Update on the usefulness of optical coherence tomography in assessing the iridocorneal angle | Archivos de la Sociedad Española de Oftalmología (English Edition)

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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Length of iris-trabecular contact &#40;TICL&#58; trabecular iris contact lentgh&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Due to its implications in the physiopathology of aqueous humor &#40;AH&#41; drainage&#44; the iridocorneal angle is a fundamental structure in the anterior chamber of the ocular globe&#46; In recent years&#44; the development of anterior segment optical coherence tomography &#40;AS&#8722;OCT&#41;&#44; an imaging technique based on low coherence interferometry that obtains in real time a fast and noninvasive examination providing images of life tissue with high resolution&#44; has enabled extremely detailed iridocorneal angle assessments&#46; OCT technology developments in capture speed and image resolution has allowed this technology to become an essential examination tool in ophthalmological practices&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;12</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Different OCT devices enable the assessment of the angular region &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Some of the main advantages of AS&#8722;OCT include the possibility of identifying the structures that comprise the angle&#44; objectively measuring the angle region&#44; exploring the angle in pediatric patients or those exhibiting traumatism because it is a noncontact examination which does not require anesthesia&#46; In this way&#44; the angle can be assessed even in the presence of angular opacities&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In addition&#44; OCT technology exhibits excellent reproducibility &#40;intraclass correlation coefficient of &#62;0&#46;9&#41; for measuring angle parameters utilizing different devices&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> However&#44; even though various studies have found a good match between angle measures obtained with different OCT devices&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> absolute values are not interchangeable&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Evaluation of iridocorneal angle structures with AS&#8722;OCT</span><p id="par0020" class="elsevierStylePara elsevierViewall">In recent years&#44; several authors have described the ways in which AS&#8722;OCT facilitates the identification of angle region structures as well as AH drainage pathways &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Trabecular meshwork &#40;TM&#41;&#58;</span> due to its relevance in AH drainage&#44; one of the main analyzed structures was TM&#46; In 2008&#44; Sarunic et al&#46; obtained the first image thereof&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> TM is identified as the hyper-refringent half-moon in the scleral groove&#44; anteriorly limited by Schwalbe&#8217;s line and posteriorly by the scleral spur&#46; Its identification varies between authors &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; with the high resolution images provided by said technology enabling the assessment of its dimensions&#46; Utilizing Swept source AS&#8722;OCT&#44; Tun et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> obtained a mean TM length of 779&#8239;&#177;&#8239;98&#8239;&#956;m&#44; although it must be said that they did not directly visualize the TM and therefore their measurements were indirect from the scleral spur up to Schwalbe&#8217;s line&#46; In their study on TM with a sample of 1006 healthy Caucasian individuals&#44; Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> observed a mean length of 497&#8239;&#177;&#8239;93&#8239;&#956;m&#44; a thickness of 174&#8239;&#177;&#8239;28&#8239;&#956;m and an area of 0&#46;069&#8239;&#177;&#8239;0&#46;031&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Other authors such as Cheung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> and Usui et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> found similar TM measurements&#44; with a mean length of 467&#8239;&#177;&#8239;60&#8239;&#956;m and 467&#8239;&#177;&#8239;61&#8239;&#956;m&#44; respectively&#46; The latter authors observed a mean area of 0&#46;067&#8239;&#177;&#8239;0&#46;058&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; The aforementioned study by Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> showed TM as an independent structure from the rest of studied parameters and did not observe association between TM size with age&#44; axial length&#44; anterior depth chamber or with angle opening&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Schlemm&#8217;s canal &#40;SC&#41;&#58;</span> in OCT&#44; the SC is seen as a long and narrow hypo-reflective space outside of the TM&#46; Kagemann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> were the first to identify it through OCT &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Due to the high resolution of the latest OCT devices&#44; at present it is possible not only to identify but also quantify SC size after several procedures&#46; A study carried out by the authors&#8217; group on the SC measurements in a population of healthy children<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> found a similar SC diameter in the temporal and nasal quadrants of 267&#8239;&#177;&#8239;84&#8239;&#956;m &#40;range 131&#8211;509&#41; and 273&#8239;&#177;&#8239;77&#8239;&#956;m &#40;range 124&#8211;486&#41;&#44; respectively &#40;p&#8239;&#61;&#8239;0&#46;125&#41;&#46; The SC area was also similar between both quadrants&#44; 9&#46;975&#8239;&#177;&#8239;3&#46;514&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> &#40;range 4&#46;000&#8211;23&#46;000&#41; versus 9&#46;688&#8239;&#177;&#8239;3&#46;297&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> &#40;range 3&#46;000&#8211;24&#46;000&#41; &#40;p&#8239;&#61;&#8239;0&#46;167&#41;&#46; No differences were observed in SC size per sex&#44; refractive defect or TM size &#40;R&#8239;&#8804;&#8239;0&#46;116&#59; p&#8239;&#8805;&#8239;0&#46;125&#41;&#46; However&#44; said study did observe larger SC size with the increase of age in children &#40;p&#8239;&#61;&#8239;0&#46;041&#41;&#46; Chen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> obtained a mean SC area in healthy adults of 2&#46;759&#8239;&#177;&#8239;823&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and 2&#46;909&#8239;&#177;&#8239;827&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> for the nasal and temporal sectors&#44; respectively&#46; Hong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> observed smaller SC sizes in patients with open angle primary glaucoma &#40;OAPG&#41; when compared to healthy subjects &#40;11&#44;332&#8239;&#177;&#8239;2015&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> vs&#46; 13&#46;991&#8239;&#177;&#8239;1&#46;357&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; In