Comparison of Mydriatic Provocative and Dark Room Prone Provocative Tests for Anterior Chamber Angle Configuration

Yamada, Rika; Hirose, Fuyuki; Matsuki, Takaaki; Kameda, Takuro; Kurimoto, Yasuo

doi:10.1097/ijg.0000000000000310

Cited by 8 publications

(6 citation statements)

References 21 publications

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“…Moreover, prone position is known to shift the anterior segment structures (lens, ciliary body, iris) forward, resulting in additional approximation of the iris towards the iridocorneal angle and an additional trigger for acute primary angle closure (APAC). 10 , 18 , 19 Several hypotheses have been advanced to account for its occurrence. As a general observation, prone position is known to reduce anterior chamber depth due to the pressure of the vitreous body and the lens towards the cornea.…”

Section: Discussionmentioning

confidence: 99%

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

Barosco

Morbio

Chemello

et al. 2021

European Journal of Ophthalmology

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Purpose: This report describes a case of bilateral primary angle closure (PAC) progressing to unilateral end-stage primary angle closure glaucoma (PACG) associated with treatment for coronavirus disease-19 (COVID-19) infection. Methods: A 64-year-old man came to our attention because of blurred vision after a 2-month hospital stay for treatment of COVID-19 infection. Examination findings revealed PACG, with severe visual impairment in the right eye and PAC in the left eye due to plateau iris syndrome. The patient’s severe clinical condition and prolonged systemic therapy masked the symptoms and delayed the diagnosis. Medical chart review disclosed the multifactorial causes of the visual impairment. Ultrasound biomicroscopy (UBM) aided in diagnosis and subsequent therapy. Results: The cause behind the primary angle closure and the iridotrabecular contact was eliminated by bilateral cataract extraction, goniosynechialysis, and myotic therapy. Conclusions: COVID-19 treatment may pose an increased risk for PAC. Accurate recording of patient and family ophthalmic history is essential to prevent its onset. Recognition of early signs of PAC is key to averting its progression to PACG.

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Section: Discussionmentioning

confidence: 99%

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

Barosco

Morbio

Chemello

et al. 2021

European Journal of Ophthalmology

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“…[8] The lack of any changes in the ocular biometric parameters in our patients of both groups is in line with other studies on the angle closure patients. [24,25,26,27] In a group of fellow eyes of 21 patients with acute primary angle closure and in 17 patients with PACG, the ACD did not change following WDT. [26] The study by Poon et al on PACG and primary open-angle glaucoma revealed no association between WDT-IOP changes and anterior chamber depth and axial length.…”

Section: Discussionmentioning

confidence: 99%

“…This difference could have resulted from the limited number of patients in each subgroup because the suggested mechanisms underlying both tests are similar. [27] In a study on PACS patients, no changes in ocular biometric or anterior chamber parameters including iridocorneal angle after peripheral iridotomy and/or pharmacologic mydriasis except for increments in anterior chamber volume were observed. [24]…”

Section: Discussionmentioning

confidence: 99%

Water-drinking Test and Pharmacologic Mydriasis as Provocative Tests in Primary Angle Closure Suspects

