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Changes in anterior segment morphology after laser peripheral iridotomy: an anterior segment optical coherence tomography study.

Abstract：

PURPOSE:Novel anterior segment optical coherence tomography (ASOCT) parameters associated with angle closure include anterior chamber area (ACA), anterior chamber volume (ACV), anterior chamber width (ACW), lens vault (LV), iris thickness (IT), iris area (I-area), and iris curvature (I-curv). We aimed to investigate changes in these parameters after laser peripheral iridotomy (LPI) in a cohort of primary angle-closure suspects (PACS). DESIGN:Prospective observational study. PARTICIPANTS AND CONTROLS:A total of 176 PACS aged ≥ 50 years who underwent LPI in 1 eye. METHODS:We analyzed ASOCT images (Visante, Carl Zeiss Meditec, Dublin, CA) from all subjects using customized software before and 1 week after LPI. Multivariate linear regression analysis was performed for predictors of percentage change in mean angle opening distance (AOD750). MAIN OUTCOME MEASURES:Change in ASOCT parameters after LPI. RESULTS:The mean age of participants was 63 ± 7.3 years. The majority of subjects were Chinese (95.5%) and women (76.7%). Mean angle width (modified Shaffer grade) changed from 0.68 ± 0.54 at baseline to 1.76±0.69 after LPI (P<0.001) with a corresponding increase in mean AOD500 (0.12 vs. 0.19 mm, P<0.001), trabecular iris surface area (TISA500, 0.06 vs. 0.08 mm(2), P<0.001), and angle recess area (ARA, 0.13 vs. 0.17 mm(2), P<0.001). Mean ACA (15.0 vs. 16.0 mm(2), P<0.001) and ACV (91.6 vs. 103.0 mm(3), P<0.001) increased significantly after LPI, but there was no change in ACW, anterior chamber depth (ACD), or LV. Mean I-curv was reduced (0.375 vs. 0.18 mm, P<0.001) after LPI, but there was no significant change in IT or I-area. After multivariate analysis, mean LV (β = 0.286, P = 0.001), mean IT at 2000 μm (IT2000, β = 0.172, P = 0.034), and intraocular pressure (β = 0.159, P = 0.042) at baseline were found to be associated with ΔAOD750. CONCLUSIONS:This study confirms that LPI results in a significant increase in the angle width in PACS. The ACA and ACV increased after LPI, but there was no change in ACD, ACW, LV, IT, or I-area. The increase in ACA/ACV was mainly due to decreased I-curv after LPI.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

How AC,Baskaran M,Kumar RS,He M,Foster PJ,Lavanya R,Wong HT,Chew PT,Friedman DS,Aung T

doi

10.1016/j.ophtha.2012.01.019

subject

Has Abstract

pub_date

2012-07-01 00:00:00

pages

1383-7

issue

7

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(12)00044-9

journal_volume

119

pub_type

杂志文章,多中心研究,随机对照试验

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