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

Abstract

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.