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Fourier-domain OCT shows promise in assessing anterior chamber angle closure risk
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Fourier-domain optical coherence tomography may be useful for measuring anterior chamber angle in glaucomatous eyes, according to a study.
“Currently, gonioscopy remains the reference standard for anterior chamber angle assessment. However, it has limitations such as requiring a highly skilled examiner and involving contact with the surface of the eye,” the study authors said.
The study authors used Fourier-domain optical coherence tomography (OCT) to measure the angle opening distance at Schwalbe’s line (AOD-SL) and gauge the impact of angle characteristics on the angle closure glaucoma.
The prospective study included 65 eyes of 35 patients with primary open-angle glaucoma (POAG) or primary angle closure glaucoma (PACG).
Patients underwent visual acuity assessment, slit lamp biomicroscopy, Goldmann applanation tonometry, dark-room gonioscopy and Fourier-domain OCT imaging.
Investigators performed horizontal scans of the nasal and temporal anterior chamber angles with 830-nm wavelength Fourier-domain OCT. Two ophthalmologists graded the images and assessed the visibility of Schwalbe’s line (SL), anterior limbus (AL), scleral spur (SS) and angle recess (AR).
OCT identified SL in 97.7% of eyes, AL in 99.2%, AR in 87.3% and SS in 80.8%.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
Perspective
Back to TopDouglas J. Rhee, MD
The diagnosis of narrow angle disorders, which includes narrow angles from pupillary block as well as plateau iris syndrome, is important. This study demonstrates the high correlation between gonioscopy and SD-OCT localization of the Schwalbe’s line.
This technology could be very useful for patients whose angle anatomy is difficult to visualize due to cooperation (ie, children) or those with poor trabecular meshwork pigmentation. In my opinion, it is important to note that clinical gonioscopy remains the gold standard method for determining anterior chamber anatomy and is very low cost. Additionally, a limitation of OCT for anterior chamber angle measurement is the inability to visualize the ciliary body.
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