Change in Angle Parameters Measured by Anterior Segment Optical Coherence Tomography after Laser Peripheral Iridotomy Alone versus Laser Peripheral Iridotomy and Argon Laser Peripheral Iridoplasty

Hyung Ju Park; Ki Ho Park; Seok Hwan Kim; Tae Woo Kim; Dong Myoung Kim

doi:10.3341/jkos.2011.52.5.566

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Park, Park, Kim, Kim, and Kim: Change in Angle Parameters Measured by Anterior Segment Optical Coherence Tomography after Laser Peripheral Iridotomy Alone versus Laser Peripheral Iridotomy and Argon Laser Peripheral Iridoplasty

Original Article

J Korean Ophthalmol Soc 2011;52(5):566-573.

Published online: 3 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.5.566

Change in Angle Parameters Measured by Anterior Segment Optical Coherence Tomography after Laser Peripheral Iridotomy Alone versus Laser Peripheral Iridotomy and Argon Laser Peripheral Iridoplasty

Hyung Ju Park, MD, Ki Ho Park, MD, PhD, Seok Hwan Kim, MD, PhD, Tae Woo Kim, MD, PhD, Dong Myoung Kim, MD, PhD

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

Address reprint requests to Ki Ho Park, MD, PhD Department of Ophthalmology, Seoul National University Hospital 101 Daehak-ro, Jongno-gu, Seoul 100-799, Korea Tel: 82-2-2072-2438, Fax: 82-2-741-3187, E-mail: kihopark@snu.ac.kr

Received 19 February 201027 October 2010 Accepted 8 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the changes in angle parameters after laser peripheral iridotomy (LPI) alone versus LPI and ALPI (argon laser peripheral iridoplasty) in primary angle closure patients by using anterior segment optical coherence tomography (AS-OCT).

Methods

A total of 25 eyes from 17 patients with narrow angles were enrolled in this present study. Eleven eyes in the LPI treatment group and 14 eyes in the LPI and ALPI combined treatment group were evaluated using AS-OCT. The anterior chamber depth (ACD), angle opening distance at 500 μm (AOD 500) and 750 μm (AOD 750), angle recess area at 500 μm (ARA 500) and 750 μm (ARA 750), trabecular-iris space area at 500 μm (TISA 500) and 750 μm (TISA 750), trabecular-iris angle (TIA) were measured. The pre- and post-treatment parameters were compared in each group. The parameter changes after laser treatment were also compared.

Results

AOD 500, AOD 750, ARA 500, ARA 750, TISA 500 and TISA 750 except ACD significantly increased following LPI treatment (p = 0.013, p = 0.010, p = 0.008, p = 0.003, p = 0.006, p = 0.003, p = 0.013, respectively, Wilcoxon signed rank test) and LPI and ALPI combined therapy (p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.001, respectively, Wilcoxon signed rank test). The AOD 500 difference, TISA 500 difference, and TISA 750 difference were significantly greater after LPI and ALPI combined therapy than after LPI treatment alone (p = 0.112, p = 0.147, p = 0.049, p =0.037, respectively, Mann-Whitney U-test).

Conclusions

The results from the present study showed LPI alone or LPI and ALPI combined therapy significantly widened the anterior chamber angle and combined therapy showed greater effect than LPI alone.

Keywords: Anterior segment optical coherence tomography, Argon laser peripheral iridoplasty, Laser peripheral iridotomy

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Figure 1.

(A) Optical coherence tomography image (Visante OCT) with graphic tools for measurement of different anterior chamber dimensions. Anterior chamber depth is measured between the corneal endothelium and a line joining the two opposite iris recesses. (B) Optical coherence tomography (Visante OCT) cross-sectional view through the anterior chamber angle region. Anterior chamber parameters such as AOD 500, AOD 750, ARA 500, ARA 750, TISA 500, TISA 750 and TIA are automatically measured.

Figure 2.

Angle changes of AS-OCT before and after laser peripheral iridotomy. (A) AS-OCT image showing angle closure before laser peripheral iridotomy. (B) AS-OCT image showing the same angle open after laser peripheral iridotomy.

Figure 3.

Angle changes of AS-OCT before and after laser peripheral iridotomy and argon laser peripheral iridoplasty. (A) AS-OCT image showing angle closure before laser peripheral iridotomy and argon laser peripheral iridoplasty. (B) AS-OCT image showing the same angle open after laser peripheral iridotomy and argon laser peripheral iridoplasty.

Table 1.

Comparison of anterior segment-optical coherence tomography (AS-OCT) parameters before only laser peripheral iridot-omy (LPI) versus LPI and argon laser peripheral iridoplasty (ALPI)

Parameter	Pre-LPI (mean ± SD)	Pre-LPI &ALPI (mean ± SD)	p-value^*
ACD^† (mm)	1.89 ± 0.07	1.90 ± 0.33	0.344
AOD^‡ 500 (μm)	58.1 ± 17.3	137.0 ± 57.0	0.000
AOD 750 (μm)	89.5 ± 32.4	155.1 ± 89.7	0.095
ARA^§ 500 (×10^-2 mm²)	7.3 ± 2.4	11.2 ± 5.1	0.058
ARA 750 (×10^-2 mm²)	9.1 ± 2.4	14.8 ± 6.4	0.033
TISA^Π 500 (×10^-2 mm²)	4.0 ± 1.1	6.7 ± 2.8	0.015
TISA 750 (×10^-2 mm²)	5.7 ± 1.2	10.3 ± 4.4	0.005
TIA^# (degrees)	6.6 ± 1.9	15.0 ± 5.9	0.000

^* Tested by Mann-Whitney U-test;

^† ACD = anterior chamber depth;

^‡ AOD = angle opening distance;

^§ ARA = area of recessed angle;

^Π TISA = trabecular-iris space area;

^# TIA = trabecular-iris angle.

