Abstract
Purpose. To investigate the effect of laser peripheral iridotomy (LPI) in subgroups of primary angle closure based on iris insertion configuration. Methods. Anterior segment optical coherence tomography (AS-OCT) images were obtained before and two weeks after LPI. Qualitative classification of angle closure eyes according to iris insertion (basal insertion group (BG) and nonbasal insertion group (NBG)) was performed. Anterior chamber depth (ACD), lens vault (LV), iris curvature, iris area, iris thickness (IT750), and angle opening distance (AOD750) 750 microns from scleral spur were calculated. Uni- and multivariate regression analysis was carried out to evaluate factors associated with AOD750 before and after LPI. Results. Ninety-two eyes of 92 subjects were categorized as NBG (39 eyes) or BG (53 eyes). The mean change after LPI was not significantly different between two groups in all parameters. In both groups, AOD750 was affected by ACD (p < 0.001, p = 0.044) before LPI. AOD750 was affected by LV (p = 0.012) in NBG, but by ACD (p < 0.001) and IT750 (p = 0.039) in BG after LPI. Conclusions. The outcomes of LPI are not significantly different between angle closure subgroups with different iris insertions. However, factors affecting AOD750 show differences between two subgroups after LPI.
Highlights
Primary angle closure glaucoma (PACG) is one of the leading causes of visual loss in Asians [1,2,3]
There was a significant difference in age between the groups, with nonbasal group (NBG) subjects being older (62.7 ± 5.7 versus 59.8 ± 7.3 years, p = 0.043)
The baseline intraocular pressure (IOP) was marginally higher in basal insertion group (BG) eyes (16.6 ± 5.2 versus 14.8 ± 3.4 mmHg, p = 0.063)
Summary
Primary angle closure glaucoma (PACG) is one of the leading causes of visual loss in Asians [1,2,3]. Previous studies have reported the several anatomical features of the eyes with PACG including short axial length and shallow anterior chamber [4,5,6,7]. Angle closure was entirely diagnosed by gonioscopic examination. Gonioscopic examination is still the reference standard for primary angle closure (PAC) diagnosis, but recent advances in imaging devices have allowed various anterior segment (AS) parameters to be measured. Among the several AS parameters, iris-related parameters have become a focus of recent studies. In several recent papers the peripheral iris thickness was reported as an important predictor of the successful outcome of laser peripheral iridotomy (LPI) [12, 13]
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