Razeghinejad¹,

Nowroozzadeh²

2019

JOVR

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PurposeTo compare the water-drinking test (WDT) and pharmacologic mydriasis as provocative tests in patients with primary angle closure suspect (PACS).MethodsThis observational non-randomized comparative study evaluated changes in intraocular pressure (IOP) in 21 patients with PACS who underwent pharmacologic mydriasis and compared it with IOP changes in 26 patients given the WDT. Ocular biometric and anterior chamber parameters were also assessed. Tests were repeated on the same patient two weeks after performing laser peripheral iridotomy (LPI).ResultsThe mean age ± standard deviation was 60 ± 7 and 57 ± 9 years in the mydriasis and WDT groups, respectively (P = 0.201). Before LPI, both provocative tests were associated with a significant increase in IOP (mydriasis: 15.1 ± 3.1 to 16.6 ± 3.5 mmHg, P = 0.025; WDT: 16.2 ± 2.8 to 18.5 ± 3.3 mmHg, P < 0.001). However, the IOP changes were not statistically different between groups (P = 0.102). After LPI, only the WDT group showed a continued significant IOP elevation after the test (mydriasis: 16.4 ± 3.3 to 16.7 ± 3.5 mmHg, P = 0.569; WDT: 14.9 ± 3.0 to 17.8 ± 4.1 mmHg, P < 0.001). The post-test IOP change was significantly greater in the WDT than in the mydriasis group (3.0 versus 0.3 mmHg, respectively; P = 0.002). Step-wise multiple regression analysis verified the type of provocative test as the only independent factor affecting the post-test IOP change after LPI (regression coefficient: 2.664; P = 0.002).ConclusionPharmacologic mydriasis and the WDT had similar IOP elevation before LPI, but after LPI, IOP elevation was much greater in the WDT group.

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“…In a study done by Yamada et al (7) on seventy eyes of seventy consecutive patients with primary angleclosure suspect, primary angle-closure, or primary angle-closure glaucoma (based on gonioscopy), AS-OCT and IOP measurement was done for all those patients after the mydriatic provocative test (MPT) and the dark room prone provocative test (DRPPT), their results revealed that ACD and AOD 500 of the positive group(with a signi cant increase in IOP after the two tests), using the MPT, were signi cantly less than those of the negative group (with an insigni cant increase in IOP). The trabecular-iris space area 500 of the positive group was signi cantly less than the negative group, using both the MPT and the DRPPT.…”

Section: -As-oct Parametersmentioning

confidence: 97%

“…It occurs due to physiological movement of the pupil and can lead to transient IOP increase in narrow angled eyes. If it became chronic, angle con guration will show permanent changes that will lead to increases in IOP and nally will cause PACG (7) .…”

Section: -As-oct Parametersmentioning

confidence: 99%

Evaluation of the Anterior Chamber Angle in Angle-Closure Suspect Patients by Anterior Segment Optical Coherence Tomography (AS-OCT) and Pentacam

Mahmoud¹,

Essam²,

Hammouda³

et al. 2021

Preprint

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Purpose: The study aims is to detect primary angle-closure glaucoma (PACG) suspects using both anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging. Methods: A prospective cross-sectional observational study on forty PACG suspect patients with a range of ages from 20 to 70 years. Angle imaging by AS-OCT (Optovue Inc., Fairmont, CA) with study parameters in the superior, inferior, nasal, and temporal quadrants were anterior chamber angle (ACA), angle opening distance at 750 µm (AOD750), and trabecular-iris space area at 750 μm (TISA). Also, angle imaging using Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) with study parameters were the anterior chamber angle (ACA), anterior chamber depth (ACD) and, anterior chamber volume (ACV). The angle evaluation was done before and after the mydriatic test.Results: As regarding AS-OCT, after the mydriatic test, we noticed a decrease in all parameters measured, some decreased significantly while others did not. A significant decrease was noticed in ACA (TIA750) in all quadrants (P value<0.001in nasal, 0.001in superior &temporal, 0.003 in inferior) and in TISA750 in the nasal quadrant only (P-value 0.004). AOD750 and TISA750 in the remaining quadrants also decreased but not significantly as ACA. As regarding Pentacam, all parameters decreased after the mydriatic test. ACA (P-value <0.001) and ACD (P-value 0.004) showed significant statistical decrease but ACV showed statistically non-significant decrease (P-value 0.558).Conclusions: AS-OCT and Pentacam are reliable investigations for the detection of PACG suspects which needs more close follow-up for a possible increase in IOP.

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Comparison of Mydriatic Provocative and Dark Room Prone Provocative Tests for Anterior Chamber Angle Configuration

Cited by 8 publications

References 21 publications

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

Water-drinking Test and Pharmacologic Mydriasis as Provocative Tests in Primary Angle Closure Suspects

Evaluation of the Anterior Chamber Angle in Angle-Closure Suspect Patients by Anterior Segment Optical Coherence Tomography (AS-OCT) and Pentacam

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