Table 2.

Changes in anterior segment-optical coherence tomography (AS-OCT) parameters before and after laser peripheral iridotomy (LPI)

Parameter	Pre-LPI (mean ± SD)	Post-LPI (mean ± SD)	p-value^*
ACD^† (mm)	1.89 ± 0.07	1.89 ± 0.06	1.000
AOD^‡ 500 (μm)	58.1 ± 17.3	143.6 ± 124.8	0.013
AOD 750 (μm) ARA^§ 500 (×10^-2 mm²)	89.5 ± 32.4 7.3 ± 2.4	202.6 ± 136.4 11.8 ± 5.1	0.010 0.008
ARA 750 (×10^-2 mm²)	9.1 ± 2.4	16.1 ± 7.6	0.003
TISA^Π 500 (×10^-2 mm²)	4.0 ± 1.1	7.1 ± 3.7	0.006
TISA 750 (×10^-2 mm²)	5.7 ± 1.2	11.4 ± 6.6	0.003
TIA^# (degrees)	6.6 ± 1.9	15.0 ± 11.5	0.013

^* Tested by Wilcoxon signed rank test;

^† ACD=anterior chamber depth;

^‡ AOD=angle opening distance;

^§ ARA=area of recessed angle;

^Π TISA = trabecular-iris space area;

^# TIA = trabecular-iris angle.

Table 3.

Changes in anterior segment-optical coherence tomography (AS-OCT) parameters before and after laser peripheral iridot-omy (LPI) and argon laser peripheral iridoplasty (ALPI)

Parameter	Pre-LPI & ALPI (mean ± SD)	Post-LPI & ALPI (mean ± SD)	p-value^*
ACD^† (mm)	1.90 ± 0.33	1.92 ± 0.25	0.656
AOD^‡ 500 (μm)	137.0 ± 57.0	303.4 ± 128.9	0.001
AOD 750 (μm)	155.1 ± 89.7	373.6 ± 169.8	0.001
ARA^§ 500 (×10^-2 mm²)	11.2 ± 5.1	18.5 ± 7.6	0.001
ARA 750 (×10^-2 mm²)	14.8 ± 6.4	26.8 ± 11.1	0.001
TISA^Π 500 (×10^-2 mm²)	6.7 ± 2.8	12.3 ± 5.0	0.001
TISA 750 (×10^-2 mm²)	10.3 ± 4.4	20.6 ± 8.6	0.001
TIA^# (degrees)	15.0 ± 5.9	29.9 ± 9.7	0.001

^* Tested by Wilcoxon signed rank test;

^† ACD =anterior chamber depth;

^‡ AOD=angle opening distance;

^§ ARA =area of recessed angle;

^Π TISA = trabecular-iris space area;

^# TIA = trabecular-iris angle.

Table 4.

Comparison in difference of anterior segment-optical coherence tomography (AS-OCT) parameters before and after only laser peripheral iridotomy (LPI) versus laser peripheral iridotomy (LPI) and argon laser peripheral iridoplasty (ALPI)

Parameter	LPI (mean ± SD)	LPI &ALPI (mean ± SD)	p-value^*
Δ ACD^† (mm)	0.00 ± 0.29	0.02 ± 0.13	0.609
Δ AOD^‡ 500 (μm)	85.6 ± 120.4	166.4 ± 108.2	0.033
Δ AOD 750 (μm)	113.1 ± 124.0	218.5 ± 164.3	0.112
Δ ARA^§ 500 (×10^-2 mm²)	4.6 ± 5.4	7.3 ± 5.9	0.147
Δ ARA 750 (×10^-2 mm²)	7.0 ± 7.8	12.1 ± 8.9	0.055
Δ TISA^Π 500 (×10^-2 mm²)	3.1 ± 3.8	5.5 ± 4.0	0.049
Δ TISA 750 (×10^-2 mm²)	5.7 ± 6.5	10.3 ± 7.2	0.037
Δ TIA^# (degrees)	8.4 ± 11.1	14.9 ± 8.3	0.052

^* Tested by Mann-Whitney U-test;

^† ACD = anterior chamber depth;

^‡ AOD = angle opening distance;

^§ ARA = area of recessed angle;

^Π TISA = trabecular-iris space area;

^# TIA = trabecular-iris angle.

Table 5.

Changes in intraocular pressure (IOP) before and after only laser peripheral iridotomy (LPI) versus laser peripheral iridot-omy (LPI) and argon laser peripheral iridoplasty (ALPI)

	IOP before treatment (mmHg)	IOP after treatment (mmHg)
	IOP before treatment (mmHg)	Immediately	1 wk	1 mon	3 mon	6 mon
LPI (mean ± SD)	15.0 ± 3.5	14.1 ± 4.4	13.5 ± 2.2	11.8 ± 0.8	17.0 ± 3.5	13.5 ± 2.6
LPI & ALPI (mean ± SD)	18.8 ± 5.1	16.3 ± 4.3	14.4 ± 3.8	15.0 ± 3.9	14.4 ± 2.6	17.8 ± 3.8
p-value^*	0.087	0.222	0.767	0.143	0.181	0.059

^* Tested by Mann-Whitney U-test.

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