scholarly journals Role of Anterior Segment OCT in the Management of Primary Narrow Angle Disease

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Javeria Muid ◽  
Sadia Farooq
Keyword(s):  
Anterior Segment ◽  
Case Series ◽  
Sampling Technique ◽  
Angle Closure ◽  
Definitive Treatment ◽  
Disease Treatment ◽  
Anterior Segment Oct ◽  
Lens Extraction ◽  
Narrow Angle

Purpose:  To highlight the role of anterior segment OCT, in complementing gonioscopic findings in the management of angle closure glaucoma. Study Design:  Descriptive observational case series. Study Place and Duration:  Study was conducted at Eye department of Shifa International Hospital, from January 2019 to March 2019. Methods:  After taking informed consent from the patients, the study was conducted at Shifa International Hospital Islamabad. Patients were selected by convenient sampling technique. Patients were diagnosed on the basis of history and clinical examination. Patients with angle closure on Gonioscopy were included in this series. Detailed ocular examination including visual acuity for distance and near, tonometry, Gonioscopy and anterior segment OCT were performed. Data was collected and presented as case series. Results:  The median age 57 years with 50% more than 60 years and 50% less than 60 years of age. Presenting IOP was less than 21 mmHg in 50% and higher in remaining 50%. On examination 37.5% were categorized as PACS, 12.5% having PAC and 50% as PACG. After definitive treatment 12.5% still needed medical treatment to prevent progression in PACG and none in PACS and PAC. Conclusion:  In narrow angle disease, treatment is designed not only to control intraocular pressure (IOP) but also to keep angle open as much as possible. Appositional closure or peripheral anterior synechiae (PAS) can damage the trabecluar meshwork. Iridoplasty, peripheral Iridotomy (PI) and early lens extraction can defer the need for filtration procedure if done well in time. Key Words:  OCT anterior segment, Narrow angle, Optic nerve head.

scholarly journals Glaucomatocyclitic Crises May Occur in Patients with Narrow or Closed Angles

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Pei-Kang Liu ◽  
Han-Yi Tseng ◽  
Min-Yu Huang ◽  
Kwou-Yeung Wu
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Case Series ◽  
Field Tests ◽  
University Hospital ◽  
Angle Closure ◽  
Narrow Angle ◽  
Grade Ii ◽  
Medical University ◽  
Glaucomatocyclitic Crisis

Purpose. To report cases of glaucomatocyclitic crises and discuss the possibility of occurrence in patients with narrow or closed angles. Background. The prevalence of angle closure is much higher among Asians than among the Western population. Currently, there is no evidence for a direct relationship between the etiology and angle structure. Design. A retrospective and observational case series. Methods. We retrospectively collected data from nine adult patients (three males and six females) who were diagnosed with a glaucomatocyclitic crisis and a shallow anterior chamber over a 21-year period, from 1995 to 2016, at the Kaohsiung Medical University Hospital. A narrow angle was defined as a grade less than the Shaffer system grade II. Ophthalmic examinations, including anterior segment biomicroscopy, direct ophthalmoscopy, intraocular pressure measurements, anterior chamber reaction, visual field tests, and the grade of the anterior chamber angle according to the Shaffer system, were reviewed. Results. These patients experienced at least one typical unilateral ocular hypertensive episode that fulfilled the criteria of a glaucomatocyclitic crisis without the angle feature. All patients had gonioscopically narrow or closed angles with or without peripheral anterior synechiae. Conclusions. The coexistence of narrow or closed angles and a glaucomatocyclitic crisis is possible, especially in patients of Asian descent. In patients with shallow anterior chambers, a glaucomatocyclitic crisis may be a cause of acute glaucoma episodes.

scholarly journals Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study

2021 ◽  
Author(s):  
Feng Gao ◽  
Jiajian Wang ◽  
Junyi Chen ◽  
Xiaolei Wang ◽  
Yuhong Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Anterior Segment ◽  
Young Patients ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Uncommon Presentation ◽  
Underlying Causes

