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Suzanne Daly, D Jackson Coleman, Harriet O Lloyd, Ronald H Silverman; Angle and Ciliary Body Conformation in Anatomically Narrow Angle by Ultrasound Biomicroscopy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5900. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The presence of anatomically narrow angles (ANA) is a common reason for referral of patients for evaluation of the angle and retroiridal structures by ultrasound biomicroscopy (UBM). In this retrospective study, we analyzed UBM images of 15 eyes of 10 patients referred for evaluation of ANA and 6 normal eyes to assess anatomic characteristics associated with ANA.
Scans were performed with a Quantel Aviso using the Lin50 50 MHz probe with a water-filled disposable ClearScan probe cover to establish acoustic coupling between the transducer and the eye. Cineloops were acquired in four quadrants and axially. Anterior chamber depth (ACD) and lens thickness (LT) were determined and compared to sex and age matched historical controls. We measured angle-opening-distance at 500 mm from the scleral spur (AOD500), maximum lateral distance of the ciliary processes from the angle, and ciliary process-to-iris distance (CPI) in each quadrant. Ciliary body cysts and plateau configuration were noted where present.
Patients ranged from 35 to 69 years of age (mean=56.2). In this series, only 7 of 15 eyes had one or more fully closed angles in at least one quadrant, and only one had two closed quadrants. Anterior chamber depth was, on average, significantly less than historic controls. AOD500 tended to be narrower superiorly and inferiorly compared to temporally and nasally. CPI was minimal inferonasally. Six eyes had cysts, 4 in multiple quadrants. Plateau configuration was present in 4 eyes. In the 7 eyes where the cysts or plateau were absent, lens thickness was found to be significantly greater than in the 8 eyes where present (p=.020).
The etiology of ANA is varied and UBM is required for diagnosis. The presence of cysts or a plateau configuration of the ciliary processes was present in roughly half of the eyes and a phacomorphic etiology is suggested in the remainder. We are expanding this retrospective study to further quantify these initial findings.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
UBM images of the superior (left) and nasal (right) quadrants of one eye, demonstrating a cyst and a plateau conformation, respectively.
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