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      New comparative ultrasound biomicroscopic findings between fellow eyes of acute angle closure and glaucomatous eyes with narrow angle Translated title: Novos achados comparativos de biomicroscopia ultra-sônica entre olhos contralaterais com fechamento angular agudo e olhos glaucomatosos com ângulo estreito

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          Abstract

          PURPOSE: To compare morphometric features between fellow acute primary angle-closure (APAC) eyes and glaucomatous or suspect eyes with narrow angle (NA). METHODS: Fellow eyes of 30 patients with unilateral APAC and 30 with NA were evaluated by ultrasound biomicroscopy (UBM) under light and dark conditions. UBM parameters such as anterior chamber depth (ACD), angle opening distance at 250 µm/500 µm from the scleral spur (AOD250/AOD500), trabecular ciliary process distance (TCPD) and iris-lens contact distance (ILCD) were measured in the superior (SQ) and inferior (IQ) quadrants. RESULTS: Significant differences between APAC fellow and NA eyes were found in ACD, P<0.001; AOD250 at SQ and IQ, P<0.001; AOD500 at SQ and IQ, P<0.001; TCPD light, P=0.010 and TCPD dark at SQ, P=0.031; and TCPD light at IQ, P=0.010. Significant differences between light and dark examinations of APAC fellow eyes were found in ILCD (P=0.009) at SQ and ILCD at IQ (P=0.006), and of NA eyes in ILCD at SQ (P=0.047) and ILCD at IQ (P<0.001). CONCLUSIONS: APAC fellow eyes have a more crowded anterior segment and shallower ACD than NA eyes. ILCD decreases in both groups when the illumination conditions change from light to dark.

          Translated abstract

          OBJETIVO: Comparar características morfométricas entre olhos contralaterais com fechamento angular primário agudo (FAPA) e olhos glaucomatosos ou suspeitos com ângulo estreito (AE). MÉTODOS: Olhos contralaterais de 30 pacientes com FAPA unilateral e olhos de 30 pacientes com AE foram avaliados através da biomicroscopia ultra-sônica (BUS) no claro e escuro. Parâmetros da BUS como a profundidade central de câmara anterior (PCA), distância da abertura angular a 250 µm/500 µm do esporão escleral (AOD250/AOD500), distância entre o processo ciliar e o trabeculado (TCPD) e distância do contato iris-cristalino (ILCD) foram medidos nos quadrantes superior (QS) e inferior (QI). RESULTADOS: Diferenças significativas entre olhos contralaterais de FAPA e olhos com AE foram encontradas na PCA, p<0,001; AOD250 no QS e QI, p<0,001; AOD500 no QS e QI, p<0,001; TCPD no claro, p=0,010 e TCPD no escuro no QS, p=0,031; e TCPD no claro no QI, p=0,010. Diferenças significativas entre exames no claro e escuro realizados em olhos contralaterais com FAPA foram encontradas na ILCD (p=0,009) no QS e ILCD no QI (p=0,006), e em olhos com SE na ILCD no QS (p=0,047) e ILCD no QI (p<0,001). CONCLUSÕES: Olhos contralaterais de FAPA apresentam um segmento anterior mais aglomerado e uma PCA menor que olhos com AE. ILCD diminui em ambos os grupos quando as condições de iluminação mudam do claro para o escuro.

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          Primary angle-closure glaucoma. Oculometry, epidemiology, and genetics in a high risk population.

          The ocular dimensions in patients suffering from primary angle-closure glaucoma (a.c.g.) have been studied in several clinical series, chiefly in Caucasians. The epidemiology and aetiology of a.c.g. are less well known although genetic factors seem to be involved. Eskimos have recently been shown to constitute a high risk population with respect to a.c.g. Consequently, a series of oculometric, epidemiologic, and genetic studies among Greenland Eskimos was undertaken. Besides the immediate purpose, prevention of blindness in this population, the survey had important general aspects and the following main results were obtained: 1a) Ocular dimensions, as well as clinical symptoms, in Eskimo a.c.g. patients correspond closely to those of a.c.g. reports from other ethnic groups and 1b) ocular dimensions of the anterior segment in the general Eskimo population deviate conspicuously towards the low level characteristic of all samples of a.c.g. patients. 2) A.c.g. prevalence rates were estimated at 1.6% in males and 5.1% in females of the general population aged 40 years or more. The epidemiology of a.c.g. seems to reflect closely the variations of axial anterior chamber depth (ACD) according to race (Eskimo, Caucasian), sex and age. Empirical a.c.g. risk estimates, depending on the ACD value, were obtained in elderly females. 3) A relatively shallow chamber was found in 1st and 2nd degree relatives of a.c.g. patients, in close agreement with an earlier study in Caucasians (Törnquist 1953). However, also in the general Eskimo population a pronounced familial resemblance with respect to ACD and corneal diameter was found. Thus the family studies indicate that the size of the anterior chamber shows a mainly genetic determination, which probably constitutes the genetic basis of a.c.g. as well. With this background a hypothesis is discussed, which interprets the small anterior chambers in Eskimos as a result of genetic adaptation to arctic environment. Corneal protection may have been the significant advantage and the a.c.g. load in elderly persons a relatively less important cost.
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            Primary angle closure glaucoma: a review of ocular biometry.

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              Anterior chamber depth and lens thickness in primary angle-closure glaucoma: a case-control study.

              Anterior chamber depth and lens thickness have been considered as important biometric determinants in primary angle-closure glaucoma (PACG). In a tertiary care centre-based case-control study, 70 patients and equal number of controls were investigated to analyse the strength of association and predictability of anterior chamber depth (ACD) and lens thickness (LT) in the disease. Mean (+/- S.D.) ACD and LT in the cases and the controls were found to be 2.28 +/- 0.19, 2.87 +/- 0.10; 4.57 +/- 0.34 and 4.13 +/- 0.19 mm respectively. Two sample t test demonstrated statistically significant difference in the ACD and LT between the cases and the controls (Difference being -0.59, 0.44; 95% confidence interval of the difference: -0.64, -0.53 and 0.34, 0.53 respectively, P < 0.01). Logistic regression analysis demonstrated statistically significant protective effect of ACD over PACG (P < 0.01). The odds ratio corresponding to an increase of 0.01 mm in ACD and LT were computed as 0.83 and 1.11 respectively.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo )
                1678-2925
                December 2008
                : 71
                : 6
                : 793-798
                Affiliations
                [1 ] Universidade Federal de Minas Gerais Brazil
                Article
                S0004-27492008000600005
                10.1590/S0004-27492008000600005
                b6e422bc-1910-4392-a6a1-869e662ea823

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-2749&lng=en
                Categories
                OPHTHALMOLOGY

                Ophthalmology & Optometry
                Anterior chamber,Câmara anterior,Segmento anterior do olho,Microscopy,Eye,Ultrasonography,Anterior eye segment,Olho,Microscopia,Ultra-sonografia,Biometria,Biometry

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