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Ultrasound Biomicroscopic Evaluation of Patients with Asymmetric Angles

Research Fellow: Cristiano Oliveira, M.D.

Patients with a narrow angle are often seen in the glaucoma practice. The management of these patients is very important because of the potential risk of development of glaucoma. The closure of a narrow angle blocks the drainage of the aqueous humor, liquid that is continuously produced and is responsible for the eye pressure. This can cause spikes of pressure that with time will damage the optic nerve at the back of the eye. Age is known to be a significant factor in angle closure and is associated with narrowing of the angle in all quadrants, especially superiorly. Among patients over 60 years of age the angle in the superior quadrant was found to be significantly narrower than the other quadrants using UBM.

Study involving twenty consecutive patients with angle asymmetry between the superior and inferior quadrants equal or greater than 2, according to Shaffer's (e.g. superior slit and inferior grade 2) determined with gonioscopy. The study aim is to evaluate patients with asymmetric angles with UBM trying to elucidate why the angle is narrower in the superior quadrant compared with the other quadrants. The UBM images obtained from each patient will be analyzed using the software for Windows UBM Pro 2000 (Paradigm Medical Industries Inc, Salt Lake City, UT). The software allows the measurement of angle recess area (ARA) in a semi-automated fashion, and also allows measurements of structures in the form of segment and angles.

Providing the important role of the biometric characteristics of narrow angle in the pathogenesis of angle-closure, we believe that the information about the sectoral particularities of the anterior chamber angle may represent a step forward a better understanding of the mechanism of angle closure.

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