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AIM: To explore the clinical application value of analysis system for ultrasound biomicroscopy(UBM)images of anterior chamber angle(ACA)based on deep learning algorithm.METHODS: A total of 4 196 UBM images were obtained from 675 patients(1 130 eyes)at the Eye Center of Renmin Hospital of Wuhan University from January 2021 to June 2022 were collected to build an image dataset. Using Unet++network to automatically segment ACA tissue, a support vector machine(SVM)algorithm was developed to automatically classify opening and closing of chamber angle, and an algorithm to automatically locate the sclera spur and measure ACA parameters was developed. Furthermore, a total of 631 UBM images of 127 subjects(221 eyes)at Huangshi Aier Eye Hospital and 594 UBM images of 188 subjects(257 eyes)at Zhongnan Hospital of Wuhan University were selected to evaluate the performance of the system under different environments.RESULTS: The accuracy of the analysis system constructed in this study for chamber angle opening and closing was 95.71%. The intra-class correlation coefficient(ICC)values of all ACA angle parameters were greater than 0.960. ICC values of all ACA thickness parameters were greater than 0.884. The accurate measurement of ACA parameters depended in part on the accurate location of the scleral spur.CONCLUSION: The intelligent analysis system constructed in this study can accurately and effectively evaluate ACA images automatically and is a potential screening tool for the rapid identification of ACA structures.
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Purpose: To correlate and analyze the pattern of the visual field (VF) defects by perimetry and anterior chamber angle parameters by AS-OCT in primary angle-closure glaucoma (PACG) across varied severity levels on presentation to a tertiary eye care center. Methods: This was a cross-sectional study, which included 323 eyes of clinically diagnosed cases of PACG. Glaucoma severity was categorized according to mean deviation (MD) as mild (-6.00 dB or more), moderate (-6.01 to -12.00 dB), and severe (-12.01 to -30.00 dB). AS-OCT measured the nasal (N) and temporal (T) angle opening distance at 500 ?m (AOD 500) and 750 ?m (AOD 750), anterior chamber angle (ACA), lens vault (LV), and anterior chamber width (ACW). The VF severity was then correlated with the AS-OCT parameters using statistical analysis. Results: The mean age ± standard deviation (SD) of the patients included in the study was 56.03 ± 8.6 years, with a 1:1.2 gender ratio. The number of eyes with mild, moderate, and severe VFs were 140 (43.3%), 88 (27.24%), and 95 (29.41%), respectively. There was no statistically significant correlation in the mean anterior chamber angle parameters (AOD 500, AOD 750, ACA 500, ACA 750, LV, ACW, and axial length (AL)) among the groups. However, the correlation between AOD 500 and LV thickness was found to be significant (P = 0.0000) with a negative Spearman’s rank correlation coefficient (r = -0.3329). Conclusion: The ACA parameters obtained by AS-OCT along the horizontal axis after elimination of pupillary block by laser peripheral iridotomy do not correlate and cannot be used to assess the disease severity of PACG
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Purpose: To assess anterior chamber configuration changes during phacoemulsification in primary angle?closure suspect (PACS/PAC) and primary open?angle glaucoma (POAG). Methods: Prospective observational comparative study of anterior segment optical coherence tomography (AS?OCT) findings before and after phacoemulsification on three groups of patients (PACS/PAC, POAG, and controls). Data were collected over a period of 9 months. Main outcome measures included mean change in anterior chamber depth (ACD), angle opening distance (AOD), and trabecular iris space area (TISA). Results: 153 patients (51 PACS/PAC, 51 POAG, and 51 controls) were included in the study. Change in all parameters (ACD, AOD at 500 um, and AOD at 750 um) between the groups demonstrated a greater change in PACS/PAC as compared to POAG and controls. AOD at 750 ?m in the temporal quadrant, which has been considered to be having the highest correlation or best representation of the angle, increased in all groups after phacoemulsification (463.59 ± 10.99 vs. 656.27 ± 9.73 mm in PACS; 521.29 ± 16.36 vs. 674.37 ± 8.72 mm in POAG; 549.27 ± 12.40 vs. 702.82 ± 13.04 mm in controls, (P < 0.001). After phacoemulsification, intraocular pressure (IOP) decreased by 2.75 ± 1.17 mm Hg in PACS/PAC (P < 0.001), 2.14 ± 1.33 mm Hg in POAG and 1.90 ± 1.25 mm Hg in controls and it was statistically significant in the PACS group compared to control (P < 0.001). Conclusion: Phacoemulsification with intraocular lens implantation is associated with increase in the ACD and angle parameters and a corresponding decrease in IOP. Findings were more pronounced in PACS/PAC suggesting early phacoemulsification may be a treatment option in this group
