Swept-source anterior segment optical coherence tomography can help distinguish early childhood glaucoma

The noninvasive swept-source anterior-segment optical coherence tomography (SS-ASOCT) can diagnose early-onset childhood glaucoma, according to a study published online May 22 in JAMA Ophthalmology.

Sushmita Kaushik, from the Advanced Eye Centre at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, and colleagues examined the use of SS-ASOCT in diagnosing pediatric patients as having early-onset childhood glaucoma versus not having glaucoma in a prospective, comparative study including pediatric patients younger than 2 years.

To analyze the visibility of the trabecular meshwork (TM) structures, the angle opening distance (500 or 250 mm), and the angle recess area (250 or 500 mm²), imaging was performed using SS-ASOCT with the ‘flying baby’ technique.

The SS-ASOCT features were compared between 23 pediatric patients without and 30 with early-onset childhood glaucoma; diagnosis was based on an eye examination using an ophthalmoscope.

The researchers found that the TM shadow was clearly visible in 100 and 26.7% of patients without glaucoma and with glaucoma, respectively. The highest area under the receiver operating characteristic curve for diagnosing pediatric patients as not having glaucoma was 0.87 for a clearly visible TM structure.

Greater anterior chamber angle measurement values were seen for pediatric patients with glaucoma versus those without glaucoma. In all young children with corneal opacity who did not have glaucoma, the TM structure was visualized; SS-ASOCT correctly diagnosed all 23 patients as not having glaucoma.

“The findings suggest the use of SS-ASOCT offers the potential for distinguishing early-onset childhood glaucoma from other conditions,” the authors write.

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