turn&#44; Imamoglu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> also observed smaller SC sizes in patients with pseudoexfoliative glaucoma than in healthy subjects &#40;4000&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> vs&#46; 5000&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#59; p&#8239;&#61;&#8239;0&#46;036&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The differences between absolute values of SC size observed by several authors in healthy populations must be noted&#46; This could be due to the use of different OCT devices&#46; In what concerns intraocular pressure &#40;IOP&#41;&#44; Hong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> did not find a correlation with SC area&#46; However&#44; a correlation has been found between IOP reduction after medical or surgical glaucoma treatment and SC size increases&#46; Accordingly&#44; Chen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> observed a 90&#37; increase in SC size after instilling travoprost&#44; while Skaat et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> documented a 21&#37; increase in SC area in healthy subjects and 24&#37; SC increase in patients with OAPG after instilling pilocarpine&#46; In addition&#44; it has been observed that other procedures could induce changes in SC size&#46; Thus&#44; Zhao et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> observed a sustained dilatation of SC during the first 6 months after phacoemulsification&#46; Skaat et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> described an 8&#37; increase in SC area after selective trabeculoplasty&#46; SC size changes have also been described after a range of surgeries such as trabeculectomy &#40;5200&#8239;&#177;&#8239;996&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> pre-surgery vs&#46; 8117&#8239;&#177;&#8239;1942&#8239;&#956;m<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> post-surgery&#59; p&#8239;&#60;&#8239;0&#46;001&#41;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> or canaloplasty &#40;SC heights and weights increased 369&#37; and 152&#37;&#44; respectively&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Recently&#44; Huang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> carried out a very interesting line of research&#44; describing AH angiography in order to obtain in-depth knowledge of its drainage pathways&#44; observing sectorial&#44; pulsating and dynamic patterns&#46; Said authors utilized AS&#8722;OCT for interpreting this new research to identify the intra-scleral spaces represented by the collectors that are part of the drainage pathways with the objective of optimizing the surgical results of various glaucoma techniques&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Scleral spur&#58;</span> it can be observed as a hyper-reflective area in the posterior vertex of TM&#44; forming part of the angle recess&#46; The percentage of identification is generally high in most studies &#40;&#62;70&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Scleral spur identification is of vital importance for OCT involving automatic angle analysis software because it is the reference point for taking several measurements&#46; For this reason&#44; interobserver variability in the identification of the scleral spur could give rise to differences in the classification of open and closed angles&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Correlation with other angle assessment techniques</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Gonioscopy&#58;</span> the reference examination for angle assessment&#46; However&#44; it comprises several drawbacks due to being a subjective technique requiring an expert examiner in addition to being uncomfortable for patients and the fact that it does not provide quantitative data&#44; all of which limits its usefulness&#46; The advantages of gonioscopy compared to OCT include direct visualization of angle structures&#44; particularly the TM and its pigmentation degree&#44; dynamic angle evaluation to differentiate apositional from synechial angle closure and the visualization of blood in CS&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> The match between AS&#8722;OCT and gonioscopy to detect angle closure ranges between moderate and good both in healthy subjects and in glaucomatous patients &#40;sensitivity&#58; 73&#8211;95&#37; and specificity&#58; 59&#8211;84&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#8211;29</span></a> In a study comprising 423 eyes&#44; Sakata et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> found that AS&#8722;OCT overestimates angle closure when compared to gonioscopy&#46; In addition&#44; they observed that in the presence of discrepancies between both techniques&#44; AS&#8722;OCT tends to classify temporal quadrants as being more open than in gonioscopy&#46; However&#44; in the lower and upper quadrants&#44; gonioscopy tends to classify angles as open whereas AS&#8722;OCT classifies them as closed&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Devices based on the Scheimpflug camera</span>&#58; these devices comprise a rotational camera that captures 50 meridional images in under 2&#8239;s&#44; and is able to produce 3&#8239;D images and enabling angle opening quantification&#46; In a previous paper studying angle opening measurement matches between the Scheimpflug camera and OCT carried out by the authors&#8217; group&#44; a total CCI of 0&#46;378 and 0&#46;589 was obtained for the temporal and nasal sectors&#44; respectively&#44; producing a match between low and moderate&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> In comparison to OCT&#44; the Scheimpflug camera tends to overestimate opening in narrow angles and underestimate opening in open angles&#46; Interestingly&#44; Grewal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> observed that the parameter obtained with the Scheimpflug camera that best correlated with angle opening assessed with OCT or gonioscopy was anterior chamber volume&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Ultrasound biomicroscopy &#40;UBM&#41;&#58;</span> this is an ecographic technique that utilizes high-frequency ultrasound transducers &#40;50&#8211;100&#8239;MHz&#41; and has become the reference for studying the posterior chamber and retro-iridian structures&#46; The usefulness of UBM for assessing the angle region includes iris configuration analysis and ciliary body arrangement&#44; cystic angle closure&#44; study of lenses in sulcus&#44; plateau iris as well as for the differential diagnostic of ciliary&#44; angle or iris tumors&#46; Mansouri et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> carried out a comparative study observing that the AS&#8722;OCT measurements exhibited good overall correlation with those taken by means of UBM for evaluation of angle opening&#46; Even so&#44; said authors frequently observed significant differences in the measurements between both devices&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Quantitative