Evaluation of ciliary cleft changes after phacoemulsification using ultrasound biomicroscopy in dogs with cataracts
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Glaucoma is one of the most serious complications that causes irreversible blindness after phacoemulsification in dogs; however, a clear mechanism has not been elucidated. This study aimed to analyse the possible anatomical factors associated with glaucoma after phacoemulsification using parameters that reflect the anatomical characteristics of dogs.A total of 69 eyes of 48 dogs were included in this study. The patients were divided into three groups: normal eye (n = 18), cataract (n = 39), and post-phacoemulsification for at least 2 months after surgery (post-phaco, n = 12). For further analysis, the dogs were subdivided into two groups according to cataract stage: phacoemulsification non-candidate and candidate groups. Non-cataracts and incipient cataracts were categorized into the non-candidate group, whereas immature and mature cataracts were categorized into the candidate group. Measurements of the ciliary cleft parameters, including the area of the ciliary cleft (CCA), length of the ciliary cleft (CCL), width of the ciliary cleft (CCW), iridocorneal angle, and angle opening distance, were obtained using ultrasound biomicroscopy.CCA, CCL, and CCW were significantly higher in the candidate group than in the non-candidate group. CCA, CCL, and CCW were significantly reduced in the post-phaco group compared to those in the cataract group. Based on these results, we found that the ciliary cleft expanded in cataract-affected eyes and narrowed after phacoemulsification. This may indicate that the space between the trabecular meshworks became narrower, potentially leading to an increase in the resistance of the aqueous humor.A narrowed ciliary cleft after phacoemulsification may be an anatomical factor associated with glaucoma.Keywords:
Ultrasound biomicroscopy
Ciliary processes
Ultrasound biomicroscopy
Ciliary processes
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Aims: To investigate the usefulness of ultrasound biomicroscopy for evaluating changes in the ciliary body in patients with Vogt-Koyanagi-Harada disease. Methods: Ultrasound biomicroscopy was used to evaluate 14 eyes of seven patients diagnosed with Vogt-Koyanagi-Harada disease. Cross sectional images of the ciliary body and thickness of the pars plana 3.0 mm posterior to the scleral spur were examined. Predicted thickness of the pars plana was obtained by multiple linear regression analysis of thickness in the acute phase and in the remission phase. Results: In the active phase, the cross sectional images showed a shallow anterior chamber in eight of the 14 eyes, ciliochoroidal detachment in five eyes, and a thickened ciliary body in all 14 eyes. Internal reflectivity of the ciliary stroma was low, with ciliary processes being unclear in 13 eyes. One month after steroid treatment, slit lamp examination findings were normal in 14 eyes. 10 eyes of five patients were examined by ultrasound biomicroscopy at this stage. Ciliochoroidal detachment was no longer seen in any eye. Internal reflection of the ciliary stroma became relatively homogeneous, and the ciliary processes were seen, though not clearly. However, the pars plana remained thickened. The actual thickness was greater at 1 month after steroid treatment than the predicted thickness for the remission phase. In the remission phase, the internal reflection was homogeneous and the ciliary processes were delineated clearly in all 14 eyes. Conclusion: Objective, quantitative evaluation of the ciliary body is possible with ultrasound biomicroscopy during the course of Vogt-Koyanagi-Harada disease. Ultrasound biomicroscopy is useful in determining disease activity in the anterior segment and in monitoring the clinical course, and it may improve evaluation of the efficacy of treatment.
Ultrasound biomicroscopy
Choroid
Ciliary processes
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Ultrasound biomicroscopy
Ectopia lentis
Ciliary processes
Quadrant (abdomen)
Ciliary muscle
Ciliary arteries
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Objective:To determine the morphologic changes and their clinical significance of the shallow anterior chamber in cyclodialysis after glaucoma surgery.Method:All eyes of patients with cyclodialysis after glaucoma surgery were examined by conventional B-scan ultrasound and ultrasound biomicroscopy (UBM) for the morphologic changes, and the measurements of relative parameters were analyzed statistically.Results:We can analyze cyclodialysis and choriodal shallow detachment by UBM which can′t do by B-scan ultrasound,and get characteristic diagnosis and analysis. The characteristic manifestations of cyclodialysis found by UBM were as follows:no echoes between sclera and ciliary body,anterior displacement and rotation of ciliary process and displacement of pars plana toward the centre of eyeball.Superciliary effusion could be observed in some cases.The shallow anterior chamber was caused by the anterior displacement and rotation of ciliary processes and the resulting anterior bulging of the iris root,and anterior displacement of ciliary processes.The cyclodialysis in all the cases was 360°. Conclusion:In the shallow anterior chamber after glaucoma surgery with cyclodialysis and without choriodal detachment,anterior chamber can′t completely dissolve usually,and we may provide evidences for treatment.
Ultrasound biomicroscopy
Sclera
Ciliary processes
Glaucoma surgery
IRIS (biosensor)
Anterior Eye Segment
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Objective:To investigate clinical the significance of diagnosis about Primary acute angle-closure glaucoma concurrent under ultrasound biomicroscopy.Method:Selected 138 cases of 169 eyes with acute angle-closure glaucoma(acute phase)as the research objects,from August 2008 to December 2012 in our hospital. Actively reduced intraocular pressure,analyzed and summarized the patients with cyclodialysis by ultrasound biomicroscopy. Result:It was improved in 43 eyes(25.44%)of all the 169 eyes,there were no statistical differences in age or sex between the patient with cyclodialysis and those without(P0.05);there was no statistical significance in corneal thickness,the anterior chamber depth and scleral with ciliary body angle between the patient with cyclodialysis and those without(P0.05);the difference of ciliary body thickness and the distance of the trabecular and ciliary body between he patient with cyclodialysis and those without had statistical significance(P0.05);gonioscopy showed Angle- closure in the patient with cyclodialysis incompletely,there were 2-o'clock at least. Conclusion:The ultrasound biomicroscopy do good to diagnosing the cyclodialysis accurately,guiding treatment of primary acute angle-closure glaucoma,which has higher diagnostic value.
