Clinical Usefulness of UBM in the Sitting Position in Anterior Chamber Depth and Angle Measurements

Tae Gi Kim; Sung Woon Moon; Ji Ho Yang; Kyung Hyun Jin

doi:10.3341/jkos.2014.55.7.1007

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Kim, Moon, Yang, and Jin: Clinical Usefulness of UBM in the Sitting Position in Anterior Chamber Depth and Angle Measurements

Original Article

J Korean Ophthalmol Soc 2014;55(7):1007-1016.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.7.1007

Clinical Usefulness of UBM in the Sitting Position in Anterior Chamber Depth and Angle Measurements

Tae Gi Kim, MD, Sung Woon Moon, MD, Ji Ho Yang, MD, Kyung Hyun Jin, MD, PhD

Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea

Address reprint requests to Kyung Hyun Jin, MD, PhD, Department of Ophthalmology, Kyung Hee University Medical Center, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Korea, Tel: 82-2-958-8451, Fax: 82-2-966-7340 E-mail: khjinmd@khmc.or.kr

Received 23 November 2013 Revised 19 February 2014 Accepted 9 June 2014

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

We compared the measurements of anterior chamber depth (ACD) and anterior chamber angle (ACA) using ultrasound biomicroscopy (UBM) in the sitting position compared with IOL Master®, Pentacam®, and Spectralis optical coherence tomography (OCT) to evaluate the clinical usefulness of UBM in the sitting position.

Methods

We evaluated 92 eyes in 47 healthy adults. ACD was measured by IOL Master®, Pentacam®, and UBM. ACA was measured using Pentacam^®, UBM, and Spectralis OCT. UBM was performed in the sitting position using bag/balloon technology. Measured values were compared statistically.

Results

ACD measured by IOL Master®, Pentacam®, and UBM was 3.57 ± 0.32 μm, 3.64 ± 0.33 μm and 3.51 ± 0.32 μm, respectively. UBM measurements of ACD were significantly shallower than with the other methods (p < 0.001). The results among the 3 methods were strongly correlated (r > 0.8, p < 0.05 in all groups). Mean ACA of 4 directions was not significantly different among the 3 methods (p > 0.05). There was strong correlation between UBM and Spectralis OCT (r = 0.957) but moderate correlation between Pentacam® and UBM and Pentacam® and Spectralis OCT (r = 0.557, 0.571, respectively, p < 0.05). Specifically, ACA of the superior quadrant showed a low correlation between Pentacam^® and UBM and Pentacam^® and Spectralis OCT (r = 0.257, 0.295, respectively).

Conclusions

ACD measured by UBM in the sitting position was shallower compared to the other methods; however, ACD measured by IOL Master®, Pentacam®, and UBM showed significant correlations among the methods. The mean ACA measured by Pentacam®, UBM, and Spectralis OCT showed no significant differences. Due to the high correlation of ACA measurements between UBM and Spectralis OCT in the present study, UBM is expected to be a good tool for measuring anterior segment parameters.

Keywords: Anterior chamber angle, Anterior chamber depth, Sitting position, UBM

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Figure 1.

An example of the result of anterior chamber angle (ACA) measurement by Pentacam®. (A) Nasal and temporal angle. (B) Superior and inferior angle. ACA is calculated by integrated software of Pentacam®.

Figure 2.

ClearScan bag/balloon technology.

Figure 3.

Ultrasound biomicroscopic image of anterior chamber and lens. Anterior chamber depth 1 (ACD1) is defined as distance from the central corneal epithelium to the anterior surface of lens capsule and ACD2 is defined as distance from the central corneal endothelium to the anterior surface of lens capsule.

Figure 4.

Ultrasound biomicroscopic (A) and spectralis optical coherence tomography (OCT), (B) image of anterior chamber angle. Anterior chamber angle (ACA) is measured by trabecular iris angle (TIA). TIA is defined as the angle between the iris and trabecular meshwork, with the apex of the angle lying in the angle recess and arms lying at a point 500 μm away from the scleral spur.

Figure 5.

Bland-Altman plots showing differences in anterior chamber depth (ACD) between devices. The upper and lower dashed lines indicate 95 % limits of agreement and the solid line indicates the mean. UBM = ultrasound biomicroscopy.

Figure 6.

