Detection of Angle Abnormalities in Hyperopes

Document Type : Original Article

Author

The Department of Ophthalmology, Faculty of Medicine, Ain Shams University

Abstract

Abstract Background: Chronic angle closure is an asymptomatic disease, so early detection of those patients is mandatory before synechial closure of angle and irreversible vision loss. Hyper-opia is one of the risk factors of angle-closure disease. Patients with symptomatic or suspected angle-closure or patients with a positive family history should undergo tonometry, gonioscopy, perimetry along with newer diagnostic modalities like AS-OCT and UBM. Aim of Study: The aim of this work was to detect abnormal-ities in anterior chamber angle in hyperopes above age of forty years old and diopteric power >1D. Patients and Methods: The study was an exploratory cross sectional study that was conducted in Ain Shams University Hospital on 100 eyes of 50 hypermetropic subjects above age of forty years and diopteric power > +1D. Each patient was fully assessed through complete ophthalmic history, slit lamp exami-nation by focusing on (tonometry, VH grading and gonioscopy) and UBM. Data was retrieved and analyzed. Results: Angle abnormalities were detected in 42.0% of the studied hyperopic subjects in the form of [34.0% prima-ry angle closure suspects (PACS), 8.0% primary angle closure (PAC)]. Plateau iris configuration (PIC) appeared in 34.1% of the studied narrow angle subjects. Additionally, APCP, CBT-max, Iris Convexity and the number of obliterated ciliary sulcus quadrants have a highly significant value in diagnosing the PIC. A negative statistically significant correlation was detected be-tween the hypermetropic amount and the average UBM values. Hypermetropic amount showed a highly significant correlation with the Van Herrick grading and the gonioscopic shaffer grad-ing. A highly significant correlation was detected between go-nioscoipc shaffer grading and UBM values of anterior chamber angle. A highly statistically significant correlation was found between the Van Herrick grading and UBM values of anterior chamber angle. Conclusion: Angle abnormalities were detected in 42.0% of the studied hyperopic subjects in the form of [34.0% prima-ry angle closure suspects (PACS), 8.0% primary angle closure (PAC)]. A negative statistically significant correlation was de-tected between the hypermetropic amount and the average UBM values AOD500, A0D750, TIA500 and TCPD. Hypermetropic amount showed a highly significant correlation with the Van Herrick grading and the gonioscopic shaffer grading.

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