Abstract Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.

scholarly journals Managing Primary Angle Closure Glaucoma – The Role of Lens Extraction in this Era

2016 ◽  
Vol 10 (1) ◽  
pp. 86-93 ◽  
Author(s):  
Nafees Baig ◽  
Ka-Wai Kam ◽  
Clement C.Y. Tham
Keyword(s):  
Gold Standard ◽  
Open Angle Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Predisposing Factor ◽  
Lens Extraction ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Anterior Position

Trabeculectomy has been the gold standard in reducing intraocular pressure (IOP) in glaucoma patients, no matter it is angle closure or open angle glaucoma. However in primary angle closure glaucoma, no matter the lens is cataractous or not, it is likely to be pathological, this thicker than usual lens, with or without a more anterior position, is often regarded as a strong contributing factor to angle closure. Lens extraction, no matter it is cataractous or clear, can theoretically eliminate this anatomical predisposing factor of angle closure, and thus IOP can be reduced. Based on recent results of a number of clinical trials, lens extraction alone or in combination with other IOP-lowering surgeries, may therefore play a more important role in the treating primary angle closure glaucoma. In cases when greater IOP-lowering effect is needed or if drug dependency has to be minimized, combined procedures, such as phacotrabeculectomy, can be considered, but the surgical risk can be higher than lens extraction alone.

Anterior Segment OCT in Primary Angle Closure Compared to Normal Subjects with Similar Shallow Anterior Chamber

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Qinghong Xie ◽  
Ping Ma ◽  
Jutima Patlidanon ◽  
Murtaza Saifee ◽  
Sean Yonamine ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Anterior Segment ◽  
Normal Subjects ◽  
Angle Closure ◽  
Anterior Segment Oct ◽  
Primary Angle Closure ◽  
Shallow Anterior Chamber

Role of Lens Extraction in Primary Angle Closure Disease

2011 ◽  
Vol 5 ◽  
pp. 20-25
Author(s):  
Anubha Rathi ◽  
Reetika Sharma ◽  
Bhaskar Jha ◽  
Shibal Bhartiya ◽  
Anita Panda
Keyword(s):  
Angle Closure ◽  
Lens Extraction ◽  
Primary Angle Closure

scholarly journals Optical Coherence Tomography Reveals New Insights into the Accommodation Mechanism

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mahmoud Mohamed Farouk ◽  
Takeshi Naito ◽  
Kayo Shinomiya ◽  
Hiroshi Eguchi ◽  
Khulood Mohammed Sayed ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Outcome Measures ◽  
Anterior Segment ◽  
Case Series ◽  
Optical Coherence ◽  
Anterior Pole ◽  
Forward Movement ◽  
Anterior Segment Oct ◽  
Lens Thickness ◽  
Significant Difference

Purpose. To evaluate the movement of the anterior and posterior lens poles during naturally stimulated accommodation in children using anterior segment optical coherence tomography (OCT).Methods. This is a prospective, observational, noncomparative case series including 18 eyes of nine children. Analysis of the anterior segment in the accommodated and unaccommodated state (with cycloplegia) was done using anterior segment OCT. The main outcome measures were the position of the anterior and posterior lens poles (in relation to the cornea) and lens thickness (LT).Results. A Statistically significant forward movement of the anterior lens pole and backward movement of the posterior lens pole with an increase in LT were found during accommodation (P<0.001). There was no significant difference between the degree of movement of the anterior lens pole and the posterior lens pole during accommodation (P=0.944).Conclusions. Anterior segment OCT provides a rapid noncontact method for studying accommodation in children. The backward movement of the posterior lens pole during accommodation nearly equals the forward movement of its anterior pole. These data minimize the theoretical hydraulic effect of the vitreous during accommodation, adding more support to the capsular theory of Helmholtz.

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