ABSTRACT
OBJECTIVE: To assess the value of noncontact goniometry with optical coherence tomography (OCT) compared with current clinical parameters in the evaluation of the anterior chamber angle (ACA). DESIGN: Prospective observational study of 138 eyes of 109 patients. METHODS: The ACA parameters and angle-opening distance (AOD) were measured with slitlamp-adapted OCT goniometry. The iris and scleral thickness and the iris convexity were assessed with OCT. Both ACA and AOD were compared with the clinical parameters of gonioscopy grade, limbal anterior chamber depth (ACD), ultrasonographic central ACD, and lens-axial length (LAL) ratio. RESULTS: Noncontact goniometry with OCT revealed mean +/- SD values of 28 degrees +/- 16 degrees for the ACA and 381 +/- 234 mum for the AOD. The mean +/- SD iris thickness was 369 +/- 84 mum, and the scleral thickness at the scleral spur was 943 +/- 148 mum. There was a significant correlation (P<.001) with the clinical parameters of gonioscopic grading, limbal ACD, ultrasonographic central ACD, and LAL ratio. The sensitivity and specificity of OCT goniometry to detect an occludable angle were 86% and 95% for ACA and 85% and 90% for AOD, respectively. CONCLUSIONS: Noncontact goniometry with OCT was helpful in evaluating the anterior chamber structures and as a screening modality. Goniometry with OCT could improve the noninvasive clinical assessment and treatment of patients with glaucoma.
Subject(s)
Anterior Chamber/pathology , Glaucoma/diagnosis , Gonioscopy/methods , Iris/pathology , Tomography, Optical Coherence/methods , Trabecular Meshwork/pathology , Adult , Aged , Aged, 80 and over , Anterior Chamber/diagnostic imaging , Female , Glaucoma/diagnostic imaging , Humans , Iris/diagnostic imaging , Male , Middle Aged , Prospective Studies , Sensitivity and Specificity , Trabecular Meshwork/diagnostic imaging , UltrasonographyABSTRACT
A 57-year-old woman was treated for mild presbyopia with implantation of scleral expansion bands (SEB). Although near vision was temporarily restored, the effect dissipated after 1 year. Slitlamp-adapted optical coherence tomography (OCT) at 1310 nm allowed precise cross-sectional visualization of the hyporeflective intrascleral segments. The OCT method provided precise images of the segment depth and thickness, the scleral thickness at the scleral spur, the anterior chamber angle, and the angle-opening distance. Intrascleral tilting of 1 segment was seen; this required removal of the SEB because of marked foreign-body sensation. Noncontact, slitlamp-adapted OCT can be used to evaluate scleral changes after SEB implantation.
