June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Iridocorneal Angle and Anterior Chamber Architecture after Laser Iridotomy or Pilocarpine in Anatomically Narrow Angles
Author Affiliations & Notes
  • Nicole Khezri
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Ruojin Ren
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Olga Adleyba
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
    Department of Ophthalmology, Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation
  • Ramiz Abumasmah
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Jason L Chien
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Mark Ghassibi
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Adam Perlstein
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Jeffrey M Liebmann
    Harkness Eye Institute, Columbia University Medical Center, New York, NY
  • Robert Ritch
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
  • Sung Chul (Sean) Park
    Moise and Chella Safra Advanced Ocular Imaging Laboratory, Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
    Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, Hofstra North Shore-LIJ School of Medicine, New York, NY
  • Footnotes
    Commercial Relationships Nicole Khezri, None; Ruojin Ren, None; Olga Adleyba, None; Ramiz Abumasmah, None; Jason Chien, None; Mark Ghassibi, None; Adam Perlstein, None; Jeffrey Liebmann, Carl Zeiss Meditec, Inc. (F), Heidelberg Engineering, GmbH (C), Heidelberg Engineering, GmbH (F), Optovue, Inc. (F), Topcon Medical Systems, Inc. (F); Robert Ritch, None; Sung Chul (Sean) Park, Heidelberg Engineering, GmbH (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4979. doi:
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      Nicole Khezri, Ruojin Ren, Olga Adleyba, Ramiz Abumasmah, Jason L Chien, Mark Ghassibi, Adam Perlstein, Jeffrey M Liebmann, Robert Ritch, Sung Chul (Sean) Park; Iridocorneal Angle and Anterior Chamber Architecture after Laser Iridotomy or Pilocarpine in Anatomically Narrow Angles. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4979.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To compare the effects of laser iridotomy (LI) and pilocarpine on the iridocorneal angle and anterior chamber structures in anatomically narrow angles (ANA).

 
Methods
 

Patients with ANA but no ocular hypertension, glaucoma or prior ocular surgery were enrolled. Temporal LI was performed 1 hr after pilocarpine 2% administration. Horizontal and vertical swept-source optical coherence tomography (OCT) (Casia SS-1000; Tomey, Inc., Nagoya, Japan) B-scans of the anterior segment were obtained at baseline, 30 minutes after pilocarpine 2%, and 1 week after LI, in a standardized dark room. Angle opening distance (AOD), angle recess area (ARA), trabecular-iris surface area (TISA) and trabecular-iris angle (TIA) were measured at the superior, inferior, nasal and temporal quadrants (Fig 1). Anterior chamber depth (ACD) and lens vault (LV) were measured in the horizontal and vertical scans, and the 2 values were averaged to generate a mean value.

 
Results
 

10 eyes (10 subjects; mean age, 55±12 years; mean intraocular pressure, 14.2±3.5 mmHg) were included. All horizontal scans were ~1-2 mm away from the LI site. Mean AOD, ARA, TISA and TIA of the 4 quadrants increased from baseline after pilocarpine and after LI (baseline vs. post-pilocarpine, all p<0.036; baseline vs. post-LI, all p<0.001), but the increase was greater after LI than after pilocarpine although statistically insignificant (post-pilocarpine vs. post-LI, all p>0.200) (Table 1). In the temporal quadrant, mean AOD, ARA, TISA and TIA increased from baseline after piloparpine and after LI (baseline vs. post-pilocarpine, all p<0.043; baseline vs. post-LI, all p<0.001), but the increase was significantly greater after LI than after pilocarpine (post-pilocarpine vs. post-LI, all p<0.019) (Table 1). In the superior, inferior and nasal quadrants, all angle parameters were similar between post-pilocarpine and post-LI (all p>0.106). ACD decreased and LV increased after pilocarpine from baseline (all p<0.012) but vice versa after LI (all p>0.108). Post-pilocarpine anterior chambers were significantly shallower with greater LV than post-LI anterior chambers (all p<0.010) (Table 1).

 
Conclusions
 

LI may be more effective than pilocarpine in widening the iridocorneal angles and deepening the anterior chamber in ANA. Near the LI site, the angles are wider post-LI than post-pilocarpine, possibly because of iris contraction from laser burns.  

 

 
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