parameters of angle study with AS&#8722;OCT</span><p id="par0065" class="elsevierStylePara elsevierViewall">In recent years&#44; a number of parameters have been standardized for measuring angle opening&#44; as described in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Angle opening</span> &#40;measured in degrees&#59; trabecular-iris angle &#91;TIA&#93;&#59; or anterior chamber angle &#91;ACA&#93;&#41;&#58; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; TIA was described in 2005 by Radhakrishnan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> who carried out a study to classify potentially occludable angles comparing OCT with Ernie Oscar B and UBM&#46; In a population of 989 subjects&#44; Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> were able to measure TIA in 94&#37; of cases with OCT RTVue&#44; obtaining a mean value of 35&#46;8&#8239;&#177;&#8239;13&#46;2 degrees&#46; In addition&#44; said authors observed a correlation between refractive defect and TIA&#44; with angle opening remaining stable between &#8722;9 and &#8722;3 diopters &#40;D&#41; with a mean angle of 46&#176;&#46; With the development of &#8722;3D&#44; the angle narrowed 2&#46;7&#176; for every D of positive increase&#44; reaching an angle opening of only 20&#176; in hypermetropic patients &#40;&#62;7D&#41;&#46; Similarly&#44; it was observed that the angle narrowed with age at a rate of 0&#46;57 degrees per year as of age 18 &#40;mean angle&#58; 50 degrees&#41; up to age 60 &#40;mean angle&#58; 30 degrees&#41;&#44; remaining subsequently stable&#46; In addition&#44; said study observed that the anterior chamber &#40;AC&#41; volume followed by AC depth constitutes the ocular parameters that best correlated with TIA &#40;R&#8239;&#62;&#8239;0&#46;80&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; Also&#44; lower mean angle opening was observed in females &#40;4&#46;5 degrees&#44; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; Similarly&#44; in the Beijing Eye Study carried out on an Asian population of 2985 healthy subjects&#44; Xu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> observed with AS&#8722;OCT utilizing OCT Visante a mean TIA of 38&#8239;&#177;&#8239;16 degrees&#44; with smaller angle opening being associated to females&#44; hypermetropia&#44; higher age and less central corneal thickness&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Angle opening distance</span> &#40;AOD&#41;&#44; introduced by Pavlin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> utilizing UBM to quantify angle opening &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The most widely used is AOD<span class="elsevierStyleInf">500&#44;</span> With AOD<span class="elsevierStyleInf">750</span> being more useful for studying iris configuration&#46; It has been observed that AOD values vary according to race and measuring device&#46; Thus&#44; in a healthy Asian population Leung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> found AOD<span class="elsevierStyleInf">500</span>&#8239;&#61;&#8239; 527&#8239;&#177;&#8239;249&#8239;&#956;m with OCT Visante&#44; a reading similar to that observed by Fernandez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> who found with Fourier domain OCT RTVue an AOD<span class="elsevierStyleInf">500</span>&#8239;&#61;&#8239; 537&#8239;&#177;&#8239;292&#8239;&#956;m in a Caucasian population&#44; whereas in patients with angle closure Mansouri et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> found a markedly diminished AOD &#40;AOD<span class="elsevierStyleInf">500</span>&#8239;&#61;&#8239; 210&#8239;&#177;&#8239;16&#8239;&#956;m&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">In what concerns the correlation between AOD<span class="elsevierStyleInf">500</span> measured with Slit-lamp OCT and gonioscopy&#44; Wirbelauer et al&#46; found a good correlation &#40;R&#8239;&#61;&#8239;0&#46;80&#41; between gonioscopy and AOD to classify narrow angles &#40;Shaffer &#8804;2 in all quadrants&#44; sensitivity 85&#37; and 90&#37; specificity&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> Concerning the usefulness of this parameter in daily clinic practice&#44; Radhakrishnan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> and Cheung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> suggested AOD<span class="elsevierStyleInf">500</span> values &#8804;191 and 172&#8239;&#956;m&#44; respectively&#44; in order to detect occludable angles &#40;Shaffer &#8804;1&#41; to establish indication for peripheral laser iridotomy &#40;PLI&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Trabecular-iris space area &#91;TISA&#93;&#41;</span>&#58; this parameter was also first described by Radhakrishnan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> TISA would represent the effective filtering area of TM as it excludes the non-filtrating region behind the scleral spur or angular recess &#40;where TM no longer exists&#59; <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; As with AOD&#44; TISA can be measured and 500 or 750&#8239;&#956;m from the scleral spur &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#41;&#46; A mean TISA<span class="elsevierStyleInf">500</span> of 0&#46;193&#8239;&#177;&#8239;0&#46;102&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> by means of OCT- Visante was found in the Leung et al&#46; study&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> whereas said parameter was 0&#46;195&#8239;&#177;&#8239;0&#46;103&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> in the Fern&#225;ndez-Vigo et al&#46; study with RTVue&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Even though TISA is a parameter that was proposed to represent the effective filtering area of TM&#44; a range of population studies have not found a correlation with IOP&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Index of trabecular-iris contact &#91;TIC&#93;&#41;&#58;</span> this term was introduced after a semiautomatic analysis with the CASIA device &#40;Tomey Corporation&#44; Nagoya&#44; Japan&#41; that assessed the percentage of 360-degree trabecular-iris contact &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; A study on an Asian population by Baskaran et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> observed that eyes with open angle in gonioscopy produced a TIC of 15&#46;2&#37;&#44; with 48&#46;5&#37; in eyes with closed angle&#46; Said authors concluded that if TIC &#62;35&#37; sensitivity and specificity for detecting angle closure was 71&#46;9&#37; and 84&#46;3&#37;&#44; respectively&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Trabecular iris contact length &#91;TICL&#93;&#41;&#58;</span> by virtue of the high-resolution provided by the latest OCT devices&#44; this new parameter was proposed to represent the linear contact distance between the iris and the TM &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#44; with the ability to precisely quantify said contact&#46; In a healthy population comprising 2012 