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Tanya Albukh, Alfredo R. Castillejos, Saman Kiumehr, Syril K. Dorairaj, Carlos G. De Moraes, Jeffrey M. Liebmann, Robert Ritch; Combined Radial And Longitudinal Imaging Of Schlemm’S Canal In Eyes With Angle-closure Using Anterior Segment Fourier-domain OCT (ASFDOCT). Invest. Ophthalmol. Vis. Sci. 2011;52(14):6282.
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© ARVO (1962-2015); The Authors (2016-present)
To qualitatively and quantitatively assess the morphology of Schlemm’s canal(SC) in eyes with occludable angles successfully treated by laser iridotomy(LI) ± argon laser peripheral iridoplasty(ALPI) and normal eyes using ASFDOCT.
20 normal subjects and 40 patients with occludable angles who 3-6 months prior had undergone an uneventful and successful LI ± ALPI relieving iridotrabecular contact were imaged using a standardized set of radial and longitudinal ASFDOCT scans of the nasal and temporal limbus. One eye per patient was randomly selected and the best image of each set was analyzed. SC area, length and width were assessed with the radial scan; and SC maximum and minimum width with the longitudinal scan. Eyes were grouped into those with appositional closure (group A n=18), synechial closure (group S n=22 PAS≤2 quadrants) or normals (group N n=20). The variables were compared among the 3 groups using a post hoc Bonferroni test. Spearman’s correlation coefficients were calculated to assess the relationship between SC morphometry and the maximum untreated IOP, number of medications, CDR, and PSD.
The groups were comparable in age (56±11years p=0.33). SC area (N=3210±1686 A=3500±1401 S=2000±1206 µm²), length (N=251, A=265, S=148 µm) and minimum longitudinal width (N=16±6, A=17±5 S=12±6 µm) were reduced in group S (all p<0.05). A negative correlation was found between SC morphometry (area, length, longitudinal minimum width) and CDR, IOP and the number of glaucoma medications (all p<.05).Qualitatively, SC in group S was visibly reduced, showing alternate areas of collapse.
Combining longitudinal and radial scans provides a better assessment of the overall condition of SC. Synechial closure may eventually cause an irreversible reduction in SC dimensions even after iridotrabecular contact has been relieved.
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