed. Clinical significance Laser peripheral iridoplasty can be used as an adjunct in angle-closure glaucoma patients with no cataract. How to cite this article Hooshmand J, Leong JCY, O'Connor J, Ang GS, Wells AP. Medium-term Anatomical Results of Laser Peripheral Iridoplasty: An Anterior Segment Optical Coherence Tomography Study. J Curr Glaucoma Pract 2017;11(3):113-119.

Anterior segment optical coherence tomography angle and vault analysis after toric and non-toric implantable collamer lens V4c implantation in patients with high myopia

2017 ◽  
Vol 102 (4) ◽  
pp. 544-548 ◽  
Author(s):  
Guillermo Garcia-De la Rosa ◽  
Andrew Olivo-Payne ◽  
Juan Carlos Serna-Ojeda ◽  
Maria Sandra Salazar-Ramos ◽  
Alejandro Lichtinger ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
High Myopia ◽  
Anterior Segment ◽  
Case Series ◽  
Optical Coherence ◽  
Implantable Collamer Lens ◽  
Iridocorneal Angle ◽  
Lighting Conditions ◽  
Icl V4c

ObjectiveTo assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions.MethodsLongitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up.ResultsSeventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001).ConclusionThere is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.

scholarly journals The mechanism of intraocular pressure rise after keratoplasty

2021 ◽  
Vol 8 (2) ◽  
pp. 114-123
Author(s):  
Diana Wyroślak-Bednarek ◽  
Zofia Pniakowska ◽  
Piotr Jurowski
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Observation ◽  
Anterior Segment ◽  
Pressure Rise ◽  
Lamellar Keratoplasty ◽  
Optical Coherence ◽  
Pupillary Block ◽  
Iridocorneal Angle ◽  
Corneal Grafting

Purpose: To determine the pathomechanism of increased intraocular pressure after penetrating and lamellar keratoplasty based on clinical observation and literature data. Materials and methods: Morphometric analysis of the anterior segment of the eye using spectroscopic optical coherence tomography, gonioscopy and biomicroscopy. Results: Pre- and postoperative spectroscopic optical coherence tomography scans in patients after keratoplasty reveal deformation of the peripheral cornea, narrowing of the iridocorneal angle, presence of anterior synechiae and various types of pupillary block. Conclusions: The mechanism of elevated intraocular pressure after corneal grafting is complex and depends on pre-, intra- and postoperative factors, such as anatomy changes of the iridocorneal angle, presence of anterior synechiae, as well as anterior and posterior pupillary block. Spectroscopic optical coherence tomography plays an important role in diagnosis and further treatment management.

Morphological analysis of functional filtering blebs with anterior segment optical coherence tomography: A short-term prediction for success of trabeculectomy

2020 ◽  
pp. 112067212092434
Author(s):  
Anuradha Raj ◽  
Harsh Bahadur
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Negative Correlation ◽  
Anterior Segment ◽  
Significant Negative Correlation ◽  
Optical Coherence ◽  
Short Term ◽  
Cross Sectional ◽  
Short Term Prediction

Purpose The aim of the study was to analyze morphological parameters of apparently functional filtering blebs with anterior segment optical coherence tomography at 1 month post trabeculectomy and to correlate these parameters with intraocular pressure at 6 months of follow-up to predict the short-term success of trabeculectomy. Methods In this cross-sectional, descriptive study, apparently functional blebs were evaluated using anterior segment optical coherence tomography with crossline scans after 1 month of trabeculectomy. Results A total of 55 eyes of 55 cases with mean age 49.29 ± 13.72 years were included in the study. On anterior segment optical coherence tomography examination, the mean bleb height and mean bleb wall thickness, subconjunctival fluid space, and scleral flap thickness were 1.45 ± 0.39 mm, 0.63 ± 0.25 mm, 0.64 ± 0.26 mm, and 0.45 ± 0.068 mm, respectively. There was statistically significant negative correlation between intraocular pressure at 1 month and bleb height ( r = −0.25, p = 0.05). There was statistically significant negative correlation between extent of cavity and intraocular pressure at 6 months ( r = −0.318, p = 0.018). Bleb height showed significant negative correlation with supra-scleral space ( r = −0.31, p = 0.02). Multi reflective bleb walls showed statistically significant increased chances of successful functioning blebs at 6 months as compared to uniform wall reflectivity ( p = 0.00). Bleb function was successful in 37 (67.3%) and unsuccessful in 18 (32.7%) in short term of 6 months of follow-up. Conclusion Bleb walls with multiform wall reflectivity on anterior segment optical coherence tomography at 1 month post trabeculectomy show increased chances of success of functioning filtering bleb at 6 months. Bleb wall characteristics on anterior segment optical coherence tomography at 1 month can predict the short-term success of blebs at 6 months.