eyes&#44; Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> observed a trabecular iris contact length of 1&#46;6&#37;&#44; with the mean TICL in said patients being 239&#8239;&#177;&#8239;79&#8239;&#956;m over a mean TM size of 486&#8239;&#177;&#8239;86&#8239;&#956;m&#46; Said trabecular iris contact was only observed in angles &#60;23 degrees&#44; with a weak correlation between TICL and IOP &#40;R&#8239;&#61;&#8239;0&#46;270&#41;&#46; In addition&#44; due to the high-resolution provided by the latest OCT devices&#44; Fern&#225;ndez-Vigo et al&#46; proposed measuring the TICL percentage&#44; i&#46;e&#46;&#44; the percentage of TM occluded by the iris which in their study reached 46&#46;9&#8239;&#177;&#8239;13&#46;9&#37; &#40;range 17&#46;2&#8211;76&#46;3&#37;&#41;&#46; A very interesting study was published by Chong et al&#46; on a population of 2045 subjects reporting an association between angle closure degree &#40;assessed with gonioscopy and OCT&#41; and IOP&#44; although it should be noted that IOP increase was slight &#40;no closed quadrant&#58; 14&#46;7&#8239;&#177;&#8239;0&#46;2&#59; one quadrant&#58; 15&#46;0&#8239;&#177;&#8239;0&#46;2&#59; two&#58; 14&#46;8&#8239;&#177;&#8239;0&#46;2&#59; three&#58; 15&#46;1&#8239;&#177;&#8239;0&#46;3&#59;four &#58; 16&#46;0&#8239;&#177;&#8239;0&#46;3&#8239;mm Hg&#59; P&#8239;&#60;&#8239;0&#46;001&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Clinic usefulness of iris-corneal angle assessment with AS&#8722;OCT</span><p id="par0100" class="elsevierStylePara elsevierViewall">Angular assessments with OCT include numerous useful purposes &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#58;</p><p id="par0105" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Angle closure mechanisms&#58;</span> Shabana et al&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> carried out a study to assess the primary angle closure mechanisms &#40;including pupil blockage&#44; plateau iris&#44; increased lens vault and the role of thick and peripheral iris&#41; analyzing angle parameters with AS&#8722;OCT&#46; said authors found higher&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">AOD<span class="elsevierStyleInf">500</span> and AOD<span class="elsevierStyleInf">750</span> values in the plateau iris group &#40;0&#46;09&#8239;&#177;&#8239;0&#46;02&#8239;mm and 0&#46;19&#8239;&#177;&#8239;0&#46;02&#8239;mm&#44; respectively&#41; due to the fact that in this case angle opening was not diminished&#46; Likewise&#44; Guzman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> used angle parameters obtained with AS&#8722;OCT to differentiate between suspected angle closure&#44; factual angle closure and glaucoma due to angle closure in 425 subjects&#46; The highest AOD<span class="elsevierStyleInf">750</span> values were exhibited by the suspected angle closure group &#40;0&#46;28&#8239;&#177;&#8239;0&#46;007&#8239;mm&#41; followed by the factual angle closure and the glaucoma due to angle closure groups&#44; respectively &#40;0&#46;24&#8239;&#177;&#8239;0&#46;012&#8239;mm and 0&#46;23&#8239;&#177;&#8239;0&#46;009&#8239;mm&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In what concerns secondary angle closure mechanisms&#44; AS&#8722;OCT can also play a crucial role for diagnosis&#44; classification and follow-up of evolution &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46; Kwon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> divided eyes with primary angle closure in 2 subgroups on the basis of the characteristics observed with OCT and UBM&#44; reporting that angle opening was a main difference in said subdivision&#44; with the ciliary body position being another important factor&#46; They also observed that both factors had a repercussion in pressure decrease after PLI &#40;<a class="elsevierStyleCrossRef" href="#fig0035">Fig&#46; 7</a>&#41;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Malign glaucoma&#58;</span> Wirbelauer et al&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a> carried out the first study assessing the usefulness of angle OCT for malign glaucoma after filtrating surgery&#44; reporting 2 cases in which&#44; after performing vitrectomy&#44; TIA and AOD<span class="elsevierStyleInf">500</span> increased from 0&#44; in both cases to 35 degrees and 425&#8239;&#956;m&#44; respectively&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Neovascular glaucoma&#58;</span> OCT was also used in neovascular glaucoma for identifying the hypo-reflectiveness tissue in the angle corresponding to neovessels as well as to assess the regression thereof after antiangiogenic therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a> By means of OCT&#44; Nadal et al&#46; observed that antiangiogenic monotherapy is frequently not enough to eliminate fibrovascular tissue and could induce the contraction thereof thus worsening angle closure&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">47</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pigment dispersion syndrome and glaucoma&#58;</span> AS&#8722;OCT can also be utilized in the diagnostic and follow-up of the pigment dispersion syndrome &#40;PDS&#41;&#44; characterized by a broad iris-cornea angle due to the concavity of the peripheral iris&#44; giving rise to inverted pupil blockage and mechanical friction of the iris against the lens surface &#40;<a class="elsevierStyleCrossRef" href="#fig0040">Fig&#46; 8</a>A&#41;&#44; with the ensuing release of pigment&#46; In a study on 63 eyes with PDS and pigment glaucoma&#44; Bimer et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> observed that the parameters measuring angle opening were larger in these patients &#40;grouping PDS and pigment glaucoma&#41; than in controls &#40;AOD<span class="elsevierStyleInf">500</span>&#8239;&#61;&#8239; 0&#46;782&#8239;&#177;&#8239;0&#46;304&#8239;mm vs&#46; 0&#46;561&#8239;&#177;&#8239;0&#46;252&#8239;mm&#59; AOD<span class="elsevierStyleInf">750</span> 1&#46;028&#8239;&#177;&#8239;0&#46;364&#8239;mm vs&#46; 0&#46;729&#8239;&#177;&#8239;0&#46;241&#8239;mm&#59; TISA<span class="elsevierStyleInf">500</span> 0&#46;288&#8239;&#177;&#8239;0&#46;120&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> vs&#46; 0&#46;201&#8239;&#177;&#8239;0&#46;083&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; An interesting study carried out by Aptel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">49</span></a> using OCT reported to diminished contact between iris and lens in PDS after peripheral laser iridotomy &#40;PLI&#41; &#40;0&#46;42&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> vs&#46; 0&#46;11&#8239;mm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#44; with values after IPL being similar to those of the control group &#40;<a class="elsevierStyleCrossRef" href="#fig0040">Fig&#46; 8</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pseudoexfoliation syndrome&#58;</span> OCT has also been utilized in subjects with the pseudoexfoliation syndrome &#40;PSX&#41; in a study by Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a> that