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International Ophthalmology

, Volume 39, Issue 10, pp 2171–2177 | Cite as

Assessment of Schlemm’s canal in acute primary angle closure: an anterior segment optical coherence tomography study

  • Tarannum MansooriEmail author
  • Appidi Abhinav Reddy
  • Naga Chandrika Tumati
  • Nagalla Balakrishna
Original Paper
  • 93 Downloads

Abstract

Purpose

To image and quantitatively evaluate the Schlemm’s canal (SC) dimensions in the eyes with acute primary angle closure (APAC) with anterior segment optical coherence tomography (AS-OCT), and compare it with the SC measurements taken after the control of intraocular pressure (IOP) and in the normal age-matched controls.

Materials and methods

Seventeen eyes of 14 patients with the newly diagnosed APAC and 59 age-matched normal subjects underwent AS-OCT to image SC. SC cross-sectional area, SC meridional and coronal diameters were measured in the temporal and nasal regions at 3 and 9 o’clock position. After laser iridotomy and control of the IOP, all SC parameters were measured again at a week later, in APAC eyes. Intrasession intraobserver reliability of the SC measurements was assessed with intraclass correlation coefficient.

Results

Mean SC-SCA (10,600 ± 2691 µm2), SC meridional (682 ± 125 µm) and coronal diameters (21.2 ± 8.2 µm) showed a significant increase in the APAC eyes at presentation, when compared to the SC parameters measured at a week later (6499 ± 1754 µm2, 450 ± 169 µm and 15.75 ± 8.6 µm, p = < 0.0001, < 0.0001 and 0.01, respectively) and in the normal controls (7192 ± 1022 µm2, 499.2 ± 179.8 µm, 15.43 ± 4.35 µm, p = 0.02, < 0.0001, 0.01, respectively). There was no difference in the measured SC parameters between the normal controls and APAC eyes, when the parameters were measured at a week, after resolution of the acute attack (all p > 0.05).

Conclusion

A significant expansion of SC was observed in the APAC eyes at presentation, when compared to the normal controls and after the acute attack resolved. SC parameters may provide a useful research tool for evaluating morphological changes in the SC in APAC eyes, during an acute attack.

Keywords

Acute primary angle closure Anterior segment optical coherence tomography Schlemm’s canal 

Notes

Acknowledgements

Authors thank Dr. Jayanthi Sivasamy and Ms. Jahnavi Gamalapathy, International Institute of Information Technology, Hyderabad, India, for guidance in the analysis of the images, and Ms. Sabera Banu, L V Prasad eye Institute, Hyderabad, India, for providing research-related articles for the study.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Johnson MC, Kamm RD (1983) The role of Schlemm’s canal in aqueous outflow from the human eye. Invest Ophthalmol Vis Sci 24:320–325PubMedGoogle Scholar
  2. 2.
    Kagemann L, Nevins JE, Jan NJ, Wollstein G, Ishikawa H, Kagemann J et al (2014) Characterisation of Schlemm’s canal cross-sectional area. Br J Ophthalmol l; 98(Suppl 2):ii10–ii14CrossRefGoogle Scholar
  3. 3.
    Kagemann L, Wollstein G, Ishikawa H, Bilonick RA, Brennen PM, Folio LS et al (2010) Identification and assessment of Schlemm’s canal by spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci 51:4054–4059CrossRefGoogle Scholar
  4. 4.
    Usui T, Tomidokoro A, Mishima K, Mataki N, Mayama C, Honda N et al (2011) Identification of Schlemm’s canal and its surrounding tissues by anterior segment fourier domain optical coherence tomography. Invest Ophthalmol Vis Sci 52:6934–6939CrossRefGoogle Scholar
  5. 5.
    Shi G, Wang F, Li X, Lu J, Ding Z, Sun X et al (2012) Morphometric measurement of Schlemm’s canal in normal human eye using anterior segment swept source optical coherence tomography. J Biomed Opt 17:016016.  https://doi.org/10.1117/1.JBO.17.1.016016 CrossRefPubMedGoogle Scholar
  6. 6.
    Kagemann L, Wang B, Wollstein G, Ishikawa H, Nevins JE, Nadler Z et al (2014) IOP elevation reduces Schlemm’s canal cross-sectional area. Invest Ophthalmol Vis Sci 55:1805–1809CrossRefGoogle Scholar
  7. 7.
    Allingham RR, de Kater AW, Ethier CR (1996) Schlemm’s canal and primary open angle glaucoma: correlation between Schlemm’s canal dimensions and outflow facility. Exp Eye Res 62:101–109CrossRefGoogle Scholar
  8. 8.
    Hong J, Xu J, Wei A, Wen W, Chen J, Yu X et al (2013) Spectral-domain optical coherence tomographic assessment of Schlemm’s canal in Chinese subjects with primary open-angle glaucoma. Ophthalmology 120:709–715CrossRefGoogle Scholar
  9. 9.
    Sihota R, Lakshmaiah NC, Walia KB, Sharma S, Pailoor J, Agarwal HC (2001) The trabecular meshwork in acute and chronic angle closure glaucoma. Indian J Ophthalmol 49:255–259PubMedGoogle Scholar
  10. 10.
    Sihota R, Goyal A, Kaur J, Gupta V, Nag TC (2012) Scanning electron microscopy of the trabecular meshwork: understanding the pathogenesis of primary angle closure glaucoma. Indian J Ophthalmol 60:183–188CrossRefGoogle Scholar
  11. 11.
    Wang F, Shi G, Li X, Lu J, Ding Z, Sun X et al (2012) Comparison of Schlemm’s canal’s biological parameters in primary open-angle glaucoma and normal human eyes with swept source optical. J Biomed Opt 17:116008CrossRefGoogle Scholar
  12. 12.
    Yan X, Li M, Chen Z, Zhu Y, Song Y, Zhang H (2016) Schlemm’s Canal and trabecular meshwork in eyes with primary open angle glaucoma: a comparative study using high-frequency ultrasound biomicroscopy. PLoS One 11:e0145824CrossRefGoogle Scholar
  13. 13.
    Skaat A, Rosman MS, Chien JL, Mogil RS, Ren R, Liebmann JM et al (2016) Effect of pilocarpine hydrochloride on the Schlemm Canal in healthy eyes and eyes with open-angle glaucoma. JAMA Ophthalmol 134:976–981CrossRefGoogle Scholar
  14. 14.
    Chen J, Huang H, Zhang S, Chen X, Sun X (2013) Expansion of Schlemm’s canal by travoprost in healthy subjects determined by Fourier-domain optical coherence tomography. Invest Ophthalmol Vis Sci 54:1127–1134CrossRefGoogle Scholar
  15. 15.
    Lee WR (1995) The pathology of the outflow system in primary and secondary glaucoma. Doyne Lect Eye (Lond). 9(Pt 1):1–23Google Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  • Tarannum Mansoori
    • 1
    Email author
  • Appidi Abhinav Reddy
    • 2
  • Naga Chandrika Tumati
    • 1
  • Nagalla Balakrishna
    • 3
  1. 1.Sita Lakshmi Glaucoma CenterAnand Eye InstituteHyderabadIndia
  2. 2.International Institute of Information TechnologyHyderabadIndia
  3. 3.National Institute of NutritionHyderabadIndia

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