Anterior Segment Imaging in Childhood Glaucoma

Anterior chamber angle examination in childhood glaucoma has always been intriguing to study to clarify the pathogenesis of such a disease and improve its management and prognosis. Ultrasound biomicroscopy (UBM) helps visualize the angle details and grade the severity of the trabeculodysgenesis. Its drawback in younger patients is that it is a contact technique often requiring sedation or anesthesia, limiting its utility in children. With the introduction of anterior segment optical coherence tomography (AS-OCT), particularly the handheld device, this obstacle has been overcome. More and more of the anterior chamber angle mystery in childhood glaucoma is now being revealed. Handheld AS-OCT can be used to measure the anterior chamber angle width and the iris thickness and provides a corneal pachymetry map, which can be used to measure the corneal thickness. Detailed angle structure visualization with precise identification of the scleral spur, trabecular meshwork, and Schlemm’s canal can be obtained. Handheld AS-OCT can also demonstrate the angle changes following angle surgery and correlate these changes with the success rates.