did not find differences in angle opening vis-&#224;-vis healthy controls&#46; OCT enabled the assessment of sedimentation in the lens anterior surface and the endothelium&#44; although no identifiable PSX sedimentation was observed in the iris-cornea angle&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">It is worthwhile noting that in recent years the use of OCT has become widespread for assessing changes that take place in the angle after different ocular interventions through laser or surgical techniques in order to understand changes on the AH drainage system in an attempt to predict its effects on IOP &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Laser iridotomy or iridoplasty&#58;</span> several studies have demonstrated the possibility of objectively observing and quantifying increases in angle parameters &#40;TIA&#44; AOD and TISA&#41; obtained with AS&#8722;OCT after PLI or iridoplasty in the presence of angle closure&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">51&#44;52</span></a> After performing PLI in eyes under the effects of an acute glaucoma episode as well as in the contralateral eye&#44; Moghimi et al&#46; &#40;<a class="elsevierStyleCrossRef" href="#fig0045">Fig&#46; 9</a>A and C&#41;&#44; observed increases in AOD<span class="elsevierStyleInf">500</span> &#40;150&#8239;&#177;&#8239;24&#8239;&#956;m a 550&#8239;&#177;&#8239;61&#8239;&#956;m&#41; in eyes under said episode as well as in contralateral eyes &#40;350&#8239;&#177;&#8239;38&#8239;&#956;m a 770&#8239;&#177;&#8239;60&#8239;&#956;m&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a> In order to predict the success factors of PLI in patients with suspected angle closure&#44; Lee et al&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">53</span></a> found that lower pretreatment values of TIA&#44; AOD and TISA were associated to larger short-term angle opening after PLI &#40;2&#8211;3 weeks&#41;&#46; Similarly&#44; Sung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">54</span></a> found that eyes with baseline values under AOD<span class="elsevierStyleInf">750</span> and IT<span class="elsevierStyleInf">750</span> exhibited larger changes in angle opening both in the short-term &#40;2 weeks&#41; and in the longer term &#40;3 years&#41; after PLI&#46; In addition&#44; Ang et al&#46; found that PLI is more likely to fail in the presence of higher TICL and lower iris anterior curvature&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">55</span></a></p><elsevierMultimedia ident="fig0045"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cataract surgery&#58;</span> regarding angle changes after lens surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; 9&#8239;B and D&#41;&#44; Zhou et al&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">56</span></a> studied the presurgery TIA values obtained with AS-OCT Visante as a predictive factor for post-surgery IOP changes and observed that the angle increased &#40;TIA from 25 to 38 degrees&#41; and and that mean IOP diminished from 15&#46;1 to 12&#46;8&#8239;mm Hg&#46; However&#44; said authors concluded that the preop angle measurements were unable to predict the hypotensor effect of IOP after cataract surgery&#46; Similarly&#44; Huang et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">57</span></a> assessed the predictive capacity of several parameters &#40;AOD<span class="elsevierStyleInf">500&#44;</span> TISA<span class="elsevierStyleInf">500&#44;</span> TIA&#44; lens vault and iris curvature&#41; on IOP reduction after cataract surgery in eyes without glaucoma&#44; including patients with narrow and open angle&#46; Accordingly&#44; both the lens vault and increased AOD<span class="elsevierStyleInf">500</span> after surgery &#40;R&#8239;&#61;&#8239; 0&#46;240&#46; P&#8239;&#61;&#8239;0&#46;041&#41; exhibited a correlation with IOP reduction &#40;R&#8239;&#61;&#8239;0&#46;235&#59; P&#8239;&#61;&#8239;0&#46;045&#59; 14&#46;97&#8239;&#177;&#8239;3&#46;35 to 12&#46;62&#8239;&#177;&#8239;3&#46;37&#8239;mm Hg&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; In agreement with the previous study&#44; Hsia et al&#46; found in a multivariable analysis that in presurgery IOP &#40;R<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#8239;&#61;&#8239;0&#46;40&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#44; AOD<span class="elsevierStyleInf">500</span> &#40;R<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#8239;&#61;&#8239;0&#46;45&#59; p&#8239;&#61;&#8239;0&#46;02&#41; and lens vault &#40;R<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#8239;&#61;&#8239;0&#46;47&#59; P&#8239;&#61;&#8239;0&#46;009&#41; were able to predict IOP reduction after cataract surgery in patients with OAPG&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">58</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Phakic lenses&#58;</span> AS&#8722;OCT has also demonstrated its usefulness for angle assessment after implanting phakic lenses for correction of various refractive defects &#40;<a class="elsevierStyleCrossRef" href="#fig0050">Fig&#46; 10</a>&#41;&#46; Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">59</span></a> observed that angle opening diminished 34&#8211;42&#37; one month after implanting a myopic epicrystalline lens &#40;ICL V4c&#44; STAAR Surgical AG&#41;&#44; and also observed a significant AOD reduction one month after surgery &#40;804&#46;6&#8239;&#177;&#8239;276&#46;8&#8239;&#956;m to 3694&#8239;&#177;&#8239;1699&#8239;&#956;m&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; However&#44; the 2-year follow-up of these patients evidenced angle closure stabilization &#40;AOD at month 369 was &#177;170 vs&#46; 354&#8239;&#177;&#8239;152 at 2 years&#59; p&#8239;&#61;&#8239;1&#44;0&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">60</span></a> TIA correlated with the lens vault 2 years after surgery &#40;R&#8239;&#61;&#8239;&#8722;0&#46;609&#59; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; In addition&#44; iris-trabecular contact was observed in 8 of the 54 studied eyes in the first month after ICL implant which did not progress at 2 years after said implant&#46; In these cases&#44; mean TICL was 307&#8239;&#177;&#8239;288&#8239;&#956;m&#46; Interestingly&#44; 7 presurgery factors were identified that could predict angle opening after ICL implant &#40;TIA&#44; age&#44; sex&#44; refractive defect&#44; IT<span class="elsevierStyleInf">500&#44;</span> white to white distance and lens size&#41; with R<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#8239;&#61;&#8239; of 0&#46;915&#46; 0&#46;839 and 0&#46;805 for the temporal&#44; nasal and inferior sectors&#44; respectively &#40;P&#8239;&#60;&#8239;0&#46;001&#41;&#46; Factors such as anterior chamber depth&#44; axial length or lens power were found to be not determining &#40;p&#8805;0&#46;05&#41;&#46; As in the study of Fern&#225;ndez-Vigo et al&#46;&#44; Yan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">61</span></a> did not find either that reductions in TIA&#44; AOD and TISA after