Dark-room Prone-position Test for Intermittent Angle Closure

PURPOSE: To determine the efficacy and safety of the dark-room prone-position test (DRPT) for intermittent angle closure (IAC) and to investigate the correlation between A-scan ultrasound biometric measurements and the results of DRPT. METHODS: Medical records were reviewed of 37 eyes in 24 patients who were diagnosed with IAC and received DRPT. The increase of intraocular pressure (IOP) induced by DRPT and the results from A-scan ultrasound biometric measurements were obtained. An increase in IOP of at least 8 mmHg from baseline was considered a positive result for DRPT. Associations between the increase of IOP induced by DRPT and the parameters of A-scan biometry were tested by linear regression analysis. RESULTS: The DRPT results were positive in 28 eyes of 19 patients. After DRPT, the IOP returned to near-baseline levels within 2 hours in all patients; some patients were treated with anti-glaucoma eye drops. Lens thickness was significantly correlated with the amount of IOP elevation induced by DRPT (r=0.338, p=0.041). CONCLUSIONS: DRPT is a safe and effective test in patients with IAC. DRPT can be used effectively to make a concrete diagnosis of IAC. Lens thickness appears to be associated with a positive response to DRPT.

Argon Laser Peripheral Iridoplasty in Angle-Closure Glaucoma

The purpose of this study is to evaluate the clinical factors in eye with continued appositional angle closure in the presence of a patent iridectomy and the clinical avaiability of argon laser peripheral iridoplasty(ALPI). In this study we retrospectively reviewed the outcome in 59 eyes of 32 patients who underwent iridectomy. After Dark Room Prone-position Test(DRPT), 15 eyes among 59 eyes(25.4%) showed DRPT positive and ALPI was successfully performed in 13 eyes among these 15 eyes(86.7%). Patients with DRPT positive were younger than those with DRPT negative. One eye had postoperative complication; iritis more than 1 week. In this study it was found that Argon lader peripheral iridoplasty is a Safe and an effective means of opening an appositionally closed angle in situations in which laser ridotomy does not physically eliminate appositional angle closure.

Dark Room Prone-position Test in Primary Angle-Closure Glaucoma

To evaluate clinical availability of the Dark Room Prone-position Test (DRPT), which is one of the provocative tests of angle-closure glaucoma, this study was carried out. Twenty nine patients (43 eyes) with primary angle-closure glaucoma (PACG) were enrolled, and seventeen primary open angle glaucoma (POAG) patients (34 eyes) arld fourty one normal persons (82 eyes) were used as control group. After DRPT, P ACG showed statistically significant intraocu lar pressure (IOP) rise of 6.3 +/- 6.82mmHg as compared with group of POAG or normal 2.0 +/- 2.04mmHg and 1.4 +/- 1.47mmHg, respectively (p<0.05). Fifteen eyes among 43eyes (34.9%) of PACG showed DRPT positive defined as over 7mmHg rise after DRPT, and the final IOP of DRPT over 21mmHg showed significant DRPT positive (43.5%) than that of under 20mmHg (0.00%) (p<0.05). Glaucomatous attack was more occurred 1.9 times in DRPT postive group than in DRPT negative one.