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Purpose: To compare the quantitative measurements of the anterior chamber angle (ACA) and iris parameters in patients with juvenile open?angle glaucoma (JOAG), pigmentary glaucoma (PG), and healthy controls using anterior segment optical coherence tomography (AS?OCT). Methods: This was a retrospective, cross?sectional study of 25 eyes with JOAG, 25 eyes with PG, and 25 control eyes. Anterior chamber depth, angle?opening distance 500 and 750, trabecular–iris space 500 and 750, scleral spur angle, iris thickness (IT, measured at the thickest part), and iris bowing were obtained using AS?OCT (Visante” OCT 3.0 Model 1000, Carl Zeiss Meditec, Inc). Results: The quantitative ACA parameters were found to be significantly higher in JOAG and PG patients compared to healthy controls (P < 0.001); there was no significant difference between the eyes with JOAG and PG (P > 0.05). In eyes with JOAG and PG, there was significantly backward bowing of the iris in temporal and nasal angles compared to control subjects (P < 0.001). Median iris bowing was not significantly different between the patients with JOAG and PG (P > 0.05). The temporal and nasal angle iris thickness were significantly thinner in eyes with JOAG than the eyes with PG (P < 0.001) and age?matched control subjects (P < 0.001). The median IT did not differ between the patients with PG and control subjects (P > 0.05). In patients with JOAG, the intraocular pressure (IOP) was inversely correlated with IT (r = ?0.43, P < 0.05). Conclusion: AS?OCT provided quantitative data on the ACA and iris parameters in JOAG and PG. The evaluation of the ACA and iris structures using AS?OCT revealed higher ACA measurements and posterior bowing of the iris in patients with JOAG and PG. Furthermore, the patients with JOAG were found to have thinner IT than the ones with PG and healthy controls
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@#AIM: To compare the change of anterior chamber angle(ACA)and vault value before and after implantable collamer lens(ICL)in two implant positions.<p>METHODS: Randomized controlled study. A total of 83 patients(154 eyes)underwent ICL(V4c, 12.6mm)surgery from 2018 to 2019 were enrolled and divided into two randomly, including into horizontal group(79 eyes)and into vertical group(75 eyes). Pentacam was used to measure the ACA at 0°, 90°, 180°, 270° points before and after implantation and the ACA changes were calculated.<p>RESULTS: After 12mo, the changes of ACA at 0°, 90°, 180°, 270° position were 15.3°±6.1°, 13.9°±6.3°, 16.5°±5.5° and 12.9°±6.0° in horizontal group while 12.9°±3.7°, 14.5°±6.8°, 14.3°±5.4° and 13.2°±5.9° in vertical group. There was a significant difference in ACA change at 0°-180° position between the two groups(<i>P</i><0.05). The vault value was 486±183μm, 422±203μm, 393±198μm and 345±165μm in the horizontal group and 432±163μm, 418±138μm, 379±133μm and 328±142μm in the vertical group at 1, 3, 6 and 12mo respectively. The vault value of the horizontal group at 1mo was significantly different from that at 6mo and 12mo after implantation(<i>P</i>>0.05). The vault value of the vertical group at 1mo was significantly different from that at 6mo and 12mo after implantation(<i>P</i><0.05).<p>CONCLUSION: During one year after ICL implantation, the ACA changes significantly in horizontal setting than in vertical setting at 0° to 180° points and there is a dynamic decreasing change in vault value.
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@#AIM: To observe the changes of anterior chamber angle after posterior chamber intraocular lens(ICL)V4c implantation for high myopia.<p>METHODS: Prospective study. ICL V4c implantation was performed on 150 cases(300 eyes)with high myopia, and the changes of visual acuity, intraocular pressure,vault and anterior chamber angle were recorded before and 1d, 1mo, 3mo, 6mo and 1a after operation. Repeated measurement analysis of variance and LSD-<i>t</i> test were used to analyze the data.<p>RESULTS: After 1d, 1mo, 3mo, 6mo, 1a operation, the recovery of UCVA was significantly higher than that before operation(<i>F</i>=98.2, <i>P</i><0.01); there were statistically significant differences in AOD500, AOD750, TISA500, TISA750 and SSA of nasal side before and after operation(<i>F</i>=108.256, 112.342, 164.856, 316.549, 115.338, <i>P</i><0.01); there were statistically significant differences in AOD500, AOD750, TISA500, TISA750 and SSA of temporal side before and after operation(<i>F</i>=102.68, 548.47, 93.37, 316.549, 117.698, all <i>P</i><0.01); the parameters of each angle decreased gradually in the 1d, 1mo and 3mo after operation on both sides, and there was statistical difference in the two comparisons(all <i>P</i><0.05), but there was no statistical significance in the parameters of each angle in the 3mo, 6mo and 1a after operation(all <i>P</i>>0.05).<p>CONCLUSION: After ICL V4c implantation, the anterior chamber angle parameters in the horizontal direction of 1d, 1mo, 3mo, 6mo and 1a were smaller than those before operation, and tended to be stable after 3mo.
