Journal of Current Glaucoma Practice

Register      Login

VOLUME 11 , ISSUE 3 ( September-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy

Citation Information : Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy. J Curr Glaucoma Pract 2017; 11 (3):86-91.

DOI: 10.5005/jp-journals-10028-1230

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

To evaluate the configuration of the anterior chamber angle quantitatively and study the morphological changes in the eye with ultrasound biomicroscopy (UBM) in primary angle closure glaucoma (PACG) patients after laser peripheral iridotomy (LPI).

Materials and methods

A total of 185 eyes of 185 PACG patients post-LPI and 126 eyes of 126 normal subjects were included in this prospective study. All subjects underwent complete ophthalmic evaluation, A-scan biometry, and UBM. The anterior segment and angle parameters were measured quantitatively and compared in both groups using Student's t-test.

Results

The PACG patients had shorter axial length, shallower central anterior chamber depth anterior chamber depth (ACD), and anteriorly located lens when compared with normal subjects. Trabecular iris angle (TIA) was significantly narrow (5.73 ± 7.76°) in patients with PACG when compared with normal subjects (23.75 ± 9.38°). The angle opening distance at 500 μm from scleral spur (AOD 500), trabecular—ciliary process distance (TCPD), iris—ciliary process distance (ICPD), and iris—zonule distance (IZD) were significantly shorter in patients with PACG than in normal subjects (p < 0.0001). The iris lens angle (ILA), scleral—iris angle (SIA), and scleral—ciliary process angle (SCPA) were significantly narrower in patients with PACG than in normal subjects (p < 0.0001). The iris—lens contact distance (ILCD) was greater in PACG group than in normal (p = 0.001). Plateau iris was seen in 57/185 (30.8%) of the eyes. Anterior positioned ciliary processes were seen in 130/185 eyes (70.3%) of eyes.

Conclusion

In PACG patients, persistent apposition angle closure is common even after LPI, which could be due to anterior rotation of ciliary body and plateau iris and overcrowding of anterior segment due to shorter axial length and relative anterior lens position.

How to cite this article

Mansoori T, Balakrishna N. Anterior Segment Morphology in Primary Angle Closure Glaucoma using Ultrasound Biomicroscopy. J Curr Glaucoma Pract 2017;11(3):86-91.


  1. Angle-closure glaucoma in an urban population in southern India. The Andhra Pradesh eye disease study. Ophthalmology 2000 Sep;107(9):1710-1716.
  2. Prevalence of angle-closure disease in a rural southern Indian population. Arch Ophthalmol 2006 Mar;124(3):403-409.
  3. Prevalence of primary glaucoma in an urban south Indian population. Indian J Ophthalmol 1998 Jun;46(2):81-86.
  4. Ocular dimensions in the heredity of angle-closure glaucoma. Br J Ophthalmol 1973 Jul;57(7):475-486.
  5. Posterior corneal curvature. Correlations in normal eyes and in eyes involved with primary angle-closure glaucoma. Br J Ophthalmol 1973 Jul;57(7):464-470.
  6. Anterior chamber dimensions in patients with narrow angles and angle-closure glaucoma. Arch Ophthalmol 1984 Jan;102(1): 46-50.
  7. The ratio of lens thickness to axial length for biometric standardization in angle-closure glaucoma. Am J Ophthalmol 1985 Apr 15;99(4):400-402.
  8. Outcome of laser peripheral iridotomy in chronic primary angle closure glaucoma. Ophthalmic Surg Lasers 1999 Jul-Aug;30(7):547-553.
  9. Laser peripheral iridotomy in primary angle-closure suspects: biometric and gonioscopic outcomes: the Liwan Eye Study. Ophthalmology 2007 Mar;114(3):494-500.
  10. Ultrasound biomicroscopy of anterior segment structures in normal and glaucomatous eyes. Am J Ophthalmol 1992 Apr 15;113(4):381-389.
  11. Quantitative assessment of the anterior segment using ultrasound biomicroscopy. Curr Opin Ophthalmol 2000 Apr;11(2):133-139.
  12. An ultrasound biomicroscopic study of the anterior segment in Indian eyes with primary angle-closure glaucoma. J Glaucoma 2002 Dec;11(6):502-507.
  13. Plateau iris in primary angle closure glaucoma: an ultrasound biomicroscopy study. J Glaucoma 2016 Feb;25(2):e82-e86.
  14. Ultrasound biomicroscopic and conventional ultrasonographic study of ocular dimensions in primary angle-closure glaucoma. Ophthalmology 1998 Nov;105(11):2091-2098.
  15. The lens opacities classification system III. The longitudinal study of Cataract study group. Arch Ophthalmol 1993 Jun;111(6):831-836.
  16. Evaluation of the anterior chamber angle in Asian Indian eyes by ultrasound biomicroscopy and gonioscopy. Indian J Ophthalmol 2006 Sep;54(3):159-163.
  17. Ultrasound biomicroscopy in the subtypes of primary angle closure glaucoma. J Glaucoma 2005 Oct;14(5):387-391.
  18. Primary angle-closure glaucoma. Oculometry, epidemiology, and genetics in a high risk population. Acta Ophthalmol Suppl 1976;(127):5-31.
  19. Increase in iris-lens contact after laser iridotomy for pupillary lock angle closure. Am J Ophthalmol 1996 Jul;122(1):53-57.
  20. Variations in ocular biometry in an adult Chinese population in Singapore: the Tanjong Pagar Survey. Invest Ophthalmol Vis Sci 2001 Jan;42(1):73-80.
  21. Gonioscopy in adult Chinese: the Liwan Eye Study. Invest Ophthalmol Vis Sci 2006 Nov;47(11):4772-4779.
  22. Anterior chamber depth and chamber angle and their associations with ocular and general parameters: the Beijing Eye Study. Am J Ophthalmol 2008 May;145(5):929-936.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.