TY - JOUR
T1 - Prevention of Blinking Alters Iris Configuration in Pigment Dispersion Syndrome and in Normal Eyes
AU - Liebmann, Jeffrey M.
AU - Tello, Celso
AU - Chew, Sek Jin
AU - Cohen, Henry
AU - Ritch, Robert
N1 - Funding Information:
Supported in part by The Glaucoma Foundation, New York, New York; an award in Memory of Mary E. and Alexander P. Hirsch, by The Fight For Sight Research Division of the National Society to Prevent Blindness, New York, New York (Dr. Tello); and The New York Eye and Ear Infirmary Department of Ophthalmology Research Fund, New York, New York. Presented in part at the ARVO Annual Meeting, Sarasota, May 1994, and the American Academy of Ophthalmology Annual Meeting, San Francisco, November 1994. Reprint requests to Jeffrey Liebmann, MD, The New York Eye and Infirmary, 310 East 14th St, New York, NY 10003.
PY - 1995
Y1 - 1995
N2 - Purpose: To examine the effect of blinking on iris configuration and aqueous humor distribution between the posterior and anterior chambers in eyes with pigment dispersion syndrome compared with healthy eyes. Methods: High-resolution, anterior segment ultrasound biomicroscopy was performed on ten eyes of ten patients with untreated pigment dispersion syndrome and on ten control subjects. Patients were scanned continuously for 15 minutes or until the maximal change in iris configuration occurred. During this time, the eyelids were held open mechanically, and blinking was prevented. Eyes then were rescanned immediately after blinking. Results: Initial iris configuration was concave in all eyes with pigment dispersion syndrome, whereas in control eyes it was concave in four eyes, planar in four eyes, and convex in two eyes. Iridozonular contact occurred in eyes with pigment dispersion syndrome only. Iridolenticular contact was greater in eyes with pigment dispersion syndrome than in control eyes. Analysis of covariance controlling for age, sex, and refractive error showed pigment dispersion syndrome to be a significant predictor of increased iris concavity. During continuous scanning, the mean change in iris position, from most concave to most convex, and mean time to the maximal change in iris configuration were greater for eyes with pigment dispersion syndrome than in control eyes and were related to the degree of initial iris concavity only (analysis of covariance). In six eyes with pigment dispersion syndrome, the eye cup was removed, normal blinking was permitted, and the eye was rescanned. The iris resumed a concave configuration in all eyes. Conclusion: Increased iris concavity in pigment dispersion syndrome appears to be related to increased iridolenticular contact. This creates an anatomic configuration that predisposes to reverse pupillary block. The accumulation of aqueous humor in the posterior chamber, when blinking is prevented, alters iris position in pigment dispersion syndrome and in healthy eyes and increases iridozonular and iridociliary-process distances while minimizing iridolenticular contact. Normal blinking appears to create transient vector forces which promote aqueous humor flow from the posterior to anterior chamber.
AB - Purpose: To examine the effect of blinking on iris configuration and aqueous humor distribution between the posterior and anterior chambers in eyes with pigment dispersion syndrome compared with healthy eyes. Methods: High-resolution, anterior segment ultrasound biomicroscopy was performed on ten eyes of ten patients with untreated pigment dispersion syndrome and on ten control subjects. Patients were scanned continuously for 15 minutes or until the maximal change in iris configuration occurred. During this time, the eyelids were held open mechanically, and blinking was prevented. Eyes then were rescanned immediately after blinking. Results: Initial iris configuration was concave in all eyes with pigment dispersion syndrome, whereas in control eyes it was concave in four eyes, planar in four eyes, and convex in two eyes. Iridozonular contact occurred in eyes with pigment dispersion syndrome only. Iridolenticular contact was greater in eyes with pigment dispersion syndrome than in control eyes. Analysis of covariance controlling for age, sex, and refractive error showed pigment dispersion syndrome to be a significant predictor of increased iris concavity. During continuous scanning, the mean change in iris position, from most concave to most convex, and mean time to the maximal change in iris configuration were greater for eyes with pigment dispersion syndrome than in control eyes and were related to the degree of initial iris concavity only (analysis of covariance). In six eyes with pigment dispersion syndrome, the eye cup was removed, normal blinking was permitted, and the eye was rescanned. The iris resumed a concave configuration in all eyes. Conclusion: Increased iris concavity in pigment dispersion syndrome appears to be related to increased iridolenticular contact. This creates an anatomic configuration that predisposes to reverse pupillary block. The accumulation of aqueous humor in the posterior chamber, when blinking is prevented, alters iris position in pigment dispersion syndrome and in healthy eyes and increases iridozonular and iridociliary-process distances while minimizing iridolenticular contact. Normal blinking appears to create transient vector forces which promote aqueous humor flow from the posterior to anterior chamber.
UR - http://www.scopus.com/inward/record.url?scp=0028899366&partnerID=8YFLogxK
U2 - 10.1016/S0161-6420(95)31001-9
DO - 10.1016/S0161-6420(95)31001-9
M3 - Article
C2 - 7891984
AN - SCOPUS:0028899366
SN - 0161-6420
VL - 102
SP - 446
EP - 455
JO - Ophthalmology
JF - Ophthalmology
IS - 3
ER -