Corneal Structural Changes in Congenital Glaucoma
Jennifer DrechslerAdrianna LeeSnehaa MaripudiLaura KuenyMoran R. LevinOsamah SaeediMarlet BazemoreBethany KarwoskiRichard H. BirdsongCamilo MartínezMohamad S. JaafarSairah YousafZubair M. AhmedWilliam P. MadiganJanet Alexander
4
Citation
30
Reference
10
Related Paper
Citation Trend
Abstract:
Objective: To identify corneal structure differences on quantitative high-frequency ultrasound biomicroscopy (UBM) among subjects with congenital glaucoma compared with controls. Methods: This prospective case–control study evaluated 180 UBM images from 44 eyes of 30 subjects (18 control and 12 glaucoma, mean age 5.2±8.0 years, range 0.2–25.8 years) enrolled in the Pediatric Anterior Segment Imaging and Innovation Study (PASIIS). ImageJ was used to quantify a comprehensive set of corneal structures according to 21 quantitative parameters. Statistical analysis compared corneal measurements in glaucoma subtypes and age-matched controls with significance testing and mixed effects models. Results: Significant differences between congenital glaucoma cases and controls were identified in 16 of 21 measured parameters including angle-to-angle, central and peripheral corneal thicknesses, scleral integrated pixel density, anterior corneal radius of curvature, and posterior corneal radius of curvature. Eight parameters differed significantly between primary congenital glaucoma and glaucoma following congenital cataract surgery. Conclusion: Multiple measurable corneal structural differences exist between congenital glaucoma and control eyes, and between primary and secondary congenital glaucoma, including but not limited to corneal width and thickness. The structural differences can be quantified from UBM image analysis. Further studies are needed to determine whether corneal features associated with glaucoma can be used to diagnose or monitor progression of congenital glaucoma.Keywords:
Ultrasound biomicroscopy
Congenital glaucoma
目的 探讨闭角型青光眼急性发作患者合并睫状体脱离的超声生物显微镜(UBM)图像特征.方法 利用UBM对高眼压状态下的急性闭角型青光眼患者作前房角、前房深度、睫状体检查,对合并睫状体脱离UBM图像的形态进行分析.结果 21例(29只眼)患者合并睫状体脱离,平均眼压为(34.84±9.37)mmHg,中央前房深度为(1.67±0.18)mm,眼轴长度为(23.10±1.25)mm.UBM图像分析示睫状体脱离双眼8例、单眼13例;脱离分级,1级11只眼、2级12只眼、3级6只眼;脱离范围2象限6只眼、3象限4只眼、全周脱离19只眼.结论 UBM检查显示原发性急性闭角型青光眼高眼压状态的患者可合并睫状体上腔脱离,对该类患者的临床初期治疗,需重视降眼压药物及适量的皮质激素联合应用。
Ultrasound biomicroscopy
Cite
Citations (0)
To report the results of ultrasound biomicroscopy(UBM) cases of ciliochoroidal effusion after a lens-induced glaucoma attack.Case 1 was an 83-year-old female. She had shallow anterior chamber with expanded cataract with exfoliation in her right eye. Intraocular pressure(IOP) of the right eye was 64 mmHg. On the next day, IOP was reduced to 16 mmHg by conservative therapy. UBM showed circumference ciliochoroidal effusion in the right eye. On the 5th day, IOP increased to 38 mmHg. UBM was repeated and showed the disappearance of ciliochoroidal effusion. On the 9th day, phacoemulsification was done to treat the lens induced glaucoma attack. Two weeks after operation, IOP of the right eye was 6 mmHg and UBM showed ciliochoroidal effusion. Case 2 was an 85-year-old female. She had been diagnosed by an ophthalmologist as having an attack of lens-induced glaucoma in her left eye. IOP was 46 mmHg. When she was referred to us, IOP was decreased to 24 mmHg and ciliochoroidal effusion was observed in her left eye by UBM.We report two cases of ciliochoroidal effusion associated with lens-induced glaucoma attack. UBM is useful to observe changes in the ciliary body after lens-induced glaucoma attack.
Ultrasound biomicroscopy
IRIS (biosensor)
Cite
Citations (1)
A 25-year-old woman developed pupillary block glaucoma in the right eye after implantation of an angle-supported phakic intraocular lens despite a preexisting moderate-sized iridectomy. Ultrasound biomicroscopy (UBM) showed ophthalmic viscosurgical device retention in the posterior chamber and a full-thickness, patent-appearing iridectomy at 12 o'clock. The intraocular pressure gradually decreased to normal after a neodymium:YAG laser iridotomy was performed midperipherally at 9 o'clock. To our knowledge, this is the first report of UBM findings of this complication.
