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Sonal Shah, Anastasia Pilat, Ravi Purohit, Viral Sheth, Joseph Abbot, Irene Gottlob; Anterior Optical Coherence Tomography in Children with Primary Congenital Glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2074.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the potential of the hand held spectral-domain optical coherence tomography (HH SD-OCT) device to improve diagnosis of primary congenital glaucoma (PCG), by visualising anterior segment structures without general anaesthetic/sedation.
Methods: The HH SD-OCT (Leica Microsystems, 2.6 µm resolution) device was used to acquire horizontal corneal scans and anterior angle scans in 25 children with PCG (11 females and 14 males; mean age 4.06±3.38, 21-bilateral involvement) and 25 gender, age and ethnicity-matched healthy controls. At the time of examination all patients had intraocular pressures controlled by surgical procedures and/ or topical medication.
Results: 13% of patients with PCG had Haab’s striae visible on OCT, 8.7% of patients had an uneven corneal structure with severe asymmetry in corneal thickness. Central corneal thickness was significantly thicker in PCG group, although pressure was controlled (p<0.001), as compared to healthy controls. OCT showed flattening of the iris with diminishing of the collarette zone in 45.7% of patients; this feature significantly correlated with horizontal corneal diameter (p=0.03) and number of surgical procedures (p=0.04). Anterior incretion of the iris was found in 10.95% of patients with PCG.
Conclusions: Our study provides for the first time evidence of anterior segment changes on OCT in patients with PCG. Iris abnormalities seen on OCT reflect structural changes correlating to the number of surgical procedures. Anterior segment changes observed on OCT have the potential to improve diagnosis and predict severity of the disease. Anterior OCT can also be beneficial in the assessment of angle structures, in defining treatment options and selecting optimal anatomical location for surgery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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