September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Long term changes in anterior chamber angle morphology and diurnal intraocular pressure fluctuation following Laser Peripheral Iridotomy for angle closure measured with Swept-source Ocular Coherence Tomography: the IMPACT Study (NIHR ID: CCRN 8955)
Author Affiliations & Notes
  • Ivailo Zhekov
    Department of Ophthalmology, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke, United Kingdom
  • Laura Sanchez-Parra
    Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
  • Jane Kean
    Department of Ophthalmology, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke, United Kingdom
  • Roger Buckley
    Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
  • Shahina Pardhan
    Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
  • Mike Parker
    Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
  • Rupert Richard Bourne
    Department of Ophthalmology, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke, United Kingdom
    Vision & Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
  • Footnotes
    Commercial Relationships   Ivailo Zhekov, None; Laura Sanchez-Parra, None; Jane Kean, None; Roger Buckley, None; Shahina Pardhan, None; Mike Parker, None; Rupert Bourne, Allergan Ltd. (F)
  • Footnotes
    Support  Allergan Ltd. (unrestricted educational grant), Hinchingbrooke Hospital Ophthalmology Research Fund
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5611. doi:
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      Ivailo Zhekov, Laura Sanchez-Parra, Jane Kean, Roger Buckley, Shahina Pardhan, Mike Parker, Rupert Richard Bourne; Long term changes in anterior chamber angle morphology and diurnal intraocular pressure fluctuation following Laser Peripheral Iridotomy for angle closure measured with Swept-source Ocular Coherence Tomography: the IMPACT Study (NIHR ID: CCRN 8955). Invest. Ophthalmol. Vis. Sci. 2016;57(12):5611.

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

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Abstract

Purpose : To evaluate temporal change in anterior chamber angle anatomy following laser peripheral iridotomy (LPI) in patients with primary angle closure by comparison with the untreated fellow eye. Additionally, the effect of LPI treatment on diurnal intraocular pressure (DIOP) fluctuation (maximum-minimum IOP) was investigated.

Methods : Thirty-nine patients newly diagnosed with bilateral primary angle closure (PAC) or primary angle closure suspects (PACS) were recruited and received LPI to one eye. The other eye acted as a control and intraocular pressure (IOP) was measured hourly with Goldmann applanation tonometer during DIOP assessments. Angle opening distance (AOD), trabecular–iris angle (TIA), angle recess area (ARA), and trabecular–iris space area (TISA) at both 500 mm and 750 mm from scleral spur were measured over 8 sections with swept source anterior segment optical coherence tomography (AS-OCT) at pre-determined intervals.

Results : An increase in all angle parameters following LPI treatment was observed, which was maintained for 6 months (e.g inferior segment AOD500 0.0402mm (p=0.008) at 1 week and 0.0396mm (p=0.003) at 6 months) following LPI procedure. The greatest effect was observed opposite the iridotomy site in the inferior and infero-temporal sections (AOD500 0.0396mm, p=0.003 and AOD750 0.0751mm, p=0.002), while the angle parameter at the site of iridotomy at the superior section increased comparably to the overall angle changes (AOD500 0.0129mm, p=0.057 and AOD750 0.022mm, p=0.006) at 6 months post LPI. There were no statistically significant differences for the overall IOP or DIOP fluctuation values in the treated group at 6 months post-LPI. For both treated and untreated groups there was no statistically significant reduction in average IOP or DIOP fluctuation at 6 months compared to baseline.

Conclusions : LPI widened all angle sections with maximum effect observed in the site opposite the iridotomy. Angle parameter changes were maintained up to 6 months after LPI treatment without any statistically significant change in DIOP fluctuation.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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