ICL implants correlated with increased IOP during 2 years after the ICL implant&#46;</p><elsevierMultimedia ident="fig0050"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="par0160" class="elsevierStylePara elsevierViewall">AS&#8722;OCT technology has evolved in recent years to provide images enabling the identification and quantification of key angle structures to determine normal angle anatomy and its alterations&#46; This could contribute to increase our knowledge on the physiopathology of glaucoma&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Said technology enables the quantification of angle opening with objective parameters&#44; mainly trabecular-iris angle &#40;TIA&#41;&#44; angle opening distance &#40;AOD&#41; and trabecular-iris surface &#40;TISA&#41;&#46; In addition&#44; OCT comprises a broad range of functions for studying angle closure mechanisms&#44; assessing changes after laser iridotomy or iridoplasty cataract surgery or implant of phakic lenses&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conflicts of interest</span><p id="par0170" class="elsevierStylePara elsevierViewall">Professor Jos&#233; Mar&#237;a Ruiz Moreno receives financial support as consultant from TOPCON&#46; None of the remaining authors have declared any conflict of interests&#46;</p></span></span>"
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              "titulo" => "Evaluation of iridocorneal angle structures with AS&#8722;OCT"
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              "titulo" => "Correlation with other angle assessment techniques"
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              "titulo" => "Quantitative parameters of angle study with AS&#8722;OCT"
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              "titulo" => "Clinic usefulness of iris-corneal angle assessment with AS&#8722;OCT"
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            0 => "Iridocorneal angle"
            1 => "Optical coherence tomography"
            2 => "Glaucoma"
            3 => "Angle width"
            4 => "Trabecular meshwork"
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            0 => "&#193;ngulo iridocorneal"
            1 => "Tomograf&#237;a de coherencia &#243;ptica"
            2 => "Glaucoma"
            3 => "Abertura angular"
            4 => "Malla trabecular"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">The iridocorneal angle&#44; due to its implications in the physiopathology of aqueous humour drainage&#44; is a fundamental structure of the anterior chamber&#46; Anterior segment optical coherence tomography &#40;AS&#8722;OCT&#41; is a rapid and non-invasive technique that obtains images in vivo&#46; The high resolution allows it to analyse the normal anatomy of the angle&#44; any alterations&#44; and the changes that occur after different therapeutic interventions&#46; AS&#8722;OCT technology has evolved to provide images that allow the identification and quantification of the angular structures in healthy subjects and in glaucoma patients&#44; and especially the trabecular meshwork and the Schlemm&#39;s canal&#46; It also enables the angle width to be quantified&#44; with some objective parameters that have been standardised in recent years&#44; such as the trabecular-iris angle &#40;TIA&#41;&#44; the angle opening distance &#40;AOD&#41;&#44; and the trabecular-iris area &#40;TISA&#41;&#46; This technique has multiple uses in the study of the different mechanisms of angle closure&#44; the evaluation of changes after a laser peripheral iridotomy or iridoplasty after cataract surgery&#44; as well as after the implantation of phakic lenses&#46;</p></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">El &#225;ngulo iridocorneal por sus implicaciones en la fisiopatolog&#237;a del drenaje del humor acuoso es una estructura fundamental de la c&#225;mara anterior&#46; La tomograf&#237;a de coherencia &#243;ptica de segmento anterior &#40;OCT-SA&#41; es una t&#233;cnica r&#225;pida y no invasiva que obtiene im&#225;genes de los tejidos vivos con una alta resoluci&#243;n permitiendo conocer la anatom&#237;a normal del &#225;ngulo&#44; sus alteraciones y los cambios que se producen en el mismo tras diferentes intervenciones terap&#233;uticas&#46; La tecnolog&#237;a de la OCT-SA ha ido evolucionando hasta ofrecer im&#225;genes que permiten identificar y cuantificar estructuras angulares claves en sujetos sanos y en pacientes con glaucoma&#44; especialmente la malla trabecular y el canal de Schlemm&#44; lo que puede contribuir a ampliar el conocimiento de la fisiopatolog&#237;a del glaucoma&#46; Adem&#225;s&#44; permite cuantificar la abertura angular con unos par&#225;metros objetivos descritos en los &#250;ltimos a&#241;os&#44; entre los que destacan el &#225;ngulo irido-trabecular &#40;TIA&#41;&#44; la distancia de abertura angular &#40;AOD&#41; y el &#225;rea irido-trabecular &#40;TISA&#41;&#46; La OCT-SA presenta m&#250;ltiples utilidades en el estudio de los distintos mecanismos del cierre angular&#44; la evaluaci&#243;n de los cambios angulares tras la realizaci&#243;n de una iridotom&#237;a l&#225;ser o iridoplastia&#44; cirug&#237;a de la catarata o el implante de lentes f&#225;quicas&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Kudsieh B&#44; Fern&#225;ndez-Vigo JI&#44; Vila-Arteaga J&#44; Aritz Urcola J&#44; Mart&#237;nez-de-la-Casa JM&#44; Garc&#237;a-Feij&#243;o J&#44; et al&#46; Actualizaci&#243;n de la utilidad de la tomograf&#237;a de coherencia &#243;ptica para el estudio del &#225;ngulo iridocorneal&#46; Arch Soc Esp Oftalmol&#46; 2019&#46; <span class="elsevierStyleInterRef" id="intr0010" href="https://doi.org/10.1016/j.oftal.2019.06.007">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;oftal&#46;2019&#46;06&#46;007</span></p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Assessment of angle opening with optical coherence tomography pre- A&#41; and post- B&#41; cataract surgery&#44; showing how angle opening increases after surgery&#46; Presurgery image C&#41;&#44; post-surgery month 1 D&#41; and one year E&#41; of a phakic epi-crystalline lens in a hypermetropic patient&#46; Diminished angle opening can be observed&#46;</p>"
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      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A&#41; angle region measurements with optical coherence tomography applying new standardized parameters&#46; AOD&#58; angle opening distance and TISA&#58; trabecular-iris area measured at 500&#8239;&#956;m from the scleral spur&#46; B and C&#41; different trabecular meshwork sizes&#46;</p>"
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        "etiqueta" => "Fig&#46; 4"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">&#205;ndice Trabecular-iris contact index &#40;TIC&#41;&#46; For calculating the TIC index the scleral spur must be located together with the contact points between the iris and the trabecular meshwork-endothelium within 360&#176; of the anterior chamber&#46; This indicates the trabecular meshwork percentages obstructed by iris tissue&#46;</p>"
