[The role of iridotrabecular contact in the pathogenesis of primary angle closure disease].

Abstract

Purpose: This study investigated the correlation between iridotrabecular contact (ITC) and clinical-anatomical parameters in patients with primary angle closure disease (PACD) based on anterior segment imaging data obtained via swept-source optical coherence tomography (SS-OCT).

Material and methods: The study analyzed data from 92 patients aged 32-89 years, including 56 patients with PACD (43 phakic and 13 pseudophakic) and 36 control group participants (21 phakic and 15 pseudophakic). All participants underwent SS-OCT imaging of the anterior segment, including measurements of the ITC index and ITC area.

Results: The study revealed that in phakic PACD patients, ITC parameters (ITC Index and ITC Area) were significantly correlated with anterior chamber depth (ACD; r=-0.42, p=0.01 and r=-0.43, p=0.00, respectively), lens vault (LV; r=0.35, p=0.02 and r=0.36, p=0.02, respectively), lens thickness (LT; r=0.47, p=0.01 and r=0.44, p=0.01, respectively), all anterior chamber angle (ACA) parameters (all p=0.00), and the number of hypotensive medications used (r=0.63, p=0.01 and r=0.68, p=0.01, respectively). In pseudophakic PACD patients, ITC Index and ITC Area were associated with the number of hypotensive medications (r=0.71, p=0.02 and r=0.72, p=0.02, respectively) and the iridotrabecular space area in the nasal sector (r=0.62, p=0.02). No significant correlations were observed in the control group, regardless of lens status.

Conclusion: ITC parameters in phakic PACD patients demonstrated the highest number of correlations compared to pseudophakic patients. The persistence of a direct relationship between ITC parameters and the number of hypotensive medications in primary angle-closure glaucoma following lens extraction supports the rationale for early surgical intervention.