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  • Correlation of IOP and Anterior Segment Imaging

    By Jean Shaw
    Selected By: Henry D. Jampel, MD
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    Journal Highlights

    Ophthalmology Glaucoma, November/December 2018

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    Xu et al. set out to characterize the relationship between intraocular pressure (IOP) and angle configuration measured by anterior segment optical coherence tomography (AS-OCT). They found that there is an anatomic threshold for angle configuration below which IOP is strongly related to the degree of angle closure. Specifically, IOP tends to increase as angle width decreases in patients with untreated primary angle-closure disease (PACD).

    The authors evaluated participants in the Chinese American Eye Study, a population-based epidemiologic study based in Los Angeles. The researchers examined 10 anterior segment param­eters that directly measure the configu­ration of the angle, and the relationship between these AS-OCT measurements and IOP was assessed using locally weighted scatterplot smoothing regres­sion and change-point analysis.

    Mean IOP was 16.3 ± 3.9 mm Hg for angle-closure eyes (n = 382) and 15.3 ± 2.7 mm Hg for open-angle eyes (n = 320). In closed-angle eyes, the mean IOP increased as AS-OCT decreased for all parameters except the trabecular-iris angle measured at 750 μm from the scleral spur. The parame­ters that had the strongest correlation with IOP below their threshold values were angle recess area and trabecular-iris space area, both at 500 μm and 750 μm from the scleral spur. There was no correlation between AS-OCT measure­ments and IOP in open-angle eyes.

    The authors suggested that their findings support the theory that PACD occurs along a disease continuum, and they recommended development of a classification system that would reflect that understanding. They also noted that this study supports an expanded role for AS-OCT in the management of angle-closure patients as a comple­ment—or possibly even an alternative—to gonioscopy.

    The original article can be found here.