Assessment of the anterior segment of patients with primary congenital glaucoma using handheld optical coherence tomography.
Pilat Anastasia V, Proudlock Frank A, Shah Sonal, Sheth Viral, Purohit Ravi, Abbot Joseph, Gottlob Irene
AI Summary
Handheld OCT non-invasively visualized key anterior segment abnormalities in congenital glaucoma, like corneal changes and iris flattening, without sedation, offering a valuable tool for diagnosis and surgical planning.
Abstract
Purpose
To investigate the potential of handheld optical coherence tomography (HH-OCT) in assessing the anterior segment of the eye in patients with primary congenital glaucoma.
Design
A prospective, case-controlled observational study.
Participants
Twenty-two patients with primary congenital glaucoma (PCG, 9 females and 13 males; mean age 4.36 ± 3.4 years) and age-, gender- and ethnicity-matched healthy participants.
Methods
Anterior OCT was performed in all participants using a high-resolution HH SD-OCT device (Envisu 2300, Leica Microsystems, Germany) without anaesthesia or sedation.
Results
Anterior HH-OCT in PCG visualised Haab's striae in 14.3%, uneven internal cornea in 9.5% and epithelial thickening in 11.9% of patients with central corneal thickening (CCT, p < 0.001). CCT was significantly correlated with the intraocular pressure (IOP, p < 0.001). The flat iris with a thin collarette zone was found in 59.5%, anterior iris insertion in 11.90% of eyes affected by PCG. Two independent examiners showed sensitivity and specificity of 87% and 77%, respectively, by instating iris thinning and flattening of the anterior profile.
Conclusions
Anterior HH-OCT has significant potential to improve diagnosis and management of PCG. Clinically relevant information can be obtained non-invasively and without sedation. High specificity makes anterior HH-OCT an important adjunct for management of PCG. Excellent visualisation of the iris insertion on OCT indicates potential for AS OCT to assist with surgical planning, including decision on the type of surgery and location of the incision.
MeSH Terms
Shields Classification
Key Concepts5
Anterior handheld optical coherence tomography (HH-OCT) in patients with primary congenital glaucoma (PCG) visualised Haab's striae in 14.3% of patients, uneven internal cornea in 9.5% of patients, and epithelial thickening in 11.9% of patients with central corneal thickening (CCT, p < 0.001) in a prospective, case-controlled observational study of 22 patients with PCG and age-, gender- and ethnicity-matched healthy participants.
Central corneal thickening (CCT) was significantly correlated with the intraocular pressure (IOP, p < 0.001) in patients with primary congenital glaucoma (PCG) in a prospective, case-controlled observational study of 22 patients with PCG and age-, gender- and ethnicity-matched healthy participants.
A flat iris with a thin collarette zone was found in 59.5% of eyes affected by primary congenital glaucoma (PCG), and anterior iris insertion was found in 11.90% of eyes affected by PCG, using anterior handheld optical coherence tomography (HH-OCT) in a prospective, case-controlled observational study of 22 patients with PCG and age-, gender- and ethnicity-matched healthy participants.
Two independent examiners showed sensitivity and specificity of 87% and 77%, respectively, by instating iris thinning and flattening of the anterior profile in patients with primary congenital glaucoma (PCG) using anterior handheld optical coherence tomography (HH-OCT) in a prospective, case-controlled observational study of 22 patients with PCG and age-, gender- and ethnicity-matched healthy participants.
Anterior handheld optical coherence tomography (HH-OCT) has significant potential to improve diagnosis and management of primary congenital glaucoma (PCG) and can obtain clinically relevant information non-invasively and without sedation, as shown in a prospective, case-controlled observational study of 22 patients with PCG and age-, gender- and ethnicity-matched healthy participants.
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