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Objective@#To investigate the changes of anterior chamber profiles after small incision lenticule extraction(SMILE) and analyze the possible influencing factors.@*Methods@#A case observation study was designed.Thirty-one patients(59 eyes) with myopia and myopic astigmatism who underwent SMILE surgery at the Refractive Surgery Center of Tianjin Eye Hospital from April to December 2015 were enrolled and examined preoperatively and at 1 month, 3 and 6 months postoperatively.The anterior chamber profiles, including anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) were measured using the Pentacam.The correlations between parameters were analyzed and the differences of the parameters at different time points were compared.This study followed the Declaration of Helsinki.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital (No.TJYYLL-2015-20). Written informed consent was obtained from each subject before the operation.@*Results@#Compared with pre-operation, the central corneal thickness (CCT) was significantly decreased at 1 month, 3 and 6 months postoperatively (all at P<0.05). Three months after surgery, the CCT was significantly higher than that at one month after surgery (P<0.001), and no significant change of CCT was found between 3 months and 6 months after surgery (P>0.05). The posterior corneal elevation (PCE) at different time points before and after surgery was significantly different (F=19.249, P<0.001), compared with the preoperation, the PCE at 1 month, 3 and 6 months postoperatively moved slightly backward (all at P<0.05). The preoperative ACD was (3.33±0.25)mm, the preoperative ACV was (217.46±31.55)mm3, and the ACD was (3.31±0.25), (3.30±0.25) and (3.30±0.25)mm, the ACV was (214.71±33.09), (211.14±33.65) and (210.08±32.19)mm3, respectively at 1 month, 3 and 6 months postoperatively, with significant differences at different time points before and after surgery (F=12.477, 12.205; both at P<0.001), compared with the preoperation, the ACD at 1 month, 3 and 6 months postoperatively and ACV at 3 months and 6 months postoperatively were obviously decreased, with a significant difference between them (all at P<0.05). There was a significant positive correlation between ACD and ACV at different time points before and after surgery (r=0.870, 0.893, 0.886, 0.884; all at P<0.001). The preoperative ACD was negatively correlated with CCT (r=-0.286, P<0.05).@*Conclusions@#The ACD is decreased postoperatively, it is basically stable at (3.30±0.25)mm, which satisfies the requirements of the ACD required for implantable collamer lens.And the stable state of ACD is also important for keratoconus detection.
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@#Risk factors including short axial length, shallow anterior chamber, narrow angles, spherical lens and other characters such as gender, age and family history are well known to be related to the attack of primary angle-closure glaucoma(PACG). In recent years, with the development of advanced techniques such as the anterior segment optical coherence tomography(AS-OCT)and ultrasound biomicroscope(UBM), the technical supports for the measurement of anterior segment parameters were largely provided, which made it possible to quantify risk factors of PACG precisely. In this paper, the relevant research progresses of commonly used anatomic parameters and their significances in pathogenesis of PACG were reviewed.