The correlation plot of the anterior chamber depth (ACD) measured by IOL master®, Pentacam® and ultrasound biomicroscopy (UBM).

Figure 7.

Bland-Altman plots showing differences in anterior chamber angle (ACA) between devices. The upper and lower dashed lines indicate 95 % limits of agreement and the solid line indicates the mean. OCT = optical coherence tomography; UBM = ultrasound biomicroscopy.

Figure 8.

The correlation plot of the mean anterior chamber angle (ACA) measured by Pentacam®, Spectralis OCT and ultrasound biomicroscopy (UBM). OCT = optical coherence tomography.

Table 1.

Comparison of different techniques of anterior chamber depth (ACD)

		IOL master®	Pentacam®	UBM	p-value^*
ACD1	Male	3.60 ± 0.36	3.66 ± 0.36	3.52 ± 0.36	<0.001
	Female	3.51 ± 0.20	3.59 ± 0.23	3.48 ± 0.25	<0.001
	Mean	3.57 ± 0.32	3.64 ± 0.33	3.51 ± 0.32	<0.001
ACD2	Male	NA	3.10 ± 0.36	2.95 ± 0.25	<0.001
	Female	NA	3.04 ± 0.23	2.94 ± 0.35	<0.001
	Mean	NA	3.08 ± 0.33	2.95 ± 0.33	<0.001

Values are presented as mean ± SD; ACD1: From the central corneal epithelium to the anterior surface of lens capsule; ACD2: From the central corneal endothelium to the anterior surface of lens capsule.

ACD = anterior chamber depth; UBM = ultrasound biomicroscopy.

^* Paired t-test, comparing IOL master®, Pentacam® and UBM.

Table 2.

Anterior chamber angle (ACA) at different directions and mean ACA

Directions		Anterior chamber angle (degree)
Directions		Pentacam®	UBM	Spectralis-OCT
Temporal ACA	Male	41.78 ± 6.10	40.98 ± 6.10	41.98 ± 6.88
	Female	39.76 ± 5.59	38.60 ± 5.82	40.48 ± 6.79
	Mean	41.11 ± 6.01	40.18 ± 6.12	41.48 ± 6.88
Superior ACA	Male	32.23 ± 4.58^*	32.61 ± 5.25^*	33.29 ± 5.66^*
	Female	33.27 ± 5.48^*	30.23 ± 4.33^{^*}	31.05 ± 4.19^*
	Mean	32.58 ± 4.93^*	31.81 ± 5.08^*	32.54 ± 5.32^*
Nasal ACA	Male	41.14 ± 5.34	40.03 ± 5.62	40.76 ± 6.49
	Female	40.11 ± 5.18	38.80 ± 5.82	39.07 ± 6.01
	Mean	40.79 ± 5.31	39.62 ± 5.71	40.19 ± 6.38
Inferior ACA	Male	37.84 ± 5.23	39.93 ± 5.78	40.42 ± 6.06
	Female	39.65 ± 5.39	39.08 ± 4.54	41.20 ± 4.71
	Mean	38.45 ± 5.35	39.64 ± 5.41	40.68 ± 5.65
Mean ACA	Male	38.25 ± 6.55	38.39 ± 6.61	39.11 ± 7.15
	Female	38.20 ± 6.12	36.68 ± 6.38	37.95 ± 6.85
	Mean	38.23 ± 6.41	37.81 ± 6.58	38.72 ± 7.07

Values are presented as mean ± SD.

UBM = ultrasound biomicroscopy; OCT = optical coherence tomography.

^* p < 0.05 = statistically significant p-value, Paired t-test comparing among the four quadrant of ACA.

Table 3.

Pearson correlations of anterior chamber angle (ACA) at different directions among Pentacam®, ultrasound biomicroscopy (UBM), Spectralis OCT

Directions	Pentacam®-UBM		UBM-Spectralis OCT		Specralis OCT-Pentacam®
Directions	Pearson correlation	p-value	Pearson correlation	p-value	Pearson correlation	p-value
Superior ACA	0.257	0.013	0.866	<0.001	0.295	0.001
Temporal ACA	0.647	<0.001	0.910	<0.001	0.567	<0.001
Nasal ACA	0.495	<0.001	0.874	<0.001	0.475	<0.001
Inferior ACA	0.317	0.002	0.859	<0.001	0.328	0.004

OCT = optical coherence tomography.

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