In Vivo Analysis of Angle Dysgenesis in Primary Congenital, Juvenile, and Adult-Onset Open Angle Glaucoma

Gupta, Viney; Chaurasia, Abadh K; Gupta, Shikha; Gorimanipalli, Bhavya; Sharma, Ajay; Gupta, Amisha

doi:10.1167/iovs.17-22695

Cited by 29 publications

(18 citation statements)

References 28 publications

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“…The rate of identifying the anterior chamber membrane varies in the literature, ranging from 100% to 12%. 5 One study identifying abnormal tissue in 100% of eyes using SD-OCT suffered from poor inter-grader agreement (κ = 0.61, P < 0.005) [21]. The lower rate of membrane identification in this study may be due to our strict criteria requiring agreement between two glaucoma specialists where equivocal cases were excluded.…”

Section: Discussionmentioning

confidence: 76%

“…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. The iUltrasound imaging system is suitable for examination in infants and children under general anesthesia in the supine position and both TM and SC can be clearly identified [10][11][12].…”

Section: Discussionmentioning

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: 76%

Section: Discussionmentioning

confidence: 99%

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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“…In this qualitative study, we analysed trabecular meshwork anatomy of children with unilateral PCG, who had been operated previously and were now old enough to co‐operate for an ASOCT. The angle dysgenesis was visualized on ASOCT as the presence of abnormal tissue or a hyper‐reflective membrane (Gupta et al 2017). This membrane appeared to be similar to what Barkan had described in PCG (Barkan 1955) and was later commented upon by Luntz (1979) as an angle cicatrization that portends a poorer success with goniotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Dysgenesis of the trabecular meshwork (TM) and the Schlemm’s canal (SC) is known to play a major role in the pathobiology of PCG. We studied the anterior segment of children with PCG and found angle anomalies that could be discerned on ultrasound biomicroscopy (UBM) and anterior segment OCT (ASOCT) (Gupta et al 2007; Gupta et al 2017). Apart from being non‐contact, the ASOCT provides higher resolution images of angle structures in comparison with the UBM (Asrani et al 2008; Kagemann et al 2010; Fernandez‐Vigo et al 2015; Imamoglu et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Differences in outflow channels between two eyes of unilateral primary congenital glaucoma

Gupta

Singh

Pandya

et al. 2020

Acta Ophthalmologica

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Purpose Primary congenital glaucoma (PCG) occurs in only one eye in some patients. We aimed to characterize anatomical features of the angle and Schlemm’s canal (SC) in vivo among fellow eyes of patients with unilateral primary congenital glaucoma. Methods Both eyes of 33 children with unilateral PCG and 30 healthy, age‐matched children, old enough to co‐operate were analysed using high‐resolution anterior segment spectral domain (SD) OCT. Subgroup analysis was done for the presence/absence of angle dysgenesis as defined by the presence of abnormal tissue/hyper‐reflective membrane within angle recess and/or the absence of SC. Other anatomical landmarks differentiating the fellow eyes from eyes with glaucoma were also evaluated and compared with healthy subjects. Results The presence of abnormal tissue at the angle and/or a hyper‐reflective membranous structure covering the meshwork was seen in all affected PCG eyes (100%) and in 21 (63%) unaffected fellow eyes; p = 0.001. The SC could be seen in 8 (24%) affected in comparison with 29 (88%) fellow unaffected eyes; p = 0.001. The ASOCT scans of 54 (90%) healthy eyes and 3 (9%) fellow PCG eyes revealed a direct communication of anterior portion of the SC with the anterior chamber. Among the fellow eyes, a communication of the supraciliary space with anterior chamber could be discerned in 26 eyes (79%). Conclusions Despite angle dysgenesis, outflow channels such as the uveoscleral or a direct communication of SC with the anterior chamber play a role in preventing the development of glaucoma in fellow eyes of unilateral PCG.

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“…As a non-invasive imaging system for biological tissue scanning, spectral-domain optical coherence tomography (SD-OCT) is increasingly being used to assess the anterior chamber angle in both normal and pathological conditions ( Gupta et al, 2017 ). The ability of SD-OCT to track from SC to superficial vascular plexuses in two-dimensional (2D) image sequences was successfully proven ( Kagemann et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Age-Related Changes in Human Schlemm’s Canal: An in Vivo Optical Coherence Tomography-Based Study

Zhao

Chen

et al. 2018

Front. Physiol.

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Purpose: To investigate age-related changes in human Schlemm’s canal (SC) using spectral-domain optical coherence tomography (SD-OCT).Methods: A total of 125 normal eyes were imaged using SD-OCT nasally and temporally. The age-related variations of SC sagittal diameter and cross-sectional area (CSA) from four age groups [A (16–20 years), B (21–40 years), C (41–60 years), and D (61–80 years)] were analyzed with Spearman correlation.Results: The positive detection rates of SC showed a significantly downward trend with age. The mean CSA was 13,296 ± 1,897 μm2 nasally and 14,552 ± 2,589 μm2 temporally. The mean CSA was significantly larger in the temporal than in the nasal region (P < 0.05). Nasal CSA values varied among the four age groups (P = 0.004).Conclusion: Our study found for the first time that SC in vivo exhibits a morphological variant with age in healthy humans. Clinicians may need to consider this phenomenon when performing examinations targeting SC for glaucoma patients.

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In Vivo Analysis of Angle Dysgenesis in Primary Congenital, Juvenile, and Adult-Onset Open Angle Glaucoma

Abstract: Angle dysgenesis in the form of abnormal tissue at the angle/hyperreflective membrane and/or absence of SC could be identified on anterior segment SD-OCT, which can be used for in vivo evaluation of eyes with developmental glaucoma.

Cited by 29 publications

References 28 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

Differences in outflow channels between two eyes of unilateral primary congenital glaucoma

Age-Related Changes in Human Schlemm’s Canal: An in Vivo Optical Coherence Tomography-Based Study

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