[The role of iridotrabecular contact in the pathogenesis of primary angle closure disease].

Purpose: This study investigated the correlation between iridotrabecular contact (ITC) and clinical-anatomical parameters in patients with primary angle closure disease (PACD) based on anterior segment imaging data obtained via swept-source optical coherence tomography (SS-OCT).

Material And Methods: The study analyzed data from 92 patients aged 32-89 years, including 56 patients with PACD (43 phakic and 13 pseudophakic) and 36 control group participants (21 phakic and 15 pseudophakic). All participants underwent SS-OCT imaging of the anterior segment, including measurements of the ITC index and ITC area.

Results: The study revealed that in phakic PACD patients, ITC parameters (ITC Index and ITC Area) were significantly correlated with anterior chamber depth (ACD; =-0.42, =0.01 and =-0.43, =0.00, respectively), lens vault (LV; =0.35, =0.02 and =0.36, =0.02, respectively), lens thickness (LT; =0.47, =0.01 and =0.44, =0.01, respectively), all anterior chamber angle (ACA) parameters (all =0.00), and the number of hypotensive medications used (=0.63, =0.01 and =0.68, =0.01, respectively). In pseudophakic PACD patients, ITC Index and ITC Area were associated with the number of hypotensive medications (=0.71, =0.02 and =0.72, =0.02, respectively) and the iridotrabecular space area in the nasal sector (=0.62, =0.02). No significant correlations were observed in the control group, regardless of lens status.

Conclusion: ITC parameters in phakic PACD patients demonstrated the highest number of correlations compared to pseudophakic patients. The persistence of a direct relationship between ITC parameters and the number of hypotensive medications in primary angle-closure glaucoma following lens extraction supports the rationale for early surgical intervention.