        ]
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        "identificador" => "fig0025"
        "etiqueta" => "Fig&#46; 5"
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Length of iris-trabecular contact &#40;TICL&#58; trabecular iris contact lentgh&#41;&#46;</p>"
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      ]
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        "identificador" => "fig0030"
        "etiqueta" => "Fig&#46; 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
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            "identificador" => "at0030"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Anterior segment optical coherence tomography &#40;AS&#8722;OCT&#41; with secondary angle closure due to several mechanisms&#46; A&#41; phakomorphic glaucoma&#46; B&#41; anteriorly protruded iris&#46; C&#41; anterior synechiae&#46; D&#41; Aniridia&#46; E&#41; Axenfeld-Rieger syndrome&#46; &#40;E&#58; courtesy of Dr&#46; Santos Bueso&#41;&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "fig0035"
        "etiqueta" => "Fig&#46; 7"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr7.jpeg"
            "Alto" => 592
            "Ancho" => 1256
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Neovascular glaucoma showing 360&#176; synechiae with iris rectification by means of optical coherence tomography&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "fig0040"
        "etiqueta" => "Fig&#46; 8"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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            "imagen" => "gr8.jpeg"
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          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Evolution control in pigment dispersion syndrome pre- A&#41; and post- B&#41; treatments by means of peripheral laser iridotomy &#40;PLI&#41;&#46;</p>"
        ]
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      8 => array:8 [
        "identificador" => "fig0045"
        "etiqueta" => "Fig&#46; 9"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr9.jpeg"
            "Alto" => 1069
            "Ancho" => 1897
            "Tamanyo" => 213809
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            "identificador" => "at0045"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluation with optical coherence tomography of angle opening in 2 clinic cases&#46; Case A&#41; exhibits pupil blockage with intraocular pressure &#40;IOP&#41; of 36&#8239;mmHg&#44; resolved after YAG iridotomy with IOP normalization to 18&#8239;mmHg&#44; image C&#41;&#46; Angle opening can be seen increased&#46; Case B&#41; exhibits an acute glaucoma episode with goniosynechiae&#44; showing a resolution of the condition D&#41; after cataract surgery and goniosynechiolysis&#46;</p>"
        ]
      ]
      9 => array:8 [
        "identificador" => "fig0050"
        "etiqueta" => "Fig&#46; 10"
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        "figura" => array:1 [
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">optical coherence tomography images showing the position of the myopic and hypermetropic ICL lens in miosis and midriasis&#44; with the possibility of assessing secondary angle changes&#46;</p>"
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      10 => array:8 [
        "identificador" => "tbl0005"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">OCT&#58; optical coherence tomography&#59; SLD&#58; Super Luminescent Diode&#59; SS&#58; Swept Source&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OCT model&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Manufacturer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Optical source&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Axial resolution<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Transversal resolution<span class="elsevierStyleSup">a</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Scan rate A-scans&#47;second&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Scan depth&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Maximum scan width&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Visante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Carl Zeiss Meditec&#44; Dublin&#44; AC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLD 1310&#8239;nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Slit Lamp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heidelberg Engineering&#44; Heidelberg&#44; Germany&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLD 1310&#8239;nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;25&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20-100&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Optovue RTVue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Optovue&#44; Inc&#44; Fermont&#44; AC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLD 840 nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spectralis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Heidelberg Engineering&#44; Heidelberg&#44; Germany&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLD 820 nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Carl Zeiss Meditec&#44; Dublin&#44; AC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLD 840 nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Casia SS-1000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tomey Corporation&#44; Nagoya&#44; Japan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SS l&#225;ser 1310&#8239;nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nidek RS 3000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nidek&#44; Gamagori&#44; Japan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLD 880 nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triton&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topcon Corporation&#44; Tokyo&#44; Japan&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SS l&#225;ser 1310&#8239;nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#8239;&#956;m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 mm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Angle structure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Identification percentage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Subjects&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OCT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Authors&#44; year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Schwalbe&#8217;s line&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cheung et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trabecular meshwork&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Quek et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1006 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RTVue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Schlemm&#8217;s canal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Kagemann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">290 healthy children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RTVue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fern&#225;ndez-Vigo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#37;86&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 OAPG50 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RTVue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#44;7&#37;70&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 healthy41 PSX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RTVue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Imamoglu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scleral spur&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CASIA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Usui et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">265 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RTVue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grewal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirrus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2139889.png"