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@#AIM: To investigate the correlation between intraocular pressure(IOP)changes pre- and post-hemodialysis(HD)and the biometric structure of the anterior chamber in patients of chronic renal failure. <p>METHODS: Fifty-two patients(take right eye as study one)with hemodialysis that were diagnosed with chronic renal failure by nephrology in our hospital from January 2015 to December 2015 were collected. Fifty-two eyes were divided into four groups based on Shaffer classification combined with ultrasound biomicroscopy(UBM)and gonioscopy manifestations: wide angle group, narrow angle group, extremely narrow group and close angle group. Venous blood was collected to get plasma colloid osmotic pressure before HD and within 60s after HD. IOP was measured with rebound intraocular pressure gauge in a supine positon approximately 30min before starting HD, 2h after HD begin and approximately 30min after HD ending. Approximately 30min before and after HD, central corneal thickness was measured with corneal endothelial cell counter, central anterior chamber depth and lens thickness were taken by A scan, angle opening distance, trabecular iris angle, iris thickness and ciliary body thickness were measured by UBM. <p>RESULTS: Plasma osmotic pressure reduced after HD, the difference was statistically significant(<i>t</i>=3.04, <i>P</i><0.05). The means of IOPs among three measurement points were not all the same(<i>F</i>=41.69, <i>P</i><0.01). The IOP in 2h after HD had significant difference compared with before HD(<i>P</i><0.01).The IOP in 30min after HD ending had significant difference compared with 2h after HD(<i>P</i><0.01). The means of IOPs among three groups were not all the same(<i>F</i>=6.44, <i>P</i><0.01). The IOP in extremely narrow angle group had significant difference compared with that in wide angle group and narrow angle group(<i>P</i><0.05). Ciliary body thickness decreased after HD in every group, while only in wide angle group showed significant change after ending HD(<i>t</i>=2.61, <i>P</i><0.05). Central corneal thickness, central anterior chamber depth, angle opening distance, trabecular iris angle and iris thickness decreased, while lens thickness increased after HD. But all these changes between before HD and after HD in every group had no significant difference. <p>CONCLUSION: The influence of hemodialysis on IOP is related to the biometric structure of the anterior chamber. And extremely narrow angle is risk factor of elevated IOP during hemodialysis, narrow angle may be a risk factor. While patients with wide angle is relatively safe. We suggest to take ocular examination as early as possible for patients with hemodialysis, and focus on patients with narrow angle.
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AIM: To research the correlation factor of the anterior segment values of eyes with different axial lengths.METHODS: In this study, 697 cases 697 eyes were included.According to axial length we divided all the cases into short axial length group, normal axial length group, mild long axial length group, moderate long axial length group and severe long axial length group.The relevant indicators of the anterior segment values of patients in the five groups was comparatively analyzed.RESULTS: In the short axial length group, the anterior chamber volume (ACV) showed a significantly negative correlation with age;anterior chamber depth (ACD) showed a significantly negative correlation with age.In the normal axial length group, the ACV showed a significantly negative correlation with age and a significantly positive correlation with axial length(AXL);the anterior chamber angle (ACA) showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly positive correlation with corneal curvature;the ACD showed a significantly negative correlation with age and a significantly positive correlation with AXL.In the mild long axial length group, the ACV showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly negative correlation with corneal curvature;the ACA showed a significantly negative correlation with age and a significantly positive correlation with AXL, and a significantly positive correlation with corneal curvature;the ACD showed a significantly negative correlation with age and a significantly positive correlation with AXL.In the moderate long axial length group, the ACV showed a significantly negative correlation with age;the ACA showed a significantly positive correlation with AXL;the ACD showed a significantly positive correlation with AXL.In the severe long axial length group, the ACV showed a significantly negative correlation with age.There were no significant differences on ACV, ACA and ACD among mild long axial length group, moderate long axial length group and severe long axial length group (P>0.05), while the difference between other groups was significant (P<0.05).CONCLUSION: There has a correlation between the anterior chamber values (ACV, ACA, ACD) age and AXL for eyes which AXL were 22-27mm, while the correlation would disappear as the AXL became shorter or longer.There was a significant growth trend of anterior chamber values for eyes with AXL <27mm.
