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New options for angle assessment could enhance angle-closure glaucoma imaging
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CHICAGO — Several new methods of measuring angle-closure glaucoma are "exciting improvements" in angle imaging, a physician said here.
Tin Aung, FRCS(Ed), PhD discussed cross-sectional angle imaging techniques, including anterior segment optical coherence tomography (OCT), high definition OCT, Swept source OCT and angle photography device EyeCam (Clarity Medical Systems), here at Glaucoma Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and the Middle East Africa Council of Ophthalmology.
"These devices are easy to perform," Dr. Aung said. "This could lead to exciting improvements in angle imaging."
Gonioscopy, the standard for angle clinical assessment, provides direct visualization of the angle structures in angle-closure glaucoma patients. It is subjective, and therefore variable, he said. Some of the newer technologies offer the advantage of objective testing.
In addition, he discussed the cross-sectional angle imaging method, ultrasound biomicroscopy (UBM), which is not a newer technology, but is also an objective method. A disadvantage of UBM is it is time-consuming, Dr. Aung said.
- Disclosure: Dr. Aung is a consultant for Clarity Medical Systems.
These technologies offer excellent opportunities to photodocument the anterior chamber angle. Furthermore, they may offer new insights into the potential role of dynamic structural changes and their possible effect on aqueous humor dynamics. However, their clinical utility remains to be determined. Although subjective, clinicians performing gonioscopy seem to have an effective screening tool for potentially occludable angles. Until studies show a superiority of these technologies to clinical gonioscopy, the impact of these new anterior chamber angle imaging technologies remains to be seen.
In contrast, ultrasound biomicroscopy (UBM), with its ability to image structures optically hidden by the iris or opaque cornea, has numerous clinical applications. UBM is an important diagnostic tool.
— Douglas J. Rhee, MD
OSN U.S. Edition Glaucoma Board Member
Disclosure: Dr. Rhee has no direct financial interest in the products discussed in this article,
nor is he a paid consultant for any companies mentioned.