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Clinical features distinguishing angle closure from pseudoplateau versus plateau iris
S Shukla1, K F Damji, P Harasymowycz
1University of Western Ontario, London, Canada.
The British Journal of Ophthalmology
|January 24, 2008
Summary
Younger males with a bumpy peripheral iris are more likely to have pseudoplateau iris (PPI). However, clinical factors have limited ability to differentiate between plateau iris (PI) and PPI, with ultrasound biomicroscopy (UBM) being crucial for diagnosis.
Area of Science:
- Ophthalmology
- Anatomy
- Biomicroscopy
Background:
- Plateau iris (PI) and pseudoplateau iris (PPI) are conditions affecting the eye's anterior chamber angle.
- Ultrasound biomicroscopy (UBM) is a key diagnostic tool for these conditions.
- Differentiating between PI and PPI based on clinical factors alone can be challenging.
Purpose of the Study:
- To identify clinical factors that can help differentiate between plateau iris (PI) and pseudoplateau iris (PPI).
- To evaluate the diagnostic utility of clinical observations in distinguishing these two angle-closure mechanisms.
Main Methods:
- Retrospective cohort study of patients diagnosed with PI or PPI via UBM.
- Defined diagnostic criteria for PI (anterior ciliary body, narrow/closed angle, iris anterior to scleral spur) and PPI (similar to PI plus iridociliary sulcus cysts).
Main Results:
- 76 patients included: 21 with PPI and 55 with PI.
- PPI patients were more likely to be male, younger, have a "bumpy" peripheral iris, and greater trabecular meshwork pigmentation.
- PPI patients exhibited less gonioscopic angle closure compared to PI patients.
Conclusions:
- Younger males with a bumpy peripheral iris have a higher likelihood of PPI.
- Clinical factors show limited ability to discriminate between PPI and PI.
- UBM is essential for confirming the underlying mechanism and guiding treatment for angle-closure.
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