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Background Laser peripheral iridoplasty (LPI) is widely used in the treatment of glaucoma by flattening the iris and widening angle of anterior chamber (AA).However,no evidence suggests the optimal site of LPI in iris.Objective This study was to compare the therapeutic effects of LPI at different sites of iris for glaucoma.Methods Glaucoma models were established in the right eyes of 40 healthy adult male pigment rabbits by intrachamber injection of 0.1 ml compound carbomer solution with 0.3％ carbomer and 0.025％ dexamethasone.The models were randomly divided into model control group,corneoscleral limbus group,one spot from corneoscleral limbus group and two spots from corneoscleral limbus group.LPI was performed at corresponding site of iris by 532 nm argon laser with the spot diameter 500 μm,energy 300 mW,exposure time 0.3 seconds and laser number 24 spots,and the rabbits in the model control group did not receive LPI.Intraocular pressure (IOP),coefficient of outflow facility (C value) were measured and calculated with Schi(o)tz tonometer before LPI and 2,4,7,14 and 30 days after LPI,and anterior chamber depth (ACD),AA,anterior chamber angle opening distance within 500 μm radius from scleral spur (AOD500) were measured with ultrasound biomicroscope (UBM).The eyeballs were extracted 30 days after LPI,and the chamber angle were observed under the optical microscope after hematoxylin and eosin staining.The use and care of the animals complied with the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health.Results UBM showed that compared with the model control group,the anterior chamber angle was evidently widened in all the LPI groups,with the best effectiveness in the one spot from corneoscleral limbus group and the worst one in the two spots from corneoscleral limbus group.Compared with the model control group,the IOP was evidently reduced,and C values,AA and AOD500 were significantly increased in the corneoscleral limbus group,one spot from corneoscleral limbus group and two spots from corneoscleral limbus group after LPI,showing significant differences among the four groups (IOP:Fgroup =16.848,P ＜ 0.01;C value:Fgroup =9.629,P ＜ 0.01;AA:Fgroup =62.336,P＜0.01;AOD500:Fgroup =77.779,P ＜ 0.01).IOP was reduced and C value,AA and AOD500 were increased in 2,4,7,14 and 30 days after LPI as compared with before LPI,with significant differences over time (IOP:Ftime =3.041,P =0.011;C value:Ftime =4.311,P＜0.01;AA:Ftime =14.627,P＜0.01;AOD500:Ftime =20.378,P＜0.01).Compared with the model control group,the ACD was significantly increased in the corneoscleral limbus group and one spot from corneoscleral limbus group,and that in the two spots from corneoscleral limbus group was significantly reduced,and the ACD was insignificantly increased over time after LPI (Fgroup =18.017,P＜0.01;Ftime =0.022,P =1.000).Hematoxylin and eosin staining showed that the trabecular meshwork and adhesion of tissure were reopened and the anterior chamber angle was widened after LPI.Conclusions LPI can widen anterior chamber angle and lower the IOP.The best therapeutic outcome for glaucoma is displayed when LPI is performed at the iris site corresponding to one spot from the corneoscleral limbus.
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PURPOSE: To compare the anterior segment measurements with a Galilei® dual Scheimpflug analyzer and anterior segment optical coherence tomography (Cirrus OCT®). METHODS: Forty-eight eyes of 24 normal young adults were assessed for repeatability with two identical measurements of the central corneal thickness, minimum corneal thickness, anterior chamber depth, and anterior chamber angle using the Galilei® dual-Scheimpflug analyzer and Cirrus OCT®. RESULTS: The central corneal thickness, anterior chamber depth, and anterior chamber angle were highly reproducible and repeatable (intraclass correlation coefficient ≥ 0.90). Repeatability of the minimum corneal thickness was slightly lower (intraclass correlation coefficient ≥ 0.69). The mean corneal thickness measured using the Galilei® dual Scheimpflug analyzer was 0.26 ± 7.11 µm thinner than that measured using the Cirrus OCT®, and the mean corneal thickness was 0.37 ± 7.35 µm thicker, but was not statistically significant. The anterior chamber depth was 0.22 ± 0.08 mm deeper than the Cirrus OCT® (p < 0.007), and the anterior chamber angle was 7.87°± 1.32° larger than the Cirrus OCT® (p = 0.04). The 95% agreements of the central corneal thickness, anterior chamber depth, and anterior chamber angle between instruments were 85.30 µm, 1.43 mm, and 27.90°, respectively, and showed a high correlation (r ≥ 0.90; p < 0.001). The repeatability of the minimum corneal thickness was slightly low (r = 0.69; p < 0.001), and the range of agreement was larger (109.58 µm). CONCLUSIONS: The anterior segment measurements obtained with the dual rotating Scheimpflug camera and new anterior segment OCT in normal eyes was comparable and reproducible. However, the agreement ranges of the measured values were relatively large, so it was difficult to exchange values between instruments.
