Egypt: Anterior Segment Optical Coherence Tomography in Primary Congenital Glaucoma

Anterior segment optical coherence tomography (HH AS-OCT) is a useful tool not only in identifying structures but will also likely serve helpful in creating future treatment strategies in primary congenital glaucoma (PCG), finds a new study. The researchers discovered that using HH AS-OCT allows for the tomographic study of the ACA in primary congenital glaucoma babies and may aid in disease pathology knowledge. As a result, it may aid in therapy optimization.

The findings of this study were published in the Nature journal Eye on 11th June 2021.

Hand-held anterior segment optical coherence tomography is an in-office, non-contact method for evaluating anterior chamber angle (ACA) architecture and characteristics in primary congenital glaucoma (PCG) and normal newborn eyes.

In the study, Hand-held anterior segment optical coherence tomography (HH AS-OCT) was used to assess normal and PCG-infant 24-month-olds (RTVue RT-100, Optovue Inc., Fremont, CA). Sedation was not necessary. The ACA width, corneal pachymetry map, and iris thickness (IT) were all measured. Identification of trabecular meshwork (TM), Schlemm's canal (SC), and scleral spur (SS) were tested in both groups.

The study comprised 48 babies (26 PCG-eyes and 22 normal-eyes) ranging in age from 9.12 to 6.7 months. The nasal and temporal ACA widths were observed to be substantially greater in PCG babies. IT was drastically decreased. TM was detected in all normal eyes (100%) and nine (34.6%) PCG-eyes. SC was found in 16 (72.7%) of the normal eyes and four (15.4%) of the PCG eyes. The iris was anteriorly inserted in all PCG-eyes, and iridotrabeculodysgenesis was clearly detected. An aberrant structure occluding the angle was found in seven (26.9%) PCG-eyes, and a hyperreflective membrane was seen in five (19.2%) (with constant iris anterior insertion). The aberrant tissue that obscured the angle was found in younger PCG infants, and iris thinning appeared to be part of the disease rather than a consequence of IOP rise.

In conclusion, hand-held anterior segment optical coherence tomography (HH AS-OCT) shows a promising utility in infant ACA examination, and further research and improvement are needed to make it completely applicable in the medical field.

Reference:

Abdeen, W., Esmael, A.F., Gawdat, G. et al. Anterior chamber angle features in primary congenital glaucoma infants using hand-held anterior segment-oct. Eye (2021). https://doi.org/10.1038/s41433-021-01583-1