scholarly journals Potential of the Pentacam in Screening for Narrow Angles in Patients with Chronic Angle-Closure Glaucoma

2021 ◽  
Vol 18 (1) ◽  
pp. 39-44
Author(s):  
Seth Lartey ◽  
Abdul-Kabir Mohammed ◽  
Emmanuel Appiagyei ◽  
Kojo Akuffo

Background: Chronic angle-closure glaucoma (CACG) is a visually destructive disease. Effective management of CACG requires identifying eyes with narrow angle. Objective: To compare pentacam with gonioscopy in detecting narrow angles in eyes with CACG. Method: We enrolled 101 eyes with glaucoma. Gonioscopy was performed on all eyes. Using Shaffer’s grading, subjects were classified into angle closure and open angle. Anterior chamber volume (ACV) and anterior chamber depth (ACD) were measured with the pentacam. Receiver operating curve was constructed for each parameter and the area under the curve (AUC) was calculated. Results: Ten eyes (9.9%) were classified as angle closure on gonioscopy. To detect narrow angles, ACV (AUC 0.956; 95% confidence interval (CI) 0.894–0.987) performed similar to ACD (AUC=0.930, p=0.33). Using a cutoff of 102 mm3 , ACV had 100% sensitivity and 88.5% specificity for detecting narrow angles in CACG patients. With an ACV cutoff of 102 mm3 , the PPV for detecting angle closure was 48.9% (95% CI, 34.8–68.2), while the NPV was 100% (94.1– 100%), using 9.9% prevalence of angle closure from this study. Conclusion: ACV and ACD measured by the pentacam have the potential to determine narrow angles in eyes with CACG. Keywords: Chronic angle-closure glaucoma, Pentacam HR, Anterior chamber volume, Gonioscopy

2020 ◽  
pp. bjophthalmol-2020-315852
Author(s):  
Yu Jiang ◽  
Wei Wang ◽  
Lanhua Wang ◽  
Mingguang He

PurposeTo assess the association of anterior segment optical coherence tomography (AS-OCT) parameters and 5-year incident narrow angle in China.MethodsThis was a prospective cohort study of people aged 50 and older residing in Liwan District, Guangzhou, China. Random clustering sampling was used to identify adults aged 50 years and older in Liwan District, Guangzhou. In 2008 and 2013, this study was repeated and added AS-OCT imaging under dark and light conditions. Customised software (ZAAP) was used to analyse horizontal AS-OCT scans. Angle opening distance (AOD), trabecular iris space area (TISA), anterior chamber volume (ACV) and maximal iris thickness (ITM) were measured. Multiple logistic regression analysis models were used to investigate the associations of the final angle status with baseline AS-OCT parameters. ORs and 95% CIs were calculated.ResultsOf the 220 subjects with eligible AS-OCT images and gonioscopic results in 2008, the response rate was 77.3%. A total of 27 (15.9%) subjects developed narrow angles and 143 (84.1%) had open angles on gonioscopy in 2013. Subjects developed narrow angles had greater spherical equivalent and shallower anterior chamber depth, smaller angle parameters, thicker IT750 and ITM, smaller anterior chamber parameters, greater lens vault, and smaller dynamic parameters (ΔITM, ΔACA, ΔACV) at baseline. After adjusting confounders, the predictors of incident narrow angles included smaller AOD750, TISA750, ΔACA and greater ITM, ΔIarea.ConclusionsIncident narrow angles were associated with smaller anterior ocular dimensions, thicker iris and smaller light-to-dark changes at baseline. These findings can help in early diagnosis in this population.


2016 ◽  
Vol 236 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Hussam El Chehab ◽  
Emilie Agard ◽  
Aurélie Russo ◽  
Ygal Boujnah ◽  
Corinne Dot

The objective of this study was to assess the intraocular pressure (IOP) as well as the anatomical modifications of the anterior segment following an aflibercept injection. Patients underwent an aflibercept intravitreal injection (IVI) (0.05 ml) with a 30.5-gauge needle and an antireflux system. IOP was assessed before injection (T0), immediately after (T1), and 5 min (T5), 15 min (T15), and 45 min (T45) after the IVI. Before the IVI and immediately after the T1 measurement, a PENTACAM® acquisition was used to evaluate the anterior chamber parameters (anterior chamber volume, depth and measure of the iridocorneal angle). At T0, IOP was 12.9 ± 1.3 mm Hg. IOP significantly increased after IVI (42.7 ± 3 mm Hg, p < 0.001). IOP returned to baseline at T45 (13.0 ± 1.2 mm Hg, p = 0.877). Anterior chamber volume decreased after IVI (160.6 vs. 168.3 mm3, p = 0.002). No significant changes were found for iridocorneal angle and anterior chamber depth. Aflibercept IVI causes an acute increase in IOP over a short period without iridocorneal angle closure.