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Humans , Young Adult , Anterior Chamber , Tomography, Optical CoherenceABSTRACT
Background The pathological basis of human primary open angle glaucoma mainly is the degeneration of trabecular meshwork and Schlemm canal.As the outflow pathway of aqueous humor, the tissue origin and characteristics of trabecular meshwork remain less clear.Studying the characteristics of trabecular meshwork may contribute a new thought to the treatment of primary open angle glaucoma.Objective This study was to explore the histological property of trabecular meshwork by detecting the expression of D2-40, a lymphatic biomarker,and CD31,CD34 and smooth muscle actin (SMA), some vascular endothelial biomarkers.Methods Twenty specimens of adult eyeballs were collected from Zhongshan Ophthalmic Center of Sun Yat-sen University,including l0 eyeballs from accident death donors,3 enucleated eyeballs due to posterior segment of choroidal malignant melanoma and 7 orbital exenterated eyeballs.The series ocular meridian sections with the thickness of 4 μm were prepared for the haematoxylin-eosin staining.Immunohistochemistry was employed to detect the expression of D2-40,CD31 ,CD34 and SMA in trabecular meshwork and Schlemm canal.Results Intact structure of chamber angle was observed under the optical microscope by haematoxylin-eosin staining.Human trabecular meshwork tissue was presented with meshlike structure,while Schlemm canal showed the lumen structure.No abnormal substance and periphery synechia were found.D2-40 was strongly expressed in the trabecular meshwork endothelial cells with staining score for 3 points, but CD31, CD34 and SMA were negatively expressed.In contrast, CD31, CD34 and SMA rather than D2-40 were positively expressed in the Schlemm canal.In addition, CD31 and CD34 were also positively expressed in the vascular endothelial cells around the trabecular meshwork.Conclusions The trabecular meshwork expresses lymphatic biomarker rather than vascular biomarkers.This result indicates that trabecular meshwork of human eyes is lymphatic vessel-like tissue.
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Background Myopia is one of the main blinding diseases worldwide.At present,a lot of studies on ocular structure focus on the changes of corneal curvature(CC),central corneal thickness (CCT),anterior chamber depth (ACD),ocular axial length (AL) and choroid and retina,but the research of anterior chamber angle section structure form and ciliary body shape is lack.Objective This study was to measure and analyze the changes of the anterior chamber angle and related tissue structure in myopic eyes.Methods One hundred and forty-nine eyes of 149 subjects were included from May 2008 to May 2010 in Eighth Hospital of Qingdao City with the ages of 18-40years old under the informed consent.The subjects were assigned to the emmetropia group (30 eyes) ([0.02±0.18] D),low myopia group(46 eyes) ([-1.64±0.69] D),moderate myopia group (35 eyes) ([-4.56±0.66] D) and high myopia group (38 eyes) ([-7.04 ± 1.02] D).Conventional indexes including intraocular pressure (IOP),CCT,CC,AL and ACD were measured,and the indexes including chamber angel open distance (AOD),iris thickness (IT1,IT2,IT3),the position of ciliary body such as A-angel,B-angel,trabecular ciliary process distance (TCPD),irisciliary process distance (ICPD) and ciliary body thickness (CBT1,CBT2,CBT3) were measured by ultrasound biomicroscope(UBM).Results The IOP,CC and CCT values showed slight change in different groups without remarkable difference among them (all at P＞0.05).As the increase of myopic degree,AL was extended and ACD was deepened,showing significant differences among the groups (both at P＜0.05).There were no significant differences in IT1,IT2 and IT3 among the four groups (all at P＞0.05).However,the measuring values of angle opening degree (TIA and AOD500),ciliary position (A-angle,B-angle,TCPD,ICPD) and CBT (CBT1,CBT2,CBT3) elevated with the increase of myopic degree (all at P＜0.05).Positive correlations were found between AOD500 and ACD,A-angle,CBT1,CBT2,AL,negative correlations was found between AOD500 and myopic degree (r =0.573,0.513,0.325,0.398,0.542,-0.435,all at P＜0.01);Positive correlations were found between TIA and ACD,A-angle,CBT1,CBT2,AL,negative correlations was found between AOD500 and myopic degree (r =0.573,0.464,0.276,0.410,0.539,-0.435,all at P ＜ 0.01).Conclusions Within certain limits,as the increase of myopic degree,ACD deepens,the anterior chamber angle widens,ciliary process thickens and ciliary body backward shifts.
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Abstract?AlM: To observe the anterior chamber angle shape of patients with diabetic retinopathy ( DR) at different stages using OCT, and to explore a more sensitive and accurate glaucoma preventing measure.?METHODS: A total of 613 cases of DR patients were divided into proliferation phase group ( 353 cases ) and background phase group ( 260 cases ) , another 100 cases of patients with only diabetes were selected as control group. OCT was used to detect the anterior chamber angle related parameters, including angle opening distance ( AOD) , trabecular-iris space area ( TlSA) , angle recess area ( ARA ) , anterior chamber depth ( ACD ) and anterior chamber angle ( ACA) .?RESULTS: There were significant difference among AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 were 0. 60 ± 0. 22mm, 0. 78 ± 0. 39mm, 0. 22 ± 0. 12mm2 , 0. 45 ± 0. 19mm2 , 0. 29 ± 0. 18mm and 0. 46 ± 0. 15mm, respectively. There were significant difference among ACA500, ACA750, ACD500 and ACD750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, ACA500, ACA750, ACD500 and ACD750 were 30. 29o ± 8. 19o, 21. 20o ± 7. 40o, 2. 32 ± 0. 23μm and 2. 52±0. 16μm, respectively. ln addition, ROC results indicated that all these indices exert significant difference on evaluating the stage of DR. ?CONCLUSlON: Anterior chamber angle shape detected using OCT can reflect the change of retinopathy. OCT is an accurate and simple technique for detecting DR staging.
