DR. TOSHIT VARSHNEY

Dr. VINEY GUPTA, Dr. SHIKHA GUPTA, Dr.KARTHIKEYAN MAHALINGAM

Abstract

Purpose: To evaluate the presence of angle dysgenesis on ASOCT (ADoA) as a predictive factor for the management of Juvenile-onset open-angle glaucoma (JOAG) eyes.

Methods: 66 JOAG eyes with uncontrolled IOP were evaluated for the presence or absence of ADoA, which was defined as the absence of Schlemm’s canal (SC) on ASOCT. B-scans in which SC was present were identified and quantified. Eyes that failed on medical management (MM) (including SLT) underwent trabeculectomy.

Results: SC was identified as present (in any B-scan) in 100% (35) eyes that underwent successful MM vs 42% (13/31) eyes that showed failure and required (p < 0.001) surgery. 93% (26/28) eyes in which SC was present in <50% ASOCT B-scans underwent surgery (p < 0.001). On regression analysis, the presence of SC increased the chances of success of MM by 2.9 times. Conclusion: The presence of ADoA is a strong predictor of failure of medical therapy in JOAG eyes and the need for trabeculectomy for IOP control.

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