Correlation Between Trabeculodysgenesis Assessed by Ultrasound Biomicroscopy and Surgical Outcomes in Primary Congenital Glaucoma

Shi, Yan; Wang, Huaizhou; Han, Ying; Cao, Kai; Vu, Vivian; Hu, Man; Chen, Xin; Zhang, Qing; Wang, Ke

doi:10.1016/j.ajo.2018.08.022

Cited by 15 publications

(36 citation statements)

References 17 publications

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“…Precise in vivo measurements of the developing anterior segment are essential in understanding the pathogenesis of congenital glaucoma [6][7][8]14]. It also provides useful information in planning glaucoma surgery [13,15]. Measurements of the TM and SC in vivo using spectraldomain optical coherence tomography (SD-OCT) or swept-source optical coherence tomography (SS-OCT) have been reported in older children [19][20][21]; however, this modality is not possible in infants and younger children due to the amount of cooperation needed to complete the test, which can only be performed in a seated, awake child.…”

Section: Discussionmentioning

confidence: 99%

“…any previous intraocular surgery. Those with severe trabeculodysgenesis under high-frequency UBM, corresponding to those with insertion of both the iris and ciliary processes before the scleral spur as we previously reported, were excluded due to the difficulty in identifying the scleral spur and measuring TM [15]. And those with no identified SC in all four quadrants under high-frequency UBM were also excluded.…”

Section: Subjectsmentioning

confidence: 99%

“…Quantitative assessment of SC and TM in adults were recently reported, [10][11][12] and its application in PCG was limited to one published report about the measurement of SC diameter in a small case series [13]. Here, we measured in vivo anterior chamber angle structure dimensions and evaluate their relations to age in patients with PCG using high-frequency UBM, which are essential in understanding the pathogenesis of congenital glaucoma [6][7][8][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

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Disease-related and age-related changes of anterior chamber angle structures in patients with primary congenital glaucoma: An in vivo high-frequency ultrasound biomicroscopy-based study

et al. 2020

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Objectives To provide in vivo measurements of anterior chamber angle structures and their relationship with age as evaluated by high-frequency ultrasound biomicroscopy (UBM) in patients with primary congenital glaucoma (PCG) Methods High-frequency UBM was done for 51 PCG eyes from 40 patients (aged from 3 to 96 months) and 11 unaffected contralateral eyes. Parameters, including the proportion of observable abnormal tissue membrane and Schlemm's canal, the largest cross-sectional area (CSA) of Schlemm's canal (SC), SC meridional diameter, trabecular-iris angle (TIA), trabecular meshwork (TM) thickness, iris thickness, ciliary process length, and corneal limbus thickness were compared between the two groups and their relationship with age was explored in PCG eyes. Results Abnormal tissue membrane was detected in 27.5% of PCG eyes and none in unaffected eyes. SC was observed in 73.1% of PGC eyes compared to 100% in unaffected eyes (P<0.001). The largest CSA of SC, SC meridional diameter, iris thickness, and corneal limbus thickness were all significantly smaller in PCG eyes compared to unaffected eyes (all P<0.05). TIA and ciliary process length in unaffected eyes were smaller than PCG eyes

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Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disease-related and age-related changes of anterior chamber angle structures in patients with primary congenital glaucoma: An in vivo high-frequency ultrasound biomicroscopy-based study

et al. 2020

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“…Corneal edema status was recorded according to the modified grading standard of corneal edema by using a slit lamp: Grade 0 represents corneal transparency without edema; Grade 1 displays the corneal localized haze edema, the endothelial layer of the cornea is smooth, and the iris texture is clearly visible; Grade 2 displays the pale gray edema of the cornea, the endothelial layer of the cornea is rough, and the iris texture is blurred; Grade 3 displays diffuse gray edema of the cornea, the corneal endothelium is cracked, and the iris is unclear; Grade 4 displays the ivory edema of the cornea, and the intraocular structure is not clear. The original corneal opacity grading criteria were firstly introduced by Wang et al in their paper about congenital glaucoma [11]. Status of the anterior chamber was measured by using an UBM.…”

Section: Methodsmentioning

confidence: 99%

Argon Laser Peripheral Iridoplasty and Argon Laser Pupilloplasty: Alternative Management for Medically Unresponsive Acute Primary Angle Closure

