Work

AS-OCTA–Guided Versus Slit Lamp-Guided Laser Peripheral Iridotomy for Primary Angle-Closure Suspect Patients: A Short-Term Result

Year: 2025

Type: article

Abstract: Purpose: This study aimed to explore the possibility of the clinical application using anterior segment optical coherence tomography angiography (AS-OCTA)-guided laser peripheral iridotomy (LPI). Methods: AS-OCT/OCTA was performed before LPI and at 1 hour, 1 day, and 1 week post-LPI. All the right eyes of patients with primary angle-closure suspect (PACS) were assigned to the AS-OCTA-guided group, in which the peripheral site with the sparsest iris vasculature on AS-OCTA images was selected for LPI. The left eyes underwent LPI in the slit lamp-guided group, where the site was chosen based on the presence of an iris crypt by clinicians using the slit lamp. The two groups were compared for the incidence of anterior chamber bleeding observed by the LPI operator, anterior chamber particle (ACP) index, mean angle opening distance (AOD750), and anterior chamber depth (ACD) measured from AS-OCT images, as well as the vessel density and perfusion area obtained from AS-OCTA images. Results: A total of 30 patients with PACS were included in this study. The incidence of anterior chamber bleeding during LPI was 13.33% in the AS-OCTA-guided group, compared with 43.33% in the slit lamp-guided group (P = 0.010). The prominent difference was observed 1 hour after LPI, with the AS-OCTA-guided group showing significantly lower vessel density (P = 0.028), perfusion area (P = 0.003), and ACP (P = 0.004), but a larger AOD750 (P < 0.001) compared with the slit lamp-guided group. Conclusions: Utilizing AS-OCTA to guide the LPI procedure can significantly decrease the incidence of anterior chamber bleeding and mitigate inflammation. Translational Relevance: This study shows that the AS-OCTA-guided LPI procedure could bridge advanced imaging technology and clinical glaucoma management.

Source: Translational Vision Science & Technology

DOI: 10.1167/tvst.14.11.2

Authors: Jingjing Lin, Jianbo Mao, Meihui He, Yun Zhang, Li Nie

Institutions: The University of Melbourne, Wenzhou Medical University, Zhejiang Provincial People's Hospital

Language: English

Topic: Glaucoma and retinal disorders

Subfield: Ophthalmology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,850