Ultrasound biomicroscopy
Gonioscopy
Angle-closure glaucoma
Ciliary processes
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Abstract Objective To investigate the relationship of the iridocorneal angle as it appears on ultrasound biomicroscopy (UBM) to increases in IOP post‐phacoemulsification in the canine eye. Animals studied 47 eyes of 28 dogs of various age, sex, and breed. Methods The ciliary process and limbus were used as a reference points to measure the angle opening distance (AOD), which was set by multiplying 0.45 by the distance between the ciliary process and limbus (when measured from the ciliary process). Pressure measurements were taken at five set points: Before, immediately post‐, one day post‐, 1 week post‐, and 1 month post‐phacoemulsification. Results A weak relationship between the AOD and the IOP one day post‐phacoemulsification (Intercept: 2.83, Slope: –1.24, P ‐value: 0.0155) was observed. No relationship immediately post‐operative (Intercept: 3.45, Slope: –1.34, P ‐value: 0.0651), 1 week post‐phacoemulsification (Intercept: 2.31, Slope: –0.01, P ‐value: 0.9829), 1 month post‐phacoemulsification (Intercept: 1.85, Slope: –0.49, P ‐value: 0.1533) was observed. The pre‐operative measurements made with UBM were: Distance from limbus to ciliary process (DLCP): (Minimum: 1.152, Maximum: 2.992, Mean: 1.91, SD: 0.468); AOD (Minimum: 0.104, Maximum: 0.764, Mean: 0.40, SD: 0.172). Conclusions The relationship between AOD as measured by UBM pre‐operatively is weakly associated with IOP pressure elevations at day one post‐phacoemulsification. Further study is required prospectively to establish the importance of this relationship. Initial measurements of the canine iridocorneal angle were created, suggesting a method to be used in the future to establish true canine normal measurements.
Ultrasound biomicroscopy
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To describe the changes in anterior segment morphology in eyes with acute primary angle closure (APAC) following transscleral cyclophotocoagulation (TCP), using ultrasound biomicroscopy (UBM). Thirteen medically unresponsive APAC eyes (13 patients) were enrolled in this prospective interventional case series. All the patients underwent TCP (20 pulses of 2000 mW during 2000 ms applied to the inferior quadrant). We recorded intraocular pressure (IOP), best corrected visual acuity (BCVA), and complications. We measured before and after TCP the UBM parameters anterior chamber depth (ACD), pupil diameter (PD), angle-opening distance at 500 μm (AOD500), iris thickness at 500 μm (IT500), trabecular-ciliary process distance (TCPD), iris-ciliary process distance (ICPD), maximum ciliary body thickness (CBTmax), and iris
Ultrasound biomicroscopy
Ciliary processes
IRIS (biosensor)
Quadrant (abdomen)
Acute angle
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Ultrasound biomicroscopy
IRIS (biosensor)
Ciliary processes
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To determine the morphologic changes and their clinical significance of cyclodialysis.173 eyes of 173 patients with cyclodialysis were examined by ultrasound biomicroscopy (UBM) for the morphologic changes, and the measurements of relative parameters were analyzed statistically.The cyclodialysis in all the cases was 360 degree. The characteristic manifestations of cyclodialysis found by UBM were as follows: no echoes between sclera and ciliary body, anterior displacement and rotation of ciliary process and displacement of pars plana toward the centre of eyeball. Superciliary effusion could be observed in some cases. In some patients, the ciliary body may be completely disintegrated from the scleral spur, but the disintegration may be quadrantal instead of 360 degree, resulting in a fistula between anterior chamber and superciliary cavity. The anterior chamber depth of the affected eye (2,115 +/- 589) microm was markedly shallower than that of the normal eye (2,736 +/- 441) microm (t = 4.49, P < 0.001). The shallowing of anterior chamber was caused by the anterior displacement and rotation of ciliary processes and the resulting anterior bulging of the iris root.UBM can be used to make a correct diagnosis of cyclodialysis irrespective of optic media condition, and can provide evidences for treatment.
Ultrasound biomicroscopy
Ciliary processes
Sclera
IRIS (biosensor)
Anterior Eye Segment
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Ciliodestructive procedures are commonly performed by the transscleral approach because ciliary processes are seldom visible. Thus the ablative energy is directed toward an “invisible” target whose position can only be estimated on the basis of experimental data. Ultrasound biomicroscopy has been recently introduced in ophthalmologic practice. This high-frequency ultrasound B-scan method gives real-time images of the subsurface structures of the anterior portion of the living eye at microscopic resolution. Ultrasound biomicroscopy perfectly visualizes the ciliary body and its surrounding structures and is a promising complementary tool for ciliodestructive procedures. The system has been used to image early and late ciliary body alterations after transscleral cyclophotocoagulation, to establish the position of the ciliary body to ensure correct laser probe placement, to locate ciliary body residuals for retreatment, and to rule out scleral damage after the procedure. An apparatus has been designed for simultaneous contact cyclophotocoagulation and ultrasound biomicroscopy analysis. A prospective randomized clinical trial is now needed to clarify the influence of ultrasound biomicroscopy on the success rate of ciliodestructive procedures.
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Ciliary processes
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