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Assessment of Schlemm’s canal in acute primary angle closure: an anterior segment optical coherence tomography study
摘要： Purpose To image and quantitatively evaluate the Schlemm’s canal (SC) dimensions in the eyes with acute primary angle closure (APAC) with anterior segment optical coherence tomography (AS-OCT), and compare it with the SC measurements taken after the control of intraocular pressure (IOP) and in the normal age-matched controls. Materials and methods Seventeen eyes of 14 patients with the newly diagnosed APAC and 59 age-matched normal subjects underwent AS-OCT to image SC. SC cross-sectional area, SC meridional and coronal diameters were measured in the temporal and nasal regions at 3 and 9 o’clock position. After laser iridotomy and control of the IOP, all SC parameters were measured again at a week later, in APAC eyes. the SC Intrasession intraobserver reliability of measurements was assessed with intraclass correlation coef?cient. Results Mean SC-SCA (10,600 ± 2691 lm2), SC meridional (682 ± 125 lm) and coronal diameters (21.2 ± 8.2 lm) showed a signi?cant increase in the APAC eyes at presentation, when compared to the SC parameters measured at a week later (6499 ± 1754 lm2, 450 ± 169 lm and 15.75 ± 8.6 lm, p = \ 0.0001, \ 0.0001 and 0.01, respectively) and in the normal controls (7192 ± 1022 lm2, 499.2 ± 179.8 lm, p = 0.02, \ 0.0001, 0.01, respectively). There was no difference in the measured SC parameters between the normal controls and APAC eyes, when the parameters were measured at a week, after resolution of the acute attack (all p [ 0.05). Conclusion A signi?cant expansion of SC was observed in the APAC eyes at presentation, when compared to the normal controls and after the acute attack resolved. SC parameters may provide a useful research tool for evaluating morphological changes in the SC in APAC eyes, during an acute attack.
关键词： Schlemm’s canal,Anterior segment optical coherence tomography,Acute primary angle closure
更新于2025-09-09 09:28:46
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Diurnal Intraocular Pressure and the Relationship With Swept-Source OCT–Derived Anterior Chamber Dimensions in Angle Closure: The IMPACT Study
摘要： PURPOSE. To evaluate diurnal intraocular pressure (DIOP) among individuals with primary angle closure (PAC) or primary angle-closure suspect (PACS). Additionally, the hypothesis that greater DIOP ?uctuation is related to smaller angle parameters was investigated. METHODS. Forty Caucasian newly referred untreated patients with bilateral PAC or PACS were recruited. Intraocular pressure (IOP) was measured hourly between 9 AM and 4 PM with Goldmann applanation tonometry. Diurnal IOP ?uctuation was de?ned as difference between maximum and minimum IOP. Angle opening distance (AOD), trabecular–iris angle (TIA), angle recess area (ARA), and trabecular–iris space area (TISA) were measured with anterior segment optical coherence tomography (AS-OCT) in dark (0.3–0.5 lux) and light (170–200 lux) on the same day as DIOP measurements in eight angle sections. RESULTS. Intraocular pressure declined as the day progressed (P < 0.001), unrelated to presence of peripheral anterior synechiae (PAS). At each time point, eyes with PAS (n ? 31) had signi?cantly higher IOPs than eyes without PAS (n ? 49; P ? 0.043). Diurnal IOP ?uctuation varied from 1.50 to 14.50 mm Hg (mean 5.99 mm Hg, SD 2.70 mm Hg). Diurnal IOP ?uctuation was unrelated to PAS. Multiple-predictor models investigating association of angle dimensions and greater DIOP ?uctuation were statistically signi?cant for AOD 750 (light), ARA 750 (light and dark), TISA 500 (light), TISA 750 (light), TIA 500 (light), and TIA 750 (light and dark). CONCLUSIONS. Diurnal IOP variation has clinical implications given that IOP level is used to distinguish between diagnostic categories of PACS and PAC. Optical coherence tomography angle parameter measurements may predict for magnitude of IOP diurnal ?uctuations in at-risk patients, which may be clinically useful when a clinical intervention is being considered.
关键词： glaucoma,intraocular pressure,angle closure
更新于2025-09-09 09:28:46