Ultrasound biomicroscopy
Iridectomy
Cite
Citations (7)
Congenital glaucoma
Cite
Citations (7)
* BACKGROUND AND OBJECTIVE: To evaluate the ability of high-frequency ultrasound biomicroscopy to diagnose traumatic cyclodialyses not evident on clinical examination. * PATIENTS AND METHODS: Six eyes of six patients with posttraumatic hypotony and/or shallow anterior chamber and suspected cyclodialysis clefts were examined with slit-lamp biomicroscopy, gonioscopy, B-scan ultrasonography, and ultrasound biomicroscopy. Ultrasound biomicroscopy provided high resolution of cross-sectional images of the anterior chamber angle, posterior chamber, and anterior uveal tissue. * RESULTS: Ultrasound biomicroscopy confirmed the disinsertion of the ciliary body from the scleral spur and associated ciliary body detachment in all eyes. Gonioscopy failed to demonstrate a cyclodialysis cleft in five eyes because of hyphema (two eyes) and abnormal iris architecture (related to trauma) precluding visualization of the angle recess (three eyes). Using information from ultrasound biomicroscopy imaging, one patient underwent a ciliary body reattachment procedure and repair of the cyclodialysis cleft. * CONCLUSION: Ultrasound biomicroscopy is a noninvasive method that can accurately diagnose the presence of traumatic cyclodialyses and can aid in surgical management. It is particularly useful in the presence of hazy media, hypotony, and/or abnormal anterior segment anatomy. [Ophthalmic Surg Lasers 1996;27:97-105.]
Ultrasound biomicroscopy
Gonioscopy
Hyphema
IRIS (biosensor)
Cite
Citations (61)
Ultrasound biomicroscopy
Mean value
IRIS (biosensor)
Cite
Citations (12)
Pseudophakic glaucoma is a secondary glaucoma in which intra-ocular pressure is elevated following cataract removal. The current study aimed to evaluate the role of ultrasound biomicroscopy (UBM) in assessing post-operative pseudophakic glaucoma.This is a case series, prospective, observational and analytical study. It included 29 eyes of 29 patients with post-operative pseudophakic glaucoma. The patients were evaluated by medical history, detailed ophthalmologic examination and UBM.UBM examination has unmasked different causes of pseudophakic glaucoma. The detected causes were classified into 3 main groups, including intraocular lens (IOL)-related causes, lens remnants and intra-ocular inflammation. Haptic-related causes were present in 9 eyes, while 6 eyes had decentered or tilted IOLs. Soemmering's ring was the main cause in 3 eyes while in one eye the cause was lens particle in the anterior chamber (AC). Silicone oil in AC with seclusio pupillae was the main cause in one eye. Peripheral anterior synechiae were detected in 8 eyes while, posterior synechiae were evident in 7 eyes. Uveitis induced by anterior chamber IOL (ACIOL) was found in 3 eyes and one eye had peripheral anterior synechiae due to neovascular glaucoma.UBM is a helpful diagnostic tool to evaluate causes of pseudophakic glaucoma through adequate visualization of different angle structures.
Ultrasound biomicroscopy
Cite
Citations (8)
Congenital glaucoma
Cite
Citations (7)
Ultrasound biomicroscopy (UBM) can be used to investigate the appearance of the anterior chamber in infants with congenital corneal opacity. This study investigated the association between the UBM-obtained clinical imaging of anterior chamber morphology and the clinical diagnosis in infants with congenital corneal opacity.This study involved 19 eyes of 10 consecutive infants with congenital corneal opacity, 13 eyes with Peters anomaly (PA, 7 cases) and 6 eye with sclerocornea (SC, 3 cases), recruited at the Kyoto Prefectural University of Medicine, Kyoto, Japan between September 2001 and January 2009. In each subject eye, UBM findings were compared with the clinical diagnosis based on slit-lamp findings and intraocular pressure (IOP).UBM findings revealed partial angle closure in 10 PA eyes and in 5 SC eyes, absence of Descemet's membrane in 13 eyes and 6 eyes, and funicular fiber from the iris in 12 eyes and 6 eyes. All 6 eyes with SC showed normal IOP, while 9 eyes with PA were diagnosed as glaucoma.Similarities in UBM appearance were observed between PA and SC. PA had a higher incidence of glaucoma; however, there was no relation between IOP and the UBM images.
Ultrasound biomicroscopy
Corneal opacity
Congenital glaucoma
Cite
Citations (5)
Ultrasound biomicroscopy
IRIS (biosensor)
Cite
Citations (3)