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Ophthalmology. 2018 Jul;125(7):994-1002. doi: 10.1016/j.ophtha.2018.01.018. Epub 2018 Feb 21.

Characterizing Anterior Segment OCT Angle Landmarks of the Trabecular Meshwork Complex.

Author information

1
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas; Robert Cizik Eye Clinic, Houston, Texas.
2
Robert Cizik Eye Clinic, Houston, Texas.
3
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas.
4
Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Department of Ophthalmology, Baylor College of Medicine, Houston, Texas; Departments of Pathology and Laboratory Medicine and of Ophthalmology, Weill Cornell Medical College of Cornell University, New York, New York; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
5
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas; Robert Cizik Eye Clinic, Houston, Texas; Department of Ophthalmology, Baylor College of Medicine, Houston, Texas. Electronic address: blieden@bcm.edu.

Abstract

PURPOSE:

To identify the presence or absence of 3 identifiable landmarks: trabecular meshwork (TM), Schlemm's canal (SC), and a novel landmark termed the band of extracanalicular limbal lamina (BELL), which is a landmark adjacent to SC visible on anterior segment (AS) OCT. These landmarks also were analyzed pathologically to identify all 3 landmarks.

DESIGN:

Retrospective review.

PARTICIPANTS:

One eye per participant from prior institutional review board-approved studies in which AS OCT imaging was performed.

METHODS:

Horizontal images from 2-dimensional angle analysis scans using a CASIA SS-1000 (Tomey, Nagoya, Japan) AS OCT were evaluated by masked readers. Logistic regression was used to analyze the potential factors of age, gender, race, intraocular pressure, gonioscopy grade, angle location, and history or presence of surgery on the visibility of these structures. Pathologic correlation on 5 previously enucleated eyes also was performed.

MAIN OUTCOME MEASURES:

Presence or absence of angle landmarks-TM, SC, and BELL-using Anterior Chamber Analysis and Interpretation software (ACAI, Houston, TX).

RESULTS:

Three hundred three angles of 153 horizontal images were included in this study. The mean age was 51.5±16.0 years, with 98 women (64%) and 100 white persons (66%). The outer border of the BELL was observed in 288 angles (95%), TM was found in 220 angles (73%), and SC was seen in 120 angles (40%). The outer border of the BELL was more visible in white persons (P = 0.02) than Asians and in eyes with a Spaeth gonioscopy grade of E than those with a grade of A (P = 0.02). Both TM (P = 0.001) and SC (P = 0.001) were more visible in temporal angles (81% for TM, 49% for SC) than in nasal angles (64% for TM, 30% for SC). Additionally, SC was more visible in open angles (43%) than in narrow angles (27%; P = 0.02). These 3 structures were verified in a pathologic study.

CONCLUSIONS:

We identified a novel AS OCT landmark adjacent to SC. This structure also was identified on pathologic samples from enucleated eyes. Further study is needed to determine the pathophysiologic relevance of these findings.

PMID:
29477691
DOI:
10.1016/j.ophtha.2018.01.018
[Indexed for MEDLINE]

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