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(Investigative Ophthalmology and Visual Science. 2007;48:4116-4122.)
© 2007 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-0010
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Dynamic Analysis of Dark–Light Changes of the Anterior Chamber Angle with Anterior Segment OCT

Christopher Kai-shun Leung,1,2,3 Carol Yim Lui Cheung,1,3 Haitao Li,1 Syril Dorairaj,4 Cedric Ka Fai Yiu,5 Amy Lee Wong,1 Jeffrey Liebmann,4,6 Robert Ritch,4,6 Robert Weinreb,2 and Dennis Shun Chiu Lam1

1From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Peoples Republic of China; the 2Hamilton Glaucoma Center, University of California, San Diego, California; 4The New York Eye and Ear Infirmary, New York, New York; the 5Department of Applied Mathematics, Hong Kong Polytechnic University, Hong Kong, Peoples Republic of China; and the 6New York Medical College, Valhalla, New York.

PURPOSE. To describe the use of anterior segment optical coherence tomography (OCT) in studying the dynamic dark–light changes of the anterior chamber angle.

METHODS. Thirty-seven normal subjects with open angles on dark-room gonioscopy and 18 subjects with narrow angles were analyzed. The dynamic dark–light changes of the anterior-chamber angle were captured with real-time video recording. The angle opening distance (AOD500) and trabecular iris space area (TISA500) of the nasal angle and the pupil diameter in each of the representative serial images were measured. Linear regression analysis was performed to investigate the association between AOD500/TISA500 and pupil diameter. Demographic and biometry measurements associated with the AOD difference (AOD500(light) – AOD500(dark)) and TISA difference (TISA500(light) – TISA500(dark)) were analyzed with univariate and multivariate regression models.

RESULTS. The AOD500/TISA500 measured in the light in the open-angle and the narrow-angle groups were 694 ± 330 µm/0.24 ± 0.10 mm2 and 265 ± 78 µm/0.10 ± 0.03 mm2, respectively. These values were significantly greater than the AOD500/TISA500 measured in the dark (492 ± 265 µm/0.16 ± 0.08 mm2 and 119 ± 82 µm/0.05 ± 0.04 mm2, respectively, all with P < 0.001). The ranges of the AOD/TISA difference were 13 to 817µm/0.011 to 0.154 mm2, with an average of 180 µm/0.073 mm2. Multivariate regression analysis identified a positive correlation between anterior chamber depth and the AOD/TISA difference. Fifty eyes showed significant correlations between AOD/TISA and pupil diameter, whereas one eye showed no association. Four eyes in the narrow angle group developed appositional angle closure in the dark.

CONCLUSIONS. The dynamic dark–light changes of the anterior chamber angle can be imaged and analyzed with anterior segment OCT. Although the angle width generally decreased linearly with increasing pupil diameter, the differences of the angle width measured in the dark and in the light varied substantially among individuals.






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