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An Ultrasound Biomicroscopy Study

Rajesh S. Kumar, MS; Desmond Quek, MBBS; Kelvin Y. Lee, MRCS(Ed); Francis T. Oen, FRCS(Ed); Hiroshi Sakai, MD, PhD; Victor T. Koh, MBBS; Lakshmana S. MohanRam, COT; Mani Baskaran, DNB; Tina T. Wong, FRCS(Ed), PhD; Tin Aung, FRCS(Ed), PhD

Arch Ophthalmol. 2008;126(12):1647-1651.

Objective  To confirm the presence of uveal effusion in the eyes of Asian patients with primary angle closure glaucoma (PACG) using ultrasound biomicroscopy (UBM).

Methods  In this observational case series, 70 patients with PACG (28 untreated patients with newly diagnosed PACG and 42 patients who had undergone previous laser iridotomy and were being monitored) and 12 patients with acute primary angle closure (APAC) were recruited. Eyes of patients with newly diagnosed PACG and APAC underwent UBM before and after laser iridotomy, whereas eyes of patients with treated PACG underwent UBM at enrollment. Uveal effusion was defined as a clear space between the choroid and sclera and was graded as follows: grade 0, none; grade 1, slitlike; grade 2, bandlike; and grade 3, obvious.

Results  Overall, uveal effusion was found in 11 of 70 eyes with PACG (15.7%; 95% confidence interval, 8.8%-26.2%) and in 3 of 12 eyes with APAC (25%; 95% confidence interval, 8.0%-53.4%). For patients with newly diagnosed PACG, uveal effusion was found in 4 of 28 eyes (14.2%; 95% confidence interval, 5.1%-32.1%) before laser iridotomy; 2 eyes had effusion after laser iridotomy. When present, the effusion was grade 1 in PACG eyes and grade 2 or 3 in APAC eyes.

Conclusions  Uveal effusion was present in a significant proportion of Asian eyes with PACG and APAC, confirming a recent report of this finding.

Author Affiliations: Singapore Eye Research Institute and Glaucoma Department, Singapore National Eye Centre (Drs Kumar, Quek, Lee, Oen, Koh, Baskaran, Wong, and Aung) and Mr MohanRam, Yong Loo Lin School of Medicine, National University of Singapore (Drs Koh and Aung), Singapore; Department of Ophthalmology, University of the Ryukus Hospital, Okinawa, Japan (Dr Sakai); and Sankara Nethralaya, Chennai, Tamil Nadu, India (Dr Baskaran).

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