Changes in Intraocular Pressure and Angle Structure after Dilation in Primary Angle-Closure Suspects with Visually Significant Cataract

Zhao, Mengya; Sun, Qiang; Oatts, Julius T.; Hu, Guangyi; Ge, Ling; Zhu, Bijun; Fu, Mingshui; Wang, Yulan; Miao, Yi; Luo, Qin; Niu, Tian; Yu, Yinxi; Ying, Gui‐Shuang; Aung, Tin; Xu, Xun; Han, Ying

doi:10.1016/j.ophtha.2020.07.009

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…It has been reported that angle synechia might interfere with results measured by AS-OCT. 27 , 28 Therefore, the generalization of the results to patients with PACG warrants further study. 29 Finally, only Chinese patients were included in the study, and the studies in other ethnic populations are needed to confirm or refute the findings. 4 , 7 …”

Section: Discussionmentioning

confidence: 99%

Effect of High Myopia on Dynamic Changes of Anterior Angle After Pharmacologic Mydriasis in Cataract Patients: A SS-ASOCT Study

Wang

Zhang

et al. 2021

Trans. Vis. Sci. Tech.

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Purpose The purpose of this study was to evaluate the effect of high myopia on anterior angle change after pharmacologic mydriasis in patients with cataract using swept-source anterior segment optical coherence tomography (SS-ASOCT). Methods This prospective cross-sectional study continuously recruited patients with cataract aged 40 years and older during the period August 2019 to August 2020. The anterior segment parameters, including central corneal thickness (CCT), anterior chamber depth (ACD), angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), trabecular-iris angle (TIA), angle to angle width (ATA), and anterior chamber volume (ACV), were obtained using SS-ASOCT at baseline and 30 minutes after mydriasis. Regression analyses were performed to identify the factors related to the relative change of AOD500 (ΔAOD500). Results A total of 938 patients (938 eyes) were included. The AOD500 decreased from 0.46 ± 0.22 mm to 0.40 ± 0.19 mm, with percent ΔAOD500 of −13.59% ± 37.73% ( P = 0.005). The patients with high myopia had a smaller reduction of anterior angle parameters, with a percent ΔAOD500 of −22.74% ± 58.09%% in non-high myopic eyes and −0.84% ± 45.47% in high myopic eyes ( P < 0.001). The stepwise multivariate regression demonstrated that the smaller reduction of AOD500 were independently associated with younger age (coefficient = −2.11, 95% confidence interval [CI] = −2.59 to −1.64, P < 0.001), presence of high myopia (coefficient = 15.35, 95% CI = 3.63 to 27.07, P = 0.010), greater baseline TISA500 (coefficient = 60.78, 95% CI = 8.75 to 112.82, P = 0.022), and ATA (coefficient = 11.21, 95% CI = 4.53 to 17.89, P = 0.001). Conclusions The anterior chamber angle decreased after pharmacologic mydriasis in these patients with cataract. Angle shallowing after pharmacologic mydriasis was significantly less pronounced in high myopic eyes than in non-high myopic eyes. Translational Relevance These findings are informative for the relative less risk of angle-closure glaucoma in highly myopic eyes.

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Section: Discussionmentioning

confidence: 99%

Effect of High Myopia on Dynamic Changes of Anterior Angle After Pharmacologic Mydriasis in Cataract Patients: A SS-ASOCT Study

Wang

Zhang

et al. 2021

Trans. Vis. Sci. Tech.

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“…Anterior segment SS-OCT images were obtained before and after dilation (SS-1000, CASIA; Tomey, Japan). Four cross-sectional images corresponding to 8 axes of the anterior chamber were assessed, as described previously 11. For each image, the scleral spur and iris recess were both automatically marked by the SS-OCT system and manually corrected to complete anterior chamber measurements by a single masked examiner (M.Z.).…”