PLoS Genetics ◽  
2014 ◽  
Vol 10 (3) ◽  
pp. e1004089 ◽  
Author(s):  
Monisha E. Nongpiur ◽  
Chiea Chuen Khor ◽  
Hongyan Jia ◽  
Belinda K. Cornes ◽  
Li-Jia Chen ◽  
...  

2020 ◽  
Vol 11 (1) ◽  
pp. 60-67
Author(s):  
Yukihisa  Takada ◽  
Takayoshi Sumioka ◽  
Nobuyuki Ishikawa ◽  
Shingo Yasuda ◽  
Ryoko Komori ◽  
...  

We observed repeated episodes of rapid increases in intraocular pressure (IOP) considered to be caused by an in-the-bag intraocular lens (IOL) instability in a patient with an implanted IOL. As acute glaucoma attack-like increase in IOP was noted in the left eye on November 8, she was admitted to Wakayama Medical University Hospital. The findings at the first examination included an IOP of 62 mm Hg, instability of a PMMA one-piece IOL, shallow anterior chamber, narrow angle, moderate mydriasis, and loss of pupillary light reaction in the left avitreous eye. On November 15, a 6-mm Hg increase in IOP was observed during 60-min dark room prone provocative testing. After the first examination, the patient perceived pain and reduced visual acuity of the left eye and emergently consulted our hospital twice. Despite miosis, normalization of the anterior chamber depth and IOP with widening of the angle were achieved by resting in the supine position. These episodes were thought to be caused by instability and anterior shift of the IOL. On January 17, 2018, suture fixation of the in-the-bag IOL was performed. The IOL was fixed by transscleral suturing of the bilateral supporting parts to the sclera. Recurrence of sudden ophthalmalgia, instability of the in-the-bag IOL, and an increase in IOP have not been observed for 1 year after surgical treatment. Instability of an in-the-bag IOL caused repeated acute angle-closure glaucoma-like attacks. The situation was well treated by suturing and fixing the haptics of IOL to the sclera.


Author(s):  
N.V. Samokhvalov ◽  
◽  
E.L. Sorokin ◽  
A.N. Marchenko ◽  
Y.E. Pashentsev ◽  
...  

Important physiological feature of the anatomically «short» eye is the disproportionately large volume of the lens relative to the volume of the eye. A gradual and continuous increase in the volume of the lens contributes to the anterior displacement of the irido-lenticular diaphragm, causing the functional block of the anterior chamber angle. This leads to persistent disorders of the hydrodynamics of the eye, up to the development of an acute attack of angle-closure glaucoma. Purpose. To study incidence of increased risk formation of primary angle-closure glaucoma (PACG) and its acute attack in young patients with moderate and high hyperopia (Hm). Material and methods. Clinical material was presented by 58 patients (116 eyes) with indicators of axial length of the eyes less than 23 mm. The main group consisted of 33 patients (66 eyes) with moderate and high Hm. The comparison group was represented by 25 patients (50 eyes) with PACG. Results. The study made it possible to identify group of increased risk of the formation of PACG, which included 19 people (58%), from selected general population of young patients with moderate and high Hm. Conclusion. Comparative analysis of morphometric parameters of structures of the anterior segment of the anatomically «short» eyes in young patients with moderate and high Hm, on the one hand, and in patients with PACG, on the other, revealed statistically significant differences between them in the anterior chamber depth in the central zone, the thickness of the lens, the anterior chamber volume, the peripheral anterior chamber depth, of the anterior chamber angle. Key words: primary angle-closure glaucoma, acute attack of angle-closure glaucoma, hyperopia, refractive surgery.


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