Light-dark changes in iris thickness and anterior chamber angle width in eyes with occludable angles

The purpose of this study was to investigate and measure light-dark changes in iris thickness (IT) and anterior chamber angle width in eyes with occludable angles and open angles by using anterior segment optical coherence tomography (AS-OCT). We examined 153 eyes of 153 Japanese patients with primary angle closure suspect, primary angle closure, primary angle closure glaucoma, or primary open angle glaucoma. AS-OCT was used to determine pupil diameter, IT, angle opening distance at 500 mu m (AOD(500)), and trabecular-iris space area at 500 mu m (TISA(500)) in each quadrant of the anterior chamber angle (superior, inferior, temporal, and nasal) under light and dark conditions. In the angle closure cases, IT, AOD(500) and TISA(500) in the dark varied significantly among the four quadrants (P < 0.05, analysis of variance). In contrast, in the open angle cases, IT, AOD(500) and TISA(500) in the dark did not differ significantly among the four quadrants. In the angle closure cases and the open angle cases, significant negative associations were found between IT difference [IT(light)-IT(dark)] and AOD(500) difference [AOD(500(light))-AOD(500(dark))] (R = -0.411, P < 0.001 and R = -0.501, P = 0.001, respectively) and between IT difference and TISA(500) difference [TISA(500(light))-TISA(500(dark))] (R = -0.475, P < 0.001 and R = -0.462, P = 0.002, respectively). Our results suggest that thickening of the iris root under dark conditions is related to the mechanism of primary angle closure. It is important to analyze both the angle structure and peripheral IT in each quadrant.