Section: Methodsmentioning

confidence: 99%

“…Four cross-sectional images corresponding to 8 axes of the anterior chamber were assessed, as described previously. 11 For each image, the scleral spur and iris recess were both automatically marked by the SS-OCT system and manually corrected to complete anterior chamber measurements by a single masked examiner (M.Z.). Images were analyzed using the manufacturer-provided software and the following parameters were collected: anterior chamber dimension parameters [anterior chamber depth (ACD), anterior chamber width (ACW), lens vault (LV)], angle parameters [angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), and trabecular-iris angle (TIA)], and volume parameters [cornea volume (CV), anterior chamber volume (ACV), iris volume (IV)].…”

Section: Ss-oct Measurementsmentioning

confidence: 99%

“…Recently, 2 groups found that ACD measured by SS-OCT can distinguish patients with PACD from controls with high sensitivity and specificity, implying that ACD may be used as an objective measurement in the clinical diagnoses of PACD 3,10. In addition, using SS-OCT, we previously identified ACD change as the main risk factor associated with IOP elevation in patients with PACS and concurrent cataract after pharmacological dilation 11. However, there is no study examining the association between ACD and other anterior chamber parameters in dynamic pupillary statuses, which may mimic physiological conditions.…”

mentioning

confidence: 99%

“…3,10 In addition, using SS-OCT, we previously identified ACD change as the main risk factor associated with IOP elevation in patients with PACS and concurrent cataract after pharmacological dilation. 11 However, there is no study examining the association between ACD and other anterior chamber parameters in dynamic pupillary statuses, which may mimic physiological conditions.…”

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confidence: 99%

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Relationship Between Optical Coherence Tomography and Anterior Chamber Depth After Pupillary Dilation in Primary Angle Closure Suspects

Kao

Yonamine

Zhao

et al. 2022

Journal of Glaucoma

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Précis: Anterior chamber depth (ACD) change after pupillary dilation is correlated with lens vault (LV) and anterior chamber width (ACW), as observed by swept-source optical coherence tomography (SS-OCT) at both horizontal and vertical scans in patients with primary angle closure suspect and cataract. Purpose: The purpose of this study is to evaluate the association between ACD and other anterior chamber parameters after pharmacological dilation in patients with primary angle closure suspect and cataract. Patients and Methods: SS-OCT was performed for 78 patients at baseline and 1 hour after pharmacological dilation. Measurements were taken at 8 evenly spaced axes at 250, 500, and 750 μm from the scleral spur. Pearson correlation coefficient (ρ) was used to evaluate the relationship between averaged ACD change and other SS-OCT parameters. Multivariable regression analyses were performed to determine the parameters that predict ACD change. Results: Across all 14 dimension and angle parameters, 12 parameters at the 270-degree axis and 10 parameters at the 0-degree axis yielded significant correlations with ACD change (ρ=0.24–0.55, P<0.05). Angle parameters were most significantly correlated to ACD change 750 µm from the scleral spur. The prediction model for ACD change after pharmacological dilation at 0 degree included decreased LV, wider ACW, and increased trabecular iris space area (all P≤0.001). The prediction model for ACD change at 270 degrees included: decreased LV, wider ACW, larger change in anterior chamber volume, larger baseline anterior chamber volume, and smaller baseline angle opening distance (all P≤0.03). Conclusions: LV and ACW, as measured in both vertical and horizontal scans, were found to be determinants of the ACD change after pharmacological pupillary dilation. Examination of these parameters may help identify patients at higher risk of developing angle-closure disease.

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Evaluation of the Diagnostic Performance of Swept-Source Anterior Segment Optical Coherence Tomography in Primary Angle Closure Disease

Oatts

et al. 2022

American Journal of Ophthalmology

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Changes in Intraocular Pressure and Angle Structure after Dilation in Primary Angle-Closure Suspects with Visually Significant Cataract

Cited by 11 publications

References 26 publications

Effect of High Myopia on Dynamic Changes of Anterior Angle After Pharmacologic Mydriasis in Cataract Patients: A SS-ASOCT Study

Effect of High Myopia on Dynamic Changes of Anterior Angle After Pharmacologic Mydriasis in Cataract Patients: A SS-ASOCT Study

Relationship Between Optical Coherence Tomography and Anterior Chamber Depth After Pupillary Dilation in Primary Angle Closure Suspects

Evaluation of the Diagnostic Performance of Swept-Source Anterior Segment Optical Coherence Tomography in Primary Angle Closure Disease

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