Analysis of anterior segment dynamics using anterior segment optical coherence tomography before and after laser peripheral iridotomy.
Analysis of anterior segment dynamics using anterior segment optical coherence tomography before and after laser peripheral iridotomy.
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DOI：
10.1001/jamaophthalmol.2013.567
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发表时间：
2013
影响因子：
8.1
通讯作者：
C. Zheng;Celeste P. Guzman;C. Cheung;Yingke He;D. Friedman;S. Ong;A. Narayanaswamy;P. Chew;S. Perera;T. Aung
中科院分区：
文献类型：
--
作者：
C. Zheng;Celeste P. Guzman;C. Cheung;Yingke He;D. Friedman;S. Ong;A. Narayanaswamy;P. Chew;S. Perera;T. Aung
目的应用眼前节光学相干断层扫描（OCT）技术评价激光周边虹膜切开术（LPI）对房角关闭患者瞳孔收缩速度和眼前节参数的影响。方法在这项前瞻性观察性研究中，使用眼前节光学相干断层扫描仪实时记录瞳孔和眼前节对照明的反应，并在LPI前后逐帧分析。使用定制软件测量瞳孔收缩的速度和前房深度和前房面积的变化，以及距离巩膜突750 μm处、括约肌区域（距离瞳孔边缘0.75 mm）和虹膜中部位置（巩膜突和瞳孔边缘之间距离的一半）的虹膜厚度。测量瞳孔直径、房角张开距离和距巩膜突500 μm处的小梁-虹膜间隙面积。瞳孔收缩的速度被定义为瞳孔直径响应于照明的变化率。结果29例患者入选。大多数是中国人（29人中有26人[90%]）和女性（29人中有18人[62%]）。LPI后前房面积、距巩膜突500 μ m处的房角张开距离和距巩膜突500 μm处的小梁虹膜间隙面积均显著增加（P < .001）。观察到LPI后瞳孔收缩速度显著增加（P <0.005）。在对光照的反应中，括约肌区域和距巩膜棘750 μm处的虹膜厚度变化率在LPI后更快（P <0.05）。同样，在LPI后，观察到距巩膜棘500 μm处的开角距离的变化速度随着照明的增加而增加（P <0.05）。结论：房角关闭患者，LPI后可观察到动态虹膜瞳孔行为的变化。LPI后瞳孔收缩速度加快。
OBJECTIVE To evaluate changes in the speed of pupil constriction and in anterior segment parameters after laser peripheral iridotomy (LPI) in patients with angle closure using anterior segment optical coherence tomography. METHODS In this prospective observational study, videos of pupil and anterior segment changes in response to illumination were captured with real-time video recording using anterior segment optical coherence tomography and were analyzed frame by frame before and after LPI. Customized software was used to measure the speed of pupil constriction and changes in anterior chamber depth and anterior chamber area, as well as iris thickness at 750 μm from the scleral spur, at the sphincter muscle region (0.75 mm from the pupillary margin), and at the mid-iris location (half the distance between the scleral spur and the pupillary margin). Pupil diameter, angle opening distance, and trabecular-iris space area at 500 μm from the scleral spur were determined. The speed of pupil constriction was defined as the rate of pupil diameter change in response to illumination. RESULTS Twenty-nine patients were included. Most were Chinese (26 of 29 [90%]) and female (18 of 29 [62%]). The anterior chamber area, angle opening distance at 500 μm from the scleral spur, and trabecular-iris space area at 500 μm from the scleral spur were significantly higher after LPI (P < .001). A significant increase was observed in the speed of pupil constriction after LPI (P < .005). In response to illumination, the rate of change in iris thickness at the sphincter muscle region and at 750 μm from the scleral spur was faster after LPI (P < .05). Similarly, an increase was observed in the speed of change of angle-opening distance at 500 μm from the scleral spur in response to illumination after LPI (P < .05). CONCLUSIONS In patients with angle closure, changes in dynamic iridopupillary behavior are observed after LPI. The speed of pupillary constriction is faster after LPI.