Residual angle closure one year after laser peripheral iridotomy in primary angle closure suspects

5 years ago

Residual angle closure one year after laser peripheral iridotomy in primary angle closure suspects

To determine the incidence and baseline clinical and anterior segment optical coherence tomography (AS-OCT) predictors associated with residual angle closure as assessed by gonioscopy 1 year after laser peripheral iridotomy (LPI) in primary angle closure suspects (PACS).

Design

Sub-analysis of randomized controlled trial data

Methods

AS-OCT images (Visante, Carl Zeiss Meditec, Dublin, CA) from 181 PACS subjects ≥ 50 years of age, were analyzed using customized software, prior to, and 1 year after LPI. Other parameters assessed were intraocular pressure (IOP) and axial length (Axl). Residual angle closure was defined as the inability to see the posterior trabecular meshwork for at least 2 quadrants on gonioscopy after LPI. Multivariate regression analysis determined the baseline predictors of residual angle closure 1 year after LPI.

Results

The mean age of participants was 62.4 (SD 9.9) years. The majority were female (137, 75.7%) and Chinese 174, 96.1%). At 1 year post LPI, 148 (81.8%) subjects had gonioscopic residual angle closure. Univariate analysis showed that baseline Axl, anterior chamber area, anterior chamber volume, angle opening distance at 750 microns from the scleral spur and angle recess area were smaller while baseline lens vault and iris curvature were larger in residual angle closure subjects (all p<0.05). Multivariate analysis revealed that baseline iris volume (B=-0.08, P=0.035) and baseline IOP (B=0.23, p=0.032) were predictors for residual angle closure.

Conclusions

One year after LPI, >80% of PACS had gonioscopic residual angle closure. Greater baseline iris volume and higher IOP at baseline are independent risk factors for residual gonioscopic angle closure.

Publisher URL: www.sciencedirect.com/science

DOI: S0002939417303707