Title: Comparative study between Gonioscopy and ultrasound Biomicroscopy in measuring angles of anterior chamber of eyes
Abstract: INTRODUCTION:
Glaucoma is the most common cause of irreversible blindness and second leading cause of blindness16. It is characterized by optic neuropathy and visual function loss. Primary angle closure glaucoma is potentially preventable if diagnosis is done before irreversible damage. Hence to an ophthalmologist direct visualisation of the angle of anterior chamber of eyes is of crucial importance. Aqueous outflow occurs through the angles and should be studied as an important structure of eyes.
Ultrasound biomicroscopy and gonioscopy are the two important measures to study angles of anterior chamber of eyes.
Gonioscopy is a subjective method of study of anterior chamber angles of eyes, it is considered as the gold standard technique. It is an integral part of diagnostic evaluation and is done routinely in all patients with glaucoma. It is often associated with misdiagnosis and under detection of angle closure.
Ultrasound biomicroscopy has revolutionised the evaluation of eye i.e. the anterior segment to understand the path of angle closure glaucoma, pigmentary glaucoma. It also helps in quantitative analysis to yield mechanism of oppositional angle closure and dynamic function of the iris. Hence early detection and treatment of angle closure significantly improves visual prognosis.
Ultrasound biomicroscopy is more established technique which allows a more objective assessment of anterior segment status. Recently used in objective measurement of anterior chamber angles. Also used to study anatomic configuration of the angle structures of the normal eyes and the glaucomatous eyes.
Advantage of ultrasound biomicroscopy is high image resolution. It also allows accurate identification of structural landmarks. It is used to measure angle parameters and also to quantify the data acquired.
AIMS AND OBJECTIVES:
1. To compare ultrasound biomicroscopy measurement of anterior chamber angle of eyes with gonioscopy in patients attending Ophthalmology outpatient department of GOVERNMENT RAJAJI HOSPITAL, MADURAI.
2. To evaluate ability of ultrasound biomicroscopy as a predictor to diagnose early stages of glaucoma.
3. To analyse whether ultrasound biomicroscopy or gonioscopy which is to be more precise method in direct documentation of all structures involved in angle structures configuration.
MATERIALS AND METHODS
SOURCE OF DATA :
It is a hospital based comparative study. It consist of patient attending the ophthalmology out patient department in GOVT. RAJAJI HOSPITAL, MADURAI. It included patients of age group of 20 – 70 years.
METHOD OF COLLECTION OF THE DATA
STUDY DESIGN: One year comparative study of patients.
SAMPLE SIZE : 100 eyes
SAMPLE : Patient attending the outpatient department.
Between the age group of 20–70 years.
PLACE : GOVT. RAJAJI HOSPITAL, MADURAI
DURATION : ONE YEAR.
INCLUSION CRITERIA
Patient attending ophthalmology OPD aged between 20 -70 years
Patient with normal cup disc ratio on funduscopy.
Patient with clinically suspected narrow angles
EXCLUSION CRITERIA
Patient with conjunctivitis, keratitis, uveitis.
Patient with perforating injury.
Patient with corneal haziness.
Patients with previous history of glaucoma surgery, laser surgery.
CONCLUSION : Gonioscopy is a subjective method. It is an useful method of grading and evaluating the angles of anterior chamber of eyes. It helps in segregating into occludable and non occludable fairly accurately when done by an experienced observer.
SUMMARY :
The present study was a comparative study conducted in department of ophthalmology in outpatient department of Govt. Rajaji Hospital, Madurai.
The objective of this test was to compare gonioscopy with ultrasound biomicroscopy for measuring the anterior chamber angle accurately. The study was done for a period of 1 year on 100 eyes of patients attending our OPD. An informed consent was obtained after explaining the risk and advantages associated with study in their own language. After meeting the inclusion and exclusion criteria patient’s eyes was subjected to anterior segment evaluation with slit lamp examination, intraocular pressure, gonioscopy, ultrasound biomicroscopy for the angle assessment of the anterior chamber.
Results of the two measurements were compared. Both methods compared with the ability of each method to define occludable and non occludable. The comparison in our study proved that anterior chamber estimation of angle categorisation into occludable and non occludable was significant. Though
gonioscopy caused over estimation of angle width it will remain the standard for evaluations of angle of anterior chamber. However ultrasound biomicroscopy though costly, it is required for objective quantification of the angles. Widespread and mandatory use of gonioscopy in evaluation of eyes will help in reducing the morbidity from angle closure glaucoma by early detection and intervention. Gonioscopy and Ultrasound biomicroscopy are equally effective.
Publication Year: 2013
Publication Date: 2013-04-01
Language: en
Type: dissertation
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