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Anterior Segment Optical Coherence Tomography and Ultrasound Biomicroscopy in Glaucoma

Sancy Low, BSc (Hons), MBBS, MRCOphth1,2, and Rizwana Siddiqi, BSc (Hons), MSc, SRO3

Glaucoma is a degenerative optic neuropathy, the second most common cause of blindness worldwide [1]. Visual loss from glaucoma occurs as a result of structural and functional damage of the optic nerve [2]. Posterior segment imaging techniques such as scanning laser ophthalmoscopy, polarimetry, and optical coherence tomography (OCT) are now widely used for the assessment of glaucomatous optic neuropathy. However, to understand the underlying etiology of glaucoma, clinical assessment of the anterior chamber angle remains an integral part of any diagnostic or follow-up examination of patients with glaucoma or ocular hypertension. The gold standard for examination of the anterior chamber angle is gonioscopy, which requires topical anesthesia and application of a contact lens to the corneal surface [3]. In recent years, there has been rapid expansion of the available methods of anterior segment imaging for glaucoma [4]. These include infrared gonioscopy [5], the scanning peripheral anterior chamber analyzer [6,7], Scheimpflug photography [8,9], and a contact-lens mounted retinal camera adapted for use in the anterior chamber [10,11]. In this review article, we will focus on the practical application of ultrasound biomicroscopy (UBM) and anterior segment OCT (AS-OCT) imaging for the diagnosis and management of glaucoma patients.

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