This is a prospective observational study of 342 subjects over four years. Sixty-five were controls who had open angles both on gonioscopy and AS-OCT, while 277 had open angles only on gonioscopy but iridotrabecular contact (ITC) on AS-OCT (one to four quadrants). At the end of the four year study period, 27.4% of those with ITC on AS-OCT at baseline developed gonioscopic angle closure in two or more quadrants, in contrast to none in the control subjects. The greater the amount of ITC on AS-OCT, the higher the likelihood of gonioscopic angle closure occurring after four years. This study confirms what many angle closure glaucoma specialists have long suspected – AS-OCT detects angle closure earlier than gonioscopy and will play an increasingly important role in the management of angle closure suspect patients.

Anterior segment imaging predicts incident gonioscopic angle closure.
Baskaran M, Iver JV, Narayanaswamy AK, et al.
OPTHALMOLOGY
2015;122:2380-4.
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Brian Ang

Royal Victorian Eye and Ear Hospital, Melbourne, Australia

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