An evaluation of the darkroom prone provocative test in family members of primary angle closure glaucoma patients

Abstract

Purpose To compare ocular biometric parameters with darkroom prone provocative test (DRPPT) in family members of primary angle closure glaucoma (PACG) patients. Methods One hundred and forty-nine family members of 46 PACG patients underwent ocular examination included slit lamp biomicroscopy, gonioscopy, fundus examination using þ 90 D lens, Goldmann applanation tonometry, darkroom prone provocative test, perimetry on Humphrey's field analyzer II and optic disc evaluation using HRT II. Ultrasonic ocular biometry and the DRPPT were then performed. IOPX 8 mmHg rise from baseline with iridocorneal touch was considered as a positive test. Results Of the 149 family members examined, 55 (36.9%) were found to have PACG. Forty (72.7%) of these had subacute PACG and 15 (27.3%) were found to have chronic PACG. Thirty-nine (70.3%) of the affected members showed a positive DRPPT. Mean anterior chamber depth (ACD) was 2.0370.3, 2.370.4, 2.770.3 mm (P ¼ 0.0001) and mean lens thickness was 4.4170.39, 3.9970.5, 3.9370.4 mm (P ¼ 0.0001) in DRPPT positives, borderlines and negatives respectively. ROC curve (ACD) plotted showed cutoff value of 2.07 mm (sensitivity 88.57%) for screening. Conclusion Anterior chamber is shallowest, lens is thickest and axial length is shortest in affected and DRPPT positive, family members of PACG patients.

Ocular changes over 60 min in supine and prone postures

“…All measures were made on the left eye using a Perkins tonometer (Mk2; Haag-Streit, Essex, UK) by a certified ophthalmologic technician. The Perkins tonometer is a handheld applanation tonometer with a spring-counterweight to compensate for gravity, so IOP can be measured in any posture (9,31,36). The root mean square difference between the Perkins and the gold standard Goldmann applanation tonometer is 1.4 mmHg in the seated position (13) with a potential negative bias of 1 mmHg in the seated position (45) and 1.8 mmHg in the supine position (2).…”

Modified Dark Room Provocative Test for Primary Angle Closure

“…Dynamic gonioscopy was used to determine whether it was a peripheral anterior synechiae or an appositional attachment. 15 When a convex iris prevented observation of the angle, the patient was requested to look in the direction of the mirror, thereby bringing the angle into view. If the posterior pigmented meshwork could not be seen, corneal indentation was performed with the gonioprism.…”

Evaluation of Endothelial Mucin Layer Thickness After Phacoemulsification With Next Generation Ophthalmic Irrigating Solution

“…Several studies have reported varying lens thickness from 4 to 6 mm. [21][22][23] Assuming an anterior chamber depth of 2.0-3.5 mm, a phaco probe-endothelium distance of 6-7 mm was appropriate assuming in-the-bag phacoemulsification. The 0.9-mm straight phaco tip was used with the bevel facing downward.…”