              ]
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          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Identification percentage of angle structures with anterior segment optical coherence tomography&#46;</p>"
        ]
      ]
      12 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0065"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Parameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Angle opening &#40;in degrees&#41; or trabecular iris angle &#40;TIA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Obtained starting from angle recess and locating one of the lines at the trabecular meshwork starting point &#40;in the area close to Schwalbe&#8217;s line&#41; and locating the other line over the iris surface reaching the perpendicular point that crosses with the trabecular meshwork line &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Angle opening distance &#40;AOD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Obtained drawing a line from the scleral spur towards the corneal endothelium at 500 &#40;AOD<span class="elsevierStyleInf">500</span>&#41; or 750 microns &#40;AOD<span class="elsevierStyleInf">750</span>&#41; followed by another line from said corneal endothelium point perpendicular thereto up to the surface of the iris&#46; The most utilized parameter for angle assessment is AOD<span class="elsevierStyleInf">500&#44;</span> with AOD<span class="elsevierStyleInf">750</span> being more useful to study iris conflagration so that if AOD<span class="elsevierStyleInf">750</span> is lower than AOD<span class="elsevierStyleInf">500</span> its means that angle tends to narrow instead of increasing&#46; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Iris-trabecular area &#40;TISA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trapezoidal area comprise between the AOD&#44; the surface of the iris&#44; the corneal endothelium and a right angle line starting from the scleral spur towards the iris&#46; This area does not include the angle recess area &#40;posterior to the scleral spur&#41; because in theory it is regarded as a non-filtrating area&#46; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trabecular - iris contact length &#40;TICL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Linear distance of contact between the iris and the trabecular meshwork from the scleral spur&#46; Only measurable in closed angles because said contact exists only under said condition &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Iridian thickness &#40;IT&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Drawing a line from the scleral spur towards the corneal endothelium at 500 or 750 microns and subsequently another line from said point of the corneal endothelium at right angles up to the surface of the iris&#46; The shortest distance between these points in the anterior surface of the iris to the posterior surface thereof is calculated as IT<span class="elsevierStyleInf">500</span> and IT<span class="elsevierStyleInf">750</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Iris curvature &#40;IC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perpendicular distance from the posterior&#47;anterior surface of the iris at the point of greatest complexity&#47;concavity up to a line between the root of the iris up to the most peripheral point of the iris pigment epithelium&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Parameters utilized in angle region measurements with optical coherence tomography &#40;OCT&#41;&#46;</p>"
        ]
      ]
      13 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0070"
            "detalle" => "Table "
            "rol" => "short"
          ]
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        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Parameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Identification of structures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Measurement of trabecular meshwork size and Schlemm&#8217;s canal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Assessment of angle opening modifications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">After laser interventions &#40;iridotomy and iridoplasty&#41;&#44; cataract surgery&#44; phakic lens implant surgery&#44; after glaucoma surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Assessment of angle closure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Study of the mechanism that accounts for primary and secondary angle closure&#44; quantification of iris-trabecular contact&#44; assessment and follow-up of synechiae&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Assessment of secondary glaucomas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pigment dispersion&#58; iris concavity and friction over the lens before and after iridotomy Neovascular glaucoma&#58; angle classification&#44; the progression or regression of synechial angle closure after treatment&#46;Malign glaucoma&#58; assessment of angle closure mechanisms after filtrating surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pediatric patients and traumatisms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Evaluation angle alterations in congenital glaucoma&#44; angle recession after traumatism&#44; cysts and angle-iris tumors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2139888.png"
              ]
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          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Usefulness of iridocorneal angle examination with optical coherence tomography &#40;OCT&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:61 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anterior chamber angle and trabecular meshwork measurements made by fourier-domain optical coherence tomography in healthy white children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            0 => "J&#46;I&#46; Fern&#225;ndez-Vigo"
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