Phacoemulsification, visco-goniosynechialysis, and goniotomy in patients with primary angle-closure glaucoma: A comparative study

2019 ◽  
pp. 112067211987933 ◽  
Author(s):  
Saeed Shokoohi-Rad ◽  
Farshid Karimi ◽  
Siamak Zarei-Ghanavati ◽  
Hossein Tireh
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Optical Coherence ◽  
Antiglaucoma Medication ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
The Difference

Objective: The aim of this study was to evaluate the effects of goniotomy on patients with primary angle-closure glaucoma who underwent “phacoemulsification and visco-goniosynechialysis.” Materials and methods: This prospective randomized clinical trial was carried out on 63 eyes of 61 patients (48–85 years) with primary angle-closure glaucoma who were enrolled. The subjects were randomly assigned into two groups. In the first group (32 eyes) and the second group (31 eyes), the patients underwent “phacoemulsification + visco-goniosynechialysis + goniotomy” and “phacoemulsification + visco-goniosynechialysis,” respectively. Intraocular pressure and antiglaucoma medication were evaluated (1 week, as well as 1, 3, and 6 months after the surgery). Anterior segment optical coherence tomography parameters (Casia, Tomey, USA) and goniotomy were evaluated preoperatively and 6 months after the surgery. Results: The mean intraocular pressure lowering the effects in the “phacoemulsification + visco-goniosynechialysis + goniotomy” group was higher than that in the “phacoemulsification + visco-goniosynechialysis” group (6.93 and 4.6, respectively). Furthermore, the difference in intraocular pressure between the two groups was significant at 3 months (P = 0.014) and 6 months (P = 0.021) after the surgery. There was no difference in anterior segment optical coherence tomography findings before the intervention; however, after the intervention, the anterior segment optical coherence tomography indices were significantly different between the two groups. Moreover, the difference in “phacoemulsification + visco-goniosynechialysis + goniotomy” indices was more than the changes in the “phacoemulsification + visco-goniosynechialysis” group. Conclusion: The results of this study showed that phacoemulsification + visco-goniosynechialysis + goniotomy is a more effective surgery than phacoemulsification + visco-goniosynechialysis alone in undercounted primary angle-closure glaucoma.

Spontaneous attachment of complex Descemet’s membrane detachment following multiple failed interventions

2021 ◽  
Vol 14 (8) ◽  
pp. e243960
Author(s):  
Shikha Gupta ◽  
Karthikeyan Mahalingam ◽  
Tushar Agarwal
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Corneal Transplant ◽  
Optical Coherence ◽  
Initial Attempt ◽  
Ocular Tissues ◽  
Surgical Interventions ◽  
Complicated Cataract ◽  
First Time

We describe a case with complex Descemet membrane detachment (DMD) which persisted despite initial two failed surgical attempts to appose the ocular tissues. However, over time, tissue alignment was obtained spontaneously. A 60-year-old woman, operated trabeculectomy, had a total DMD intraoperatively during a complicated cataract surgery. Initial attempt to DM repositioning with intracameral air injection failed. Anterior Segment Optical Coherence Tomography (ASOCT) showed detachment of both DM and pre-Descemet’s layer (PDL). After consultation with a corneal surgeon, patient was again attempted for Intra-operative Optical Coherence Tomography (iOCT)-guided settlement of DMD with intracameral air which again failed. So, the patient was registered for lamellar corneal transplant, but at 3 months follow-up, DM had spontaneously attached, confirmed on ASOCT. This case shows for the first time that even complex DMDs involving PDL, can spontaneously appose despite failed surgical interventions.

scholarly journals Age-Related Changes in the Rhesus Macaque Eye

2021 ◽  
Author(s):  
Kira Lin ◽  
Tu Tran ◽  
Soohyun Kim ◽  
Sangwan Park ◽  
Jiajia Chen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Rhesus Macaque ◽  
Axial Length ◽  
Rhesus Macaques ◽  
Anterior Segment ◽  
Optical Coherence ◽  
Lens Thickness ◽  
Age Related ◽  
Age Related Changes

Purpose: To assess age-related changes in the rhesus macaque eye and evaluate them to corresponding human age-related eye disease. Methods: Data from eye exams and imaging tests including intraocular pressure (IOP), lens thickness, axial length, and retinal optical coherence tomography (OCT) images were evaluated from 142 individuals and statistically analyzed for age-related changes. Quantitative autofluorescence (qAF) was measured as was the presence of macular lesions as related to age. Results: Ages of the 142 rhesus macaques ranged from 0.7 to 29 years (mean=16.4 years, stdev=7.5 years). Anterior segment measurements such as IOP, lens thickness, and axial length were acquired. Advanced retinal imaging in the form of optical coherence tomography and qAF were obtained. Quantitative assessments were made and variations by age groups were analyzed to compare with established age-related changes in human eyes. Quantitative analysis of data revealed age-related increase in intraocular pressure, ocular biometry (lens thickness and axial length), and presence of macular lesions. Age-related changes in thicknesses of retinal layers on OCT were observed and quantified. Age was correlated with increased qAF. Conclusions: The rhesus macaque has age-related ocular changes similar to humans. IOP increases with age while retinal ganglion cell layer thickness decreases. Macular lesions develop in some aged animals. Our findings support the concept that rhesus macaques may be useful for the study of important age-related diseases such as glaucoma, macular diseases, and cone disorders, and for development of therapies for these diseases.

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