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Objective To observe the effect of postoperative central vault on the anterior chamber after implantation of im-plantable contact lens V4c .Methods To carry out a retrospective study of 56 eyes with implantable contact lens V4c implantation in Chongqing Bright Eye Hospital from November 2 ,2014 to February 5 ,2015 ,examined anterior chamber angle before surgery ,the anterior chamber angular width (ACA) and anterior chamber volume (ACV) were measured by pentacam .the postoperative central vault and ACA and ACV during the first and third and sixth months after surgery were measured ,the pigment grade in anterior chamber after operation were recorded .The change of ACA and ACV of the 56 eyes was correlation analyzed .Results At first month after surgery ,the postoperative central vault was 250 ~ 765 μm ,the reduced amount of ACA was (13 .67 ± 1 .67)° ,the re-duced amount of ACV was (94 .23 ± 17 .02)mm3 .At the third month ,the postoperative central vault of the 55 eyes was 239 ~ 761μm ,the reduced amount of ACA was (13 .70 ± 1 .68)° ,The reduced amount of ACV was (93 .6 ± 17 .48)mm3 .At the sixth month , the postoperative central vault of the 51 eyes was 246 ~ 761 μm ,the reduced amount of ACA was (13 .60 ± 1 .69)° ,the reduced a-mount of ACV was(94 .29 ± 17 .80)mm3 .No case of pigment was found for grade Ⅱ .The statistical comparison of the amount of ACV and ACA decreased in different postoperative central vaults showed that the difference was statistically significant ,there were statistically significant differences in the amount of ACV and ACA between different central postoperative central vault(P< 0 .05) . Conclusion Anterior chamber angle was narrowed and anterior chamber volume decreased in the posterior chamber intraocular lensimplant-ation after implantable contact lens V4c implantation ,the postoperative central vault is related to the change of anterior chamber angle and ACV .Appropriate postoperative central vault has positive clinical significance for keeping anterior chamber angle open .
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PURPOSE: We compared the measurements of anterior chamber depth (ACD) and anterior chamber angle (ACA) using ultrasound biomicroscopy (UBM) in the sitting position compared with IOL Master(R), Pentacam(R), and Spectralis optical coherence tomography (OCT) to evaluate the clinical usefulness of UBM in the sitting position. METHODS: We evaluated 92 eyes in 47 healthy adults. ACD was measured by IOL Master(R), Pentacam(R), and UBM. ACA was measured using Pentacam(R), UBM, and Spectralis OCT. UBM was performed in the sitting position using bag/balloon technology. Measured values were compared statistically. RESULTS: ACD measured by IOL Master(R), Pentacam(R), and UBM was 3.57 +/- 0.32 microm, 3.64 +/- 0.33 microm and 3.51 +/- 0.32 microm, respectively. UBM measurements of ACD were significantly shallower than with the other methods (p 0.8, p 0.05). There was strong correlation between UBM and Spectralis OCT (r = 0.957) but moderate correlation between Pentacam(R) and UBM and Pentacam(R) and Spectralis OCT (r = 0.557, 0.571, respectively, p < 0.05). Specifically, ACA of the superior quadrant showed a low correlation between Pentacam(R) and UBM and Pentacam(R) and Spectralis OCT (r = 0.257, 0.295, respectively). CONCLUSIONS: ACD measured by UBM in the sitting position was shallower compared to the other methods; however, ACD measured by IOL Master(R), Pentacam(R), and UBM showed significant correlations among the methods. The mean ACA measured by Pentacam(R), UBM, and Spectralis OCT showed no significant differences. Due to the high correlation of ACA measurements between UBM and Spectralis OCT in the present study, UBM is expected to be a good tool for measuring anterior segment parameters.
