This issue at a glance

In this issue of JOCO, Moghimi et al present “Qualitative evaluation of anterior segment in angle closure disease using anterior segment optical coherence tomography”. In this prospective, cross-sectional study, one eye of 115 patients with angle closure disease was evaluated using anterior segment optical coherence tomography (AS-OCT). The patients were divided into three subgroups: fellow eye of acute angle closure (FAAC), primary angle closure glaucoma (PACG), and primary angle closure suspect (PAGS). They found a significant difference in the mechanism of this event in the three subgroups (p ¼ 0.03). While the majority of FAAC and of PACS eyes had dominantly pupillary block mechanism in the PACG group, this phenomena was observed in only 48.7% of cases (p ¼ 0.03). The percentage of exaggerated lens vault and plateau iris was higher in PACG group. FAAC group had the shallowest AC and greater iris curvature and lens vault which were statistically significant compared with the two other groups. The iris thickness was not significantly different in the three groups. They concluded that pupillary block was a major factor in the mechanism of primary acute angle closure glaucoma. Primary angle closure glaucoma is the most frequent cause of blindness in the world1; therefore, AS-OCT imaging can indicate which eyes should be treated before angle closure occurs.