Abstract
Objective
This study aimed to evaluate the ability of a digital fundus camera to observe the development of the anterior chamber angle (ACA) in premature infants.
Methods
Forty-eight eyes of preterm infants (n=48) were examined by a digital fundus camera to observe the development of the ACA. ACA grading was performed based on the visualization of the anterior chamber structures according to the Scheie Angle Depth Evaluating System.
Results
ACA images from all 48 infants were successfully acquired using RetCam3. The corrected gestational age ranged from 30 weeks to 49 weeks, which covered the period from 2 months preterm to >2 months post-term. As the corrected gestational age increased, the corrected gestational age grading was significantly decreased. The mean corrected gestational ages of the infants corresponding to the ACA classification from grade IV to grade 0 were 32.75±1.89, 37.20±1.30, 39.75±2.38, 40.56±2.24, and 44.23±2.14 weeks, respectively, which were all significantly different (P<0.05). The regression analysis showed a linear correlation between the grading of the ACA and the corrected gestational age (R2=0.724, P=0.0001).
Conclusion
The ACA of a full-term newborn can be fully detected and evaluated by a digital fundus camera. For premature infants, part of the ACA is not visible physiologically; however, it should not be misdiagnosed as angle closure or a narrow angle.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Sampaolesi R, Caruso R. Ocular Echometry in the Diagnosis of Congenital Glaucoma. Arch Ophthalmol, 1982,100(4):574–577
Pan X, Maram J, Nittala MG, et al. Reproducibility and agreement of four anterior segment-optical coherence tomography devices for anterior chamber angle measurements. Graefes Arch Clin Exp Ophthalmol, 2020,258(7):1475–1481
Alward WL. A history of gonioscopy. Optom Vis Sci, 2011,88(1):29
Sakata LM, Lavanya R, Friedman DS, et al. Comparison of Gonioscopy and Anterior Segment Ocular Coherence Tomography in Detecting Angle Closure in Different Quadrants of the Anterior Chamber Angle. Ophthalmology, 2008,115(5):769–774
Friedman DS, He M. Anterior Chamber Angle Assessment Techniques. Surv Ophthalmol, 2008,53(3): 250–257
Riva I, Micheletti E, Oddone F, et al. Anterior Chamber Angle Assessment Techniques: A Review. J Clin Med, 2020,9(12):3814
Leung KS, Weinreb RN. Anterior chamber angle imaging with optical coherence tomography. Eye, 2011,25(3):261–267
Hao H, Zhao Y, Yan Q, et al. Angle-closure assessment in anterior segment OCT images via deep learning. Med Image Anal, 2021,69:101956
Hussein TR, Shalaby SM, Elbakary MA, et al. Ultrasound biomicroscopy as a diagnostic tool in infants with primary congenital glaucoma. Clin Ophthalmol, 2014,8:1725–1730
Tandon A, Watson C, Ayyala R. Ultrasound biomicroscopy measurement of Schlemm’s canal in pediatric patients with and without glaucoma. J AAPOS, 2017,21(3):234–237
Shi Y, Han Y, Xin C, et al. 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. PLoS One, 2020,15(1):e227602
Salcone EM, Johnston S, Vanderveen D. Review of the use of digital imaging in retinopathy of prematurity screening. Semin Ophthalmol, 2010,25(5–6):214–217
Cheng J, Liu J, Lee BH, et al. Closed angle glaucoma detection in RetCam images. Annu Int Conf IEEE Eng Med Biol Soc, 2010,2010:4096–4099
Azad RV, Chandra P, Chandra A, et al. Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma. Indian J Ophthalmol, 2014,62 (2):163–166
Scheie HG. Width and Pigmentation of the Angle of the Anterior Chamber: A System of Grading by Gonioscopy. AMA Arch Ophthalmol, 1957,58(4):510–512
Barishak YR. The development of the angle of the anterior chamber in vertebrate eyes. Doc Ophthalmol, 1978,45(2):329–360
Zha Y, Zhu G, Zhuang J, et al. Axial Length and Ocular Development of Premature Infants without ROP. J Ophthalmol, 2017,2017:6823965
Choi MY. Long term refractive outcome in eyes of preterm infants with and without retinopathy of prematurity: comparison of keratometric value, axial length, anterior chamber depth, and lens thickness. Br J Ophthalmol, 2000,84 (2):138–143
Azad RV, Chandra P, Chandra A, et al. Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma. Indian J Ophthalmol, 2014,62 (2):163–166
Perera SA, Mani B, Friedman DS, et al. Use of EyeCam for imaging the anterior chamber angle. Invest Ophthalmol Vis Sci, 2010,51 (6):2993–2997
Perera SA, Quek DT, Baskaran M, et al. Demonstration of angle widening using EyeCam after laser peripheral iridotomy in eyes with angle closure. Am J Ophthalmol, 2010,149 (6):903–907
Mukherjee AN, Watts P, Almadfai H, et al. Impact of retinopathy of prematurity screening examination on cardiorespiratory indices: a comparison of indirect ophthalmoscopy and retcam imaging. Ophthalmology, 2006,113(9):1547–1552
Wu C, Petersen RA, Vanderveen DK. RetCam imaging for retinopathy of prematurity screening. J AAPOS, 2006,10(2):107–111
Acknowledgements
We would like to express our sincere gratitude to the Department of Neonatology, Tongji Hospital, which gave supports during data collection.
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
All the authors declare no conflict of financial interests.
Rights and permissions
About this article
Cite this article
Zhang, X., Luo, Dl., Chen, B. et al. Evaluation of the Anterior Chamber Angle Structures in Perinatal Infants Using a Wide-Field Digital Fundus Camera. CURR MED SCI 42, 1305–1309 (2022). https://doi.org/10.1007/s11596-022-2646-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-022-2646-9