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Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography

Indentation gonioscopy is commonly used in the clinic to evaluate peripheral anterior synechia (PAS) of angle closure glaucoma (ACG). The examination requires contacting with the cornea, resulting in an uncomfortable feeling for patients, and it only provides qualitative outcomes which may be affect...

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Autores principales: Ye, Shuling, Bao, Chenhong, Chen, Yulei, Shen, Meixiao, Lu, Fan, Zhang, Shaodan, Zhu, Dexi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011042/
https://www.ncbi.nlm.nih.gov/pubmed/35433648
http://dx.doi.org/10.3389/fbioe.2022.856531
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author Ye, Shuling
Bao, Chenhong
Chen, Yulei
Shen, Meixiao
Lu, Fan
Zhang, Shaodan
Zhu, Dexi
author_facet Ye, Shuling
Bao, Chenhong
Chen, Yulei
Shen, Meixiao
Lu, Fan
Zhang, Shaodan
Zhu, Dexi
author_sort Ye, Shuling
collection PubMed
description Indentation gonioscopy is commonly used in the clinic to evaluate peripheral anterior synechia (PAS) of angle closure glaucoma (ACG). The examination requires contacting with the cornea, resulting in an uncomfortable feeling for patients, and it only provides qualitative outcomes which may be affected by subjective judgment of the clinicians. Previous studies had reported to identify the presence of PAS by measuring the changes of morphological parameters of the anterior chamber angle (ACA) under the pupillary light reflex, by anterior segment optical coherence tomography (AS-OCT). However, this method was invalid for some subjects who had low sensitiveness to light. This article describes an air-puff dynamic anterior segment optical coherence tomography (DAS-OCT) system that can evaluate the presence of PAS in a non-contact approach. The peripheral cornea is deformed by an air puff jetted from the DAS-OCT, causing a transfer of force to the ACA, just as how indentation gonioscopy works. The dynamic changes of the ACA before and after the air puff are recorded by OCT. Ten eyes of normal subjects were enrolled in this study to validate the repeatability and availability of the measurements. Then, ten samples of the ACA from five subjects with ACG were recruited and were assigned into two groups, the non PAS group (NPAS) and PAS group, according to the results of gonioscopy. The ACA structural parameters including the angle opening distance at 750 μm to the scleral spur (AOD750) and the trabecular-iris space area at 750 μm anterior to the scleral spur (TISA750) were then calculated automatically by a custom-written algorithm. The intraclass correlation coefficient (ICC) of measured parameters was all above 0.85 for normal subjects, exhibiting good repeatability. For patients, both parameters showed significant differences between the two groups after the air puff, while no differences were observed before the air puff. AOD750dif and TISA750dif between two groups showed more significant differences, indicating that they could be used as indicators to identify the presence of PAS. In conclusion, the DAS-OCT system proposed in this study is demonstrated effective to identify the presence of PAS by measuring the changes of the ACA via a noncontact approach. It shows great potential for applications in guidance for diagnosis of angle closure glaucoma.
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spelling pubmed-90110422022-04-16 Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography Ye, Shuling Bao, Chenhong Chen, Yulei Shen, Meixiao Lu, Fan Zhang, Shaodan Zhu, Dexi Front Bioeng Biotechnol Bioengineering and Biotechnology Indentation gonioscopy is commonly used in the clinic to evaluate peripheral anterior synechia (PAS) of angle closure glaucoma (ACG). The examination requires contacting with the cornea, resulting in an uncomfortable feeling for patients, and it only provides qualitative outcomes which may be affected by subjective judgment of the clinicians. Previous studies had reported to identify the presence of PAS by measuring the changes of morphological parameters of the anterior chamber angle (ACA) under the pupillary light reflex, by anterior segment optical coherence tomography (AS-OCT). However, this method was invalid for some subjects who had low sensitiveness to light. This article describes an air-puff dynamic anterior segment optical coherence tomography (DAS-OCT) system that can evaluate the presence of PAS in a non-contact approach. The peripheral cornea is deformed by an air puff jetted from the DAS-OCT, causing a transfer of force to the ACA, just as how indentation gonioscopy works. The dynamic changes of the ACA before and after the air puff are recorded by OCT. Ten eyes of normal subjects were enrolled in this study to validate the repeatability and availability of the measurements. Then, ten samples of the ACA from five subjects with ACG were recruited and were assigned into two groups, the non PAS group (NPAS) and PAS group, according to the results of gonioscopy. The ACA structural parameters including the angle opening distance at 750 μm to the scleral spur (AOD750) and the trabecular-iris space area at 750 μm anterior to the scleral spur (TISA750) were then calculated automatically by a custom-written algorithm. The intraclass correlation coefficient (ICC) of measured parameters was all above 0.85 for normal subjects, exhibiting good repeatability. For patients, both parameters showed significant differences between the two groups after the air puff, while no differences were observed before the air puff. AOD750dif and TISA750dif between two groups showed more significant differences, indicating that they could be used as indicators to identify the presence of PAS. In conclusion, the DAS-OCT system proposed in this study is demonstrated effective to identify the presence of PAS by measuring the changes of the ACA via a noncontact approach. It shows great potential for applications in guidance for diagnosis of angle closure glaucoma. Frontiers Media S.A. 2022-04-01 /pmc/articles/PMC9011042/ /pubmed/35433648 http://dx.doi.org/10.3389/fbioe.2022.856531 Text en Copyright © 2022 Ye, Bao, Chen, Shen, Lu, Zhang and Zhu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Ye, Shuling
Bao, Chenhong
Chen, Yulei
Shen, Meixiao
Lu, Fan
Zhang, Shaodan
Zhu, Dexi
Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography
title Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography
title_full Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography
title_fullStr Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography
title_full_unstemmed Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography
title_short Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography
title_sort identification of peripheral anterior synechia by corneal deformation using air-puff dynamic anterior segment optical coherence tomography
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011042/
https://www.ncbi.nlm.nih.gov/pubmed/35433648
http://dx.doi.org/10.3389/fbioe.2022.856531
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