Subject(s)
Adult , Humans , Anterior Chamber , Microscopy, Acoustic , Tomography, Optical CoherenceABSTRACT
Background: Blotchy pigments in the anterior chamber (AC) angle are considered diagnostic of primary angle closure (PAC). But there are no reports either on the prevalence of blotchy pigments in AC angles or the validity of this sign. Aims: To determine the prevalence of blotchy pigments in AC angles and to evaluate their relationship with glaucomatous optic neuropathy (GON) in eyes with occludable angles. Setting and Design: Cross-sectional, comparative study. Materials and Methods: Gonioscopy was performed in 1001 eyes of 526 subjects (245 eyes of 148 consecutive, occludable angle subjects and 756 eyes of 378 non-consecutive, open angle subjects), above 35 years of age. Quadrant-wise location of blotchy pigments was documented. Statistical Analysis: Odds of blotchy pigments in occludable angles against that in open angles were evaluated. Relationship of GON with blotchy pigments in occludable angle eyes was evaluated using a multivariate model. Results: Prevalence of blotchy pigments in occludable angles was 28.6% (95% CI, 22.9-34.3) and in open angles was 4.7% (95% CI, 3.2-6.3). Blotchy pigments were more frequently seen in inferior (16%) and superior quadrants (15%) of occludable angles, and inferior quadrant of open angles (4%). Odds of superior quadrant blotchy pigments in occludable angles were 33 times that in open angles. GON was seen in 107 occludable angle eyes. Blotchy pigments were not significantly associated with GON (odds ratio = 0.5; P = 0.1). Conclusions: Blotchy pigments were seen in 28.6% of occludable angle eyes and 4.7% of open angles eyes. Presence of blotchy pigments in the superior quadrant is more common in occludable angles. Presence of GON in occludable angle eyes was not associated with blotchy pigments.
Subject(s)
Anterior Chamber , Glaucoma, Angle-Closure/epidemiology , Glaucoma, Open-Angle , Humans , Iris Diseases/etiology , Optic Nerve Diseases/etiology , Retinal Pigments/analysis , Retinal Pigments/pathologyABSTRACT
Primary angle closure glaucoma (PACG) is a major form of glaucoma in large populous countries in East and South Asia. The high visual morbidity from PACG is related to the destructive nature of the asymptomatic form of the disease. Early detection of anatomically narrow angles is important and the subsequent prevention of visual loss from PACG depends on an accurate assessment of the anterior chamber angle (ACA). This review paper discusses the advantages and limitations of newer ACA imaging technologies, namely ultrasound biomicroscopy, Scheimpflug photography, anterior segment optical coherence tomography and EyeCam, highlighting the current clinical evidence comparing these devices with each other and with clinical dynamic indentation gonioscopy, the current reference standard.
Subject(s)
Anterior Chamber , Diagnostic Techniques, Ophthalmological/standards , Diagnostic Techniques, Ophthalmological/trends , Early Diagnosis , Glaucoma, Angle-Closure/diagnosis , Gonioscopy/methods , Humans , Microscopy, Acoustic , Photography/methods , Tomography, Optical CoherenceABSTRACT
Objective@#This study investigated the effect of brimonidine on the anterior-chamber angle in eyes with narrow angles using noncontact three-dimensional anterior-segment analyzer Pentacam.@*Methods@#Nine eyes with narrow angles were distributed to one of three treatment groups—single topical dose of 0.15% brimonidine tartrate, 0.5% timolol maleate (positive control), or balanced salt solution (negative control)—in a prospective, single-masked, crossover, comparative trial. The primary outcome measure was anterior-chamber angle at baseline, and 2 and 4 hours after instillation of the treatment drug. Secondary outcome measures were pupil diameter, intraocular pressure (IOP), and anterior-chamber depth and volume. After a two-week washout period, eyes were crossed over to the other treatment modes. All baseline and posttreatment measurements were taken. Repeated analysis of variance (ANOVA) was used for statistical analysis.@*Results@#Anterior-chamber angle, depth, and volume did not differ significantly for all treatment groups. Brimonidine caused a significant decrease in pupil diameter, most notably 2 hours after instillation, from baseline of 2.36 ± 0.37 mm to 2.17 ± 0.35 mm. (p = 0.03). There was a significant decrease in IOP from baseline to hour 4 after treatment for both brimonidine (11.4 ± 2.2 to 9 ± 1.8 mm Hg, p < 0.001) and timolol (11.9 ± 2.3 to 9.4 ± 2.1 mm Hg, p = 0.003).@*Conclusions@#Brimonidine produced a miotic trend with no significant opening of the anterior-chamber angle in patients with narrow angles.