Pulsatile Motion of Trabecular Meshwork in Patient With Iris Cyst by Phase-Sensitive Optical Coherence Tomography

Monday, April 20, 2015: 2:00 PM
Room 1A (San Diego Convention Center)
Tueng Shen, MD, PhD
Yi-Chen Sun, MD, MS
Murray A. Johnstone, MD
Peng Li, PhD
Ruikang Wang, PhD

Purpose
To investigate the feasibility of using in vivo Phase-Sensitive OCT to evaluate the dynamic movement of the trabecular meshwork in a patient with iris cyst.

Methods
A 45-year-old man was noted with an iris lesion in his right eye during the regular eye exam. Slit lamp examination revealed a 3x3 mm bulging mass located at 9 o’clock behind the iris and protruding into temporal angle. Gonioscopy and Ultrasound biomicroscopy (UBM) both showed temporal iris bulging and obscuring the view of angle approximately 1.5 clock hours.    UBM evaluation showed cystic lesion.  Phase-sensitive optical coherence tomography (PhS-OCT) was then used to measure the trabecular meshwork (TM) motion near the iris lesion with closed angle.  Similar measurements were obtained on the same eye where the iris structure was normal with open angle.  The measurements were obtained via upright exam position with non-contact technique.

Results
PhS-OCT, a non-contact examination, showed apparent structural changes in temporal angle comparing with its nasal angle in the same image. Quantitative measurements of the TM motion clearly showed the difference between the closed angle region and the open angle region of the same eye.

Conclusion
PhS-OCT can be a very useful tool to monitor the dynamic movements of the TM.  By clearly demonstrating the significant difference in the TM movements in same eye of different regions (including angle occlusion from the iris cyst), our technique has a great potential to improve our understanding and treatment decisions of many ocular diseases surrounding iridocorneal angle.