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Assessment of the anterior segment of patients with primary congenital glaucoma using handheld optical coherence tomography.

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posted on 14.06.2019, 15:38 by AV Pilat, FA Proudlock, S Shah, V Sheth, R Purohit, J Abbot, I Gottlob
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.

Funding

This work was supported by a Medical Research Council Grant (MR/J004189/1) and the Ulverscroft Foundation.

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Citation

Eye, 2019

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/Biological Sciences/Neuroscience, Psychology and Behaviour

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VoR (Version of Record)

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Eye

Publisher

Springer Nature, College of Ophthalmologists

eissn

1476-5454

Acceptance date

02/01/2019

Copyright date

2019

Available date

14/06/2019

Publisher version

https://www.nature.com/articles/s41433-019-0369-3

Notes

The online version of this article (https://doi.org/10.1038/s41433-019-0369-3) contains supplementary material, which is available to authorized users

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en

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