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Invest Ophthalmol Vis SciOctober 201717 citations

Plateau Iris Distribution Across Anterior Segment Optical Coherence Tomography Defined Subgroups of Subjects With Primary Angle Closure Glaucoma.

Verma Sushma, Nongpiur Monisha E, Oo Hnin H, Atalay Eray, Goh David, Wong Tina T, Perera Shamira A, Aung Tin


AI Summary

This study found plateau iris is common (37%) and similarly distributed across PACG subgroups, with thicker peripheral irises increasing its likelihood, impacting tailored treatment approaches.

Abstract

Purpose

We previously identified three distinct subgroups of patients with primary angle closure glaucoma (PACG) based on anterior segment optical coherence tomography (ASOCT) imaging. Group 1 was characterized by a large iris area with deepest anterior chambers, group 2 by a large lens vault (LV) and shallow anterior chamber depth (ACD), and group 3 displayed intermediate values across iris area, LV, and ACD. The purpose of the present study was to determine the distribution of plateau iris in these subgroups using ultrasound biomicroscopy (UBM) features.

Methods

UBM images of the 210 subjects who were previously enrolled for the ASOCT subgrouping analysis and had undergone laser peripheral iridotomy were assessed and graded by a single glaucoma fellowship trained clinician. Plateau iris was defined as the presence of all the following UBM criteria in at least two quadrants: anteriorly directed ciliary body, absent ciliary sulcus, iris angulation, flat iris plane, and iridoangle touch.

Results

Of 210 subjects, 23 were excluded due to poor-quality images. Based on standardized UBM criteria, the overall prevalence of plateau iris was 36.9% (n = 187). The proportion of plateau iris was similar across the three groups (subgroup 1:35.4% (n = 29); subgroup 2:39.0% (n = 32); subgroup 3:34.8% (n = 8), P = 0.87). On multiple logistic regression analysis, iris thickness at 750 μm from the scleral spur (IT750) was the only variable associated with plateau iris (odds ratio: 1.5/100 μm increase in iris thickness [IT], P = 0.04).

Conclusions

The proportion of plateau iris was similar across the three ASOCT-based PACG subgroups and more than one-third of subjects with PACG were diagnosed with plateau iris based on standardized UBM criteria. In addition, we noted that eyes with increased peripheral IT have an increased likelihood of plateau iris.


MeSH Terms

AgedAnterior Eye SegmentFemaleGlaucoma, Angle-ClosureGonioscopyHumansIntraocular PressureIris DiseasesMaleMicroscopy, AcousticMiddle AgedPrevalenceSingaporeTomography, Optical Coherence

Key Concepts4

The overall prevalence of plateau iris was 36.9% (n = 187) in subjects with primary angle closure glaucoma (PACG) based on standardized ultrasound biomicroscopy (UBM) criteria.

EpidemiologyCross-sectionalCross-sectional studyn=187 subjects with PACGCh10Ch13

The proportion of plateau iris was similar across three previously identified anterior segment optical coherence tomography (ASOCT)-defined subgroups of subjects with primary angle closure glaucoma (PACG) (subgroup 1: 35.4% (n = 29); subgroup 2: 39.0% (n = 32); subgroup 3: 34.8% (n = 8), P = 0.87).

PrognosisCross-sectionalCross-sectional studyn=69 subjects with PACG across three su…Ch4Ch13

Iris thickness at 750 μm from the scleral spur (IT750) was the only variable associated with plateau iris in subjects with primary angle closure glaucoma (PACG) (odds ratio: 1.5/100 μm increase in iris thickness [IT], P = 0.04) on multiple logistic regression analysis.

PrognosisCross-sectionalCross-sectional study with logistic regressionn=187 subjects with PACGCh4Ch13

Plateau iris was defined by the presence of all the following ultrasound biomicroscopy (UBM) criteria in at least two quadrants: anteriorly directed ciliary body, absent ciliary sulcus, iris angulation, flat iris plane, and iridoangle touch.

DiagnosisCross-sectionalCross-sectional studyn=210 subjects initially enrolledCh4Ch13

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