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

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).

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.

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.

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.