Zhou

Zhao

Shi

et al. 2019

Journal of Ophthalmology

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Objective. To introduce the combined laser technique, argon laser peripheral iridoplasty (ALPI) and argon laser pupilloplasty (ALPP), in the management of medically unresponsive acute primary angle closure (APAC). Design. Retrospective study. Methods. We retrospectively reviewed the records of 23 patients (27 eyes) with APAC, who were applied ALPI and ALPP when traditional treatment failed. The visual acuity and intraocular pressure (IOP) were monitored before surgery and at 1, 2, 12, 24, and 48 h after surgery. Additionally, the angle-opening status was monitored before surgery and 48 h after the treatment by using an ultrasonic biological microscope (UBM), and the presurgical and postsurgical cornea edema statuses were observed by using a slit lamp. We also documented the complications of laser treatment. Results. For the ALPI + ALPP laser-effective group, the presurgical IOP was 52.1 ± 9.3 mmHg and the postsurgical IOP was 37.6 ± 10.9 mmHg (1 h), 28.4 ± 12.4 mmHg (2 h), 19.9 ± 9.0 mmHg (6 h), 16.8 ± 7.3 mmHg (12 h), 15.9 ± 5.9 mmHg (24 h), and 14.9 ± 5.0 mmHg (48 h), with statistically significant differences (p<0.05) in each time point. It was observed in all the patients that the corneal edema alleviated, the angles opened, and visual acuity recovered with varying degrees at 48 h after applying combined laser treatment. For the ALPI + ALPP laser-ineffective group, further interventions were taken. Definite treatment was given in both groups to maintain the long-term IOP control. Conclusions. Although the combination of ALPI and ALPP is a temporizing therapeutic strategy for APAC, it is effective in relieving pupillary block which is unresponsive to miotic agents, opening the closed angle to a certain extent, restoring the transparency of cornea, and reducing IOP to a safe level for further definitive treatment.

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“…1,2 Its main pathology lies in the trabecular meshwork maldevelopment (isolated trabeculodysgenesis) that leads to increase outflow resistance to the aqueous drainage. [3][4][5][6] The treatment of primary congenital glaucoma is essentially a surgical procedure. The role of topical antiglaucoma medications is only temporary before the preparation for the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

Elhofi¹,

Helaly²

2020

OPTH

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Purpose: To evaluate the safety and efficacy of non-penetrating deep sclerectomy with a collagen implant versus trabeculectomy in primary congenital glaucoma. Subjects and Methods: This was a retrospective interventional comparative nonrandomized clinical study that included 80 eyes of 80 children presenting with primary congenital glaucoma under the age of 3 years. Forty eyes have undergone non-penetrating deep sclerectomy (NPDS) and the other 40 eyes have undergone penetrating trabeculectomy. The main outcome measure was the reduction in intraocular pressure (IOP). Secondary outcomes included percentage of patients with complete and qualified success, need for topical antiglaucoma medications, rate of complications, and need for further interventions. Complete success of the surgical outcome was considered an IOP ≤16 mmHg with no antiglaucoma medications. Qualified success was considered an IOP ≤16 mmHg using antiglaucoma medications. Results: The mean preoperative IOP was 27.4 ± 6.9 and 28.5 ± 6.6 mmHg in NPDS and trabeculectomy groups, respectively (p = 0.175). At the end of the follow-up period, the mean IOP was 11.2 ± 4.5 and 11.1 ± 3.4 mmHg with a mean reduction of 16.2 and 17.4 mmHg in NPDS and trabeculectomy groups, respectively. At the end of the follow-up period, ie at 36 months postoperative, the complete success rate was 60% (24 eyes) versus 57.5% (23 eyes), the qualified success rate was 25% (10 eyes) versus 25% (10 eyes), the overall success rate was 85% (34 eyes) versus 82.5% (33 eyes), and the rate of failure was 15% (6 eyes) versus 17.5% (7 eyes) in NPDS and trabeculectomy groups, respectively (p = 0.952). Eight cases (20%) of the trabeculectomy group had shallow anterior chamber. None of the NPDS group cases suffered from shallow anterior chamber. Conclusion: Non-penetrating deep sclerectomy appears to be an efficient and safe surgical alternative to penetrating trabeculectomy in treatment of primary congenital glaucoma. Nonpenetrating deep sclerectomy has fewer postoperative complications in comparison to penetrating trabeculectomy with a comparative postoperative reduction in the intraocular pressure and overall success rates. Trial Registration: The trial was registered on 11/01/2020 with number PACTR202002874953456 (https://pactr.samrc.ac.za).

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Correlation Between Trabeculodysgenesis Assessed by Ultrasound Biomicroscopy and Surgical Outcomes in Primary Congenital Glaucoma

Cited by 15 publications

References 17 publications

Disease-related and age-related changes of anterior chamber angle structures in patients with primary congenital glaucoma: An in vivo high-frequency ultrasound biomicroscopy-based study

Disease-related and age-related changes of anterior chamber angle structures in patients with primary congenital glaucoma: An in vivo high-frequency ultrasound biomicroscopy-based study

Argon Laser Peripheral Iridoplasty and Argon Laser Pupilloplasty: Alternative Management for Medically Unresponsive Acute Primary Angle Closure

<p>Non-Penetrating Deep Sclerectomy versus Trabeculectomy in Primary Congenital Glaucoma</p>

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