Abstract
Purpose
To identify the determinants of anterior chamber angle narrowing after mydriasis by quantitative assessment of the anterior chamber components using anterior segment optical coherence tomography (AS-OCT).
Methods
In this intervention study, anterior chamber angle analysis was performed using AS-OCT in patients with cataract before pharmacological pupillary dilation and 30 min afterwards. Angle narrowing was quantified by the change of angle opening distance 500 after mydriasis (ΔAOD500). Multivariate linear regression and stepwise selection regression were used to identify which parameters in AS-OCT significantly determined ΔAOD500.
Results
One hundred and two Japanese patients (age, mean ± standard deviation, 71.9 ± 11.2 years) were enrolled. Multivariate analysis indicated that smaller ΔAOD500 were significantly associated with larger lens vault (LV; P < 0.001), larger iris area (IA; P = 0.003), and posterior corneal arch distance (PCAL; P = 0.01). Stepwise linear regression analysis revealed that smaller ΔAOD500 was independently associated with larger LV (partial R 2 = 0.232, P < 0.001), larger IA (partial R 2 = 0.080, P = 0.001), and smaller PCAL (partial R 2 = 0.066, P = 0.002) before mydriasis. These three factors explained 37.7 % of the decrease in ΔAOD500.
Conclusion
Larger LV, larger IA, and smaller PCAL contribute considerably to anterior chamber angle narrowing after mydriasis in patients with cataract.
This is a preview of subscription content, access via your institution.
References
Foster PJ, Johnson GJ (2001) Glaucoma in China: how big is the problem? Br J Ophthalmol 85:1277–1282
Nongpiur ME, Sakata LM, Friedman DS, He M, Chan YH, Lavanya R, Wong TY, Aung T (2010) Novel association of smaller anterior chamber width with angle closure in Singaporeans. Ophthalmology 117:1967–1973
Wang B, Sakata LM, Friedman DS, Chan YH, He M, Lavanya R, Wong TY, Aung T (2010) Quantitative iris parameters and association with narrow angles. Ophthalmology 117:11–17
Wang BS, Narayanaswamy A, Amerasinghe N, Zheng C, He M, Chan YH, Nongpiur ME, Friedman DS, Aung T (2011) Increased iris thickness and association with primary angle closure glaucoma. Br J Ophthalmol 95:46–50
Wu RY, Nongpiur ME, He MG, Sakata LM, Friedman DS, Chan YH, Lavanya R, Wong TY, Aung T (2011) Association of narrow angles with anterior chamber area and volume measured with anterior-segment optical coherence tomography. Arch Ophthalmol 129:569–574
Leung CK, Chan WM, Ko CY, Chui SI, Woo J, Tsang MK, Tse RK (2005) Visualization of anterior chamber angle dynamics using optical coherence tomography. Ophthalmology 112:980–984
Aptel F, Denis P (2010) Optical coherence tomography quantitative analysis of iris volume changes after pharmacologic mydriasis. Ophthalmology 117:3–10
Nongpiur ME, He M, Amerasinghe N, Friedman DS, Tay WT, Baskaran M, Smith SD, Wong TY, Aung T (2011) Lens vault, thickness, and position in Chinese subjects with angle closure. Ophthalmology 118:474–479
Mapstone R (1968) Mechanics of pupil block. Br J Ophthalmol 52:19–25
Pavlin CJ, Harasiewicz K, Foster FS (1992) Ultrasound biomicroscopy of anterior segment structures in normal and glaucomatous eyes. Am J Ophthalmol 113:381–389
Radhakrishnan S, Huang D, Smith SD (2005) Optical coherence tomography imaging of the anterior chamber angle. Ophthalmol Clin N Am 18:375–381
Yuen LH, He M, Aung T, Htoon HM, Tan DT, Mehta JS (2010) Biometry of the cornea and anterior chamber in chinese eyes: an anterior segment optical coherence tomography study. Invest Ophthalmol Vis Sci 51:3433–3440
Quigley HA, Silver DM, Friedman DS, He M, Plyler RJ, Eberhart CG, Jampel HD, Ramulu P (2009) Iris cross-sectional area decreases with pupil dilation and its dynamic behavior is a risk factor in angle closure. J Glaucoma 18:173–179
Sng CC, Foo LL, Cheng CY, Allen JC Jr, He M, Krishnaswamy G, Nongpiur ME, Friedman DS, Wong TY, Aung T (2012) Determinants of anterior chamber depth: the Singapore Chinese eye study. Ophthalmology 119:1143–1150
Congdon NG, Youlin Q, Quigley H, Hung PT, Wang TH, Ho TC, Tielsch JM (1997) Biometry and primary angle-closure glaucoma among Chinese, white, and black populations. Ophthalmology 104:1489–1495
Lowe RF (1970) Aetiology of the anatomical basis for primary angle-closure glaucoma. Biometrical comparisons between normal eyes and eyes with primary angle-closure glaucoma. Br J Ophthalmol 54:161–169
Sihota R, Lakshmaiah NC, Agarwal HC, Pandey RM, Titiyal JS (2000) Ocular parameters in the subgroups of angle closure glaucoma. Clin Exp Ophthalmol 28:253–258
George R, Paul PG, Baskaran M, Ramesh SV, Raju P, Arvind H, McCarty C, Vijaya L (2003) Ocular biometry in occludable angles and angle closure glaucoma: a population based survey. Br J Ophthalmol 87:399–402
Bron AJ, Vrensen GF, Koretz J, Maraini G, Harding JJ (2000) The ageing lens. Ophthalmologica 214:86–104
Seah SK, Foster PJ, Chew PT, Jap A, Oen F, Fam HB, Lim AS (1997) Incidence of acute primary angle-closure glaucoma in Singapore. An island-wide survey. Arch Ophthalmol 115:1436–1440
He M, Foster PJ, Ge J et al (2006) Prevalence and clinical characteristics of glaucoma in adult Chinese: a population-based study in Liwan District, Guangzhou. Invest Ophthalmol Vis Sci 47:2782–2788
Ozaki M, Nongpiur ME, Aung T, He M, Mizoguchi T (2012) Increased lens vault as a risk factor for angle closure: confirmation in a Japanese population. Graefes Arch Clin Exp Ophthalmol 250:1863–1868
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Arimura, S., Takamura, Y., Takihara, Y. et al. Determinants of anterior chamber angle narrowing after mydriasis in the patients with cataract. Graefes Arch Clin Exp Ophthalmol 253, 307–312 (2015). https://doi.org/10.1007/s00417-014-2817-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-014-2817-x
Keywords
- Angle analysis
- Anterior chamber components
- Anterior segment optical coherence tomography
- Lens vault
- Mydriasis