Ultrasound biomicroscopic evaluation of anterior segment cysts as a risk factor for ocular hypertension and closure angle glaucoma

AIM: To investigate the relationship between the ultrasound biomicroscopic (UBM) features of anterior - segment cysts (ASCs) and increased intraocular pressure (IOP) as a risk factor for closed-angle glaucoma (CAG). METHODS: Totally 24 eyes with recently diagnosed ASCs were divided into two groups. First group with ASC and ocular normotension(n=13), second group with ASC and ocular hypertension (n=11). An ophthalmologic examination, including tonometry, slit -lamp biomicroscopy (SLBM), gonioscopy, fundoscopy, pentacam, and UBM, was performed. The features of the ASCs were compared with the IOP. RESULTS: ASCs were accurately diagnosed and delineated in 24 eyes using UBM. IOP was elevated in those ASCs with a secondary aetiology (P=0.027), iridociliary location(P=0.006), deformed shape (P=0.013), increased size (P =0.001) and elongated pupillary aperture (P=0.009). However, the count (P=0.343) of ASCs, anterior chamber depth (ACD; P=0.22) and axial lenght (AL; P =0.31) were not associated with ocular hypertension. Correlations were found between the IOP and ASC size (r =-0.712; P=0.003), anterior chamber angle (ACA; r =-0.985; P<0.001), angle opening area (AOA; r=0.885; P<0.001), angulation of iris (r=-0.776, P<0.001), and affected iris quadrant (r=-0.655, P=0.002). CONCLUSION: Ocular hypertension in some eyes with ASC might be associated with various mechanisms, including secondary aetiology, iridociliary location, deformed shape, increased size and elongated pupill, which can be determined by UBM.