أبحاث طبية / Medical Research

**Title:** The Role of Anterior Segment Optical Coherence Tomography (AS-OCT) in the Diagnosis and Follow-up of Glaucoma Patients ### **Background** Glaucoma is a leading cause of irreversible blindness, requiring early diagnosis and ongoing monitoring. Traditional evaluation of the anterior chamber angle relies on gonioscopy, which is subjective. AS-OCT offers a non-contact, high-resolution, and objective method to visualize anterior segment structures such as angle width, angle opening distance (AOD), trabecular-iris space area (TISA), and iris configuration. It is particularly useful for diagnosing angle-closure glaucoma and monitoring progression. ### **Problem** Early detection and monitoring of glaucoma are challenging due to variability in clinical assessments. Limited local data exist on the effectiveness of AS-OCT in this context. ### **Objectives** * **General:** Evaluate AS-OCT’s role in diagnosing and following up glaucoma patients. * **Specific:** * Assess anterior chamber angle parameters via AS-OCT * Compare AS-OCT measurements with gonioscopy * Monitor anterior segment changes over time * Evaluate AS-OCT in detecting abnormal iris configuration, glaucoma shunt position, and trabeculectomy bleb ### **Research Questions** 1. How accurate is AS-OCT in diagnosing different types of glaucoma? 2. Can AS-OCT detect angle closure reliably compared to gonioscopy? 3. Is AS-OCT useful for monitoring disease progression? ### **Methodology** * **