Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions

Objective: To determine the presence of iridotrabecular contact (ITC) and compare the changes in anterior chamber angle (ACA) measurements in room lights-on and lights-off conditions using the anterior segment optical coherence tomography (AS-OCT) in eyes diagnosed as primary angle closure suspects...

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Main Authors: James Paul S. Gomez, MD, DPBO, Edgar U. Leuenberger, MD, DPBO
Format: Article
Language:English
Published: Philippine Academy of Ophthalmology 2019-06-01
Series:Philippine Journal of Ophthalmology
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Online Access:https://paojournal.com/index.php/pjo/article/view/112
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author James Paul S. Gomez, MD, DPBO
Edgar U. Leuenberger, MD, DPBO
author_facet James Paul S. Gomez, MD, DPBO
Edgar U. Leuenberger, MD, DPBO
author_sort James Paul S. Gomez, MD, DPBO
collection DOAJ
description Objective: To determine the presence of iridotrabecular contact (ITC) and compare the changes in anterior chamber angle (ACA) measurements in room lights-on and lights-off conditions using the anterior segment optical coherence tomography (AS-OCT) in eyes diagnosed as primary angle closure suspects (PACS) by gonioscopy. Methods: This is a retrospective review of 144 eyes of 79 patients (70 females, 9 males) with PACS. All eyes were imaged using the Visante® time-domain AS-OCT (Carl Zeiss Meditec, Dublin, CA). Each eye was imaged twice; the first scan was done with the room lights on followed by a second scan done after turning the room lights off for 2 minutes. The principal outcome measure was the presence of ITC in either lighting condition. Other angle metrics that were assessed included anterior chamber depth (ACD), angle opening distance (AOD), trabecular-iris space area (TISA), and scleral spur angle (SSA). Presence of ITC and differences in the angle metrics between the 2 lighting conditions were then analyzed using the t-tests and logistic regression. Results: ITC was present in 36.8% (53) of the study eyes. Twenty percent (20%) of the study eyes (29) did not initially exhibit ITC in the lights-on phase but developed ITC when imaged with the lights off. Persistent ITC was seen in 16.6% (24 eyes) in both lighting conditions. ITC occurred in 52.2% of the eyes with ACD less than 2.18 mm. Logistic regression showed that there is a 91% decrease in the odds of having ITC in lights-off condition for every millimeter of ACD increase. Age was not associated with the occurrence of ITC in the lights-off condition. All other analyzed parameters decreased significantly in the lights-off condition (p<0.05) except for the ACD, nasal TISA-500, and temporal SSA. Conclusions: The presence of ITC is a well-established characteristic of eyes with angle closure. In eyes with PACS, detection of ITC may be enhanced with AS-OCT imaging in lights-off condition.
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spelling doaj-art-d769ab0c6d8a4e85b171555d39dbef432025-08-20T01:49:15ZengPhilippine Academy of OphthalmologyPhilippine Journal of Ophthalmology0031-76592019-06-014411924112Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off ConditionsJames Paul S. Gomez, MD, DPBO0Edgar U. Leuenberger, MD, DPBO1Asian Eye Institute Phinma Plaza Building, Hidalgo Drive Rockwell, Makati, Metro ManilaAsian Eye Institute Phinma Plaza Building, Hidalgo Drive Rockwell, Makati, Metro ManilaObjective: To determine the presence of iridotrabecular contact (ITC) and compare the changes in anterior chamber angle (ACA) measurements in room lights-on and lights-off conditions using the anterior segment optical coherence tomography (AS-OCT) in eyes diagnosed as primary angle closure suspects (PACS) by gonioscopy. Methods: This is a retrospective review of 144 eyes of 79 patients (70 females, 9 males) with PACS. All eyes were imaged using the Visante® time-domain AS-OCT (Carl Zeiss Meditec, Dublin, CA). Each eye was imaged twice; the first scan was done with the room lights on followed by a second scan done after turning the room lights off for 2 minutes. The principal outcome measure was the presence of ITC in either lighting condition. Other angle metrics that were assessed included anterior chamber depth (ACD), angle opening distance (AOD), trabecular-iris space area (TISA), and scleral spur angle (SSA). Presence of ITC and differences in the angle metrics between the 2 lighting conditions were then analyzed using the t-tests and logistic regression. Results: ITC was present in 36.8% (53) of the study eyes. Twenty percent (20%) of the study eyes (29) did not initially exhibit ITC in the lights-on phase but developed ITC when imaged with the lights off. Persistent ITC was seen in 16.6% (24 eyes) in both lighting conditions. ITC occurred in 52.2% of the eyes with ACD less than 2.18 mm. Logistic regression showed that there is a 91% decrease in the odds of having ITC in lights-off condition for every millimeter of ACD increase. Age was not associated with the occurrence of ITC in the lights-off condition. All other analyzed parameters decreased significantly in the lights-off condition (p<0.05) except for the ACD, nasal TISA-500, and temporal SSA. Conclusions: The presence of ITC is a well-established characteristic of eyes with angle closure. In eyes with PACS, detection of ITC may be enhanced with AS-OCT imaging in lights-off condition.https://paojournal.com/index.php/pjo/article/view/112iridotrabecular contactas-octangle metrics
spellingShingle James Paul S. Gomez, MD, DPBO
Edgar U. Leuenberger, MD, DPBO
Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions
Philippine Journal of Ophthalmology
iridotrabecular contact
as-oct
angle metrics
title Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions
title_full Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions
title_fullStr Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions
title_full_unstemmed Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions
title_short Determination of Iridotrabecular Contact Using the Anterior Segment Optical Coherence Tomography in Lights-on and Lights-off Conditions
title_sort determination of iridotrabecular contact using the anterior segment optical coherence tomography in lights on and lights off conditions
topic iridotrabecular contact
as-oct
angle metrics
url https://paojournal.com/index.php/pjo/article/view/112
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