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Degree of angle closure and extent of peripheral anterior synechiae: an anterior segment OCT study.

Su DH, Friedman DS, See JL, Chew PT, Chan YH, Nolan WP, Smith SD, Huang D, Zheng C, Li Y, Foster PJ, Aung T

Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751.

AIMS: To evaluate the relationship between angle width as determined by anterior segment optical coherence tomography (AS-OCT) and the presence of peripheral anterior synechiae (PAS). METHODS: This was a prospective observational case series in which 203 subjects with primary angle closure or open angles were recruited. Images of the nasal, temporal and inferior angles were obtained with AS-OCT in dark conditions. Subjects then underwent gonioscopy by an independent examiner who was masked to the AS-OCT findings. PAS were identified by gonioscopy and defined as abnormal adhesions of the iris to the angle that were at least half a clock hour in width and present to the level of the anterior trabecular meshwork or higher. The total clock hours of PAS were recorded. RESULTS: Sixty-eight subjects (33.5%) were PACS, 76 subjects (37.4%) had PAC/PACG, 14 (6.9%) had primary open angle glaucoma, and 45 (22.2%) subjects were normal with open angles. There was a weak but significant correlation between the angle opening distance (AOD), trabecular iris space area (TISA) and angle recess area (ARA) with clock hours of PAS (Spearman's correlation coefficients = -0.30, -0.32 and -0.32, respectively, p<0.001). The mean values of the AOD, TISA and ARA in the nasal, temporal and inferior quadrants were significantly less in eyes with PAS compared with those without (p<0.001, Mann-Whitney U test). Analysis by quadrant showed that these parameters were smaller in the nasal and temporal quadrants in eyes with PAS (p<0.01). CONCLUSIONS: Angle width determined by AS-OCT and the extent of PAS were weakly correlated, and angle width was significantly smaller in eyes with PAS.

Published 24 December 2007 in Br J Ophthalmol, 92(1): 103-7.
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