P116 The suspect “occludable” angle after mydriasis on AS OCT: new aspects of differential diagnosis Zihret Abazi 1 , Lidija Magarasevic 1 , Dusica Risovic 2 , Svetlana Sukalo 1 1 Eye Clinic, Zvezdara University Medical Center, Belgrade - Serbia 2 Department of Ophthalmology, School of Medicine, University of Belgrade, Belgrade - Serbia Purposes: To determine if morphological factors detected by AS OCT can be correlated with gonioscopy suspect occludable angles, in normotensive patients, who has initial glaucoma damage of the optic disc, before and after medical mydriasis. Methods: Prospective cross-sectional study with 21 patients (21 eyes). In all patients were performed complete ophthalmological examinations: gonioscopy (suspect occludable angles = posterior trabecular meshwork difficultly visible without indentation for ≥ 2 quadrants), SAP , OCT PNO, AS OCT (angles narrower than 10 degrees in 2/4 quadrants), before and after Tropicamide 1% medical mydriasis. Results: Initially 21 eyes were classified by Shaffer classification in group I after gonioscopy. The mean IOP was 14 ± 3.7 mmHg. TIA in zone 3 and 9 h was 8 ± 4.8°, 11 ± 5.2°, respectively. After pupil dilatation the mean IOP was 21 ± 4.5 mmHg. Complete closure of the chamber angle was seen in 4 eyes. Iridocorneal touch in more than three quadrants, with no possibility of visualization with the indentation was seen in 15 patients. AS OCT showed iridocorneal touch in 19 patients, at least in 2/4 quadrants. Conclusions: AS OCT in patients with gonioscopy-determined suspect occludable angle (Shaffer I) and initial glaucoma damaged optic disc can be useful for accurate diagnoses of the angle closure glaucoma, especially if it is done before and after pupil dilatation with medications. Increased IOP after medical mydriasis also confirms angle closure. The mechanism of closure of the chamber angle can be dublefold: in patients with voluminous iris complete blockade of trabecular meshwork can be seen by AS OCT, while others present high iridocorneal touch with the pocket in the level of scleral spur. AS OCT findings of angle closure in patients with suspect “occludable”angles can be an indication for preventive LPI.
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P116
The suspect “occludable” angle after mydriasis on AS OCT: new aspects of differential diagnosisZihret Abazi1, Lidija Magarasevic1, Dusica Risovic2, Svetlana Sukalo1
1Eye Clinic, Zvezdara University Medical Center, Belgrade - Serbia2Department of Ophthalmology, School of Medicine, University of Belgrade, Belgrade - Serbia
Purposes: To determine if morphological factors detected by AS OCT can be correlated with gonioscopy suspect occludable angles, in normotensive patients, who has initial glaucoma damage of the optic disc, before and after medical mydriasis. Methods: Prospective cross-sectional study with 21 patients (21 eyes). In all patients were performed complete ophthalmological examinations: gonioscopy (suspect occludable angles = posterior trabecular meshwork difficultly visible without indentation for ≥ 2 quadrants), SAP, OCT PNO, AS OCT (angles narrower than 10 degrees in 2/4 quadrants), before and after Tropicamide 1% medical mydriasis.Results: Initially 21 eyes were classified by Shaffer classification in group I after gonioscopy. The mean IOP was 14 ± 3.7 mmHg. TIA in zone 3 and 9 h was 8 ± 4.8°, 11 ± 5.2°, respectively. After pupil dilatation the mean IOP was 21 ± 4.5 mmHg. Complete closure of the chamber angle was seen in 4 eyes. Iridocorneal touch in more than three quadrants, with no possibility of visualization with the indentation was seen in 15 patients. AS OCT showed iridocorneal touch in 19 patients, at least in 2/4 quadrants.Conclusions: AS OCT in patients with gonioscopy-determined suspect occludable angle (Shaffer I) and initial glaucoma damaged optic disc can be useful for accurate diagnoses of the angle closure glaucoma, especially if it is done before and after pupil dilatation with medications. Increased IOP after medical mydriasis also confirms angle closure. The mechanism of closure of the chamber angle can be dublefold: in patients with voluminous iris complete blockade of trabecular meshwork can be seen by AS OCT, while others present high iridocorneal touch with the pocket in the level of scleral spur. AS OCT findings of angle closure in patients with suspect “occludable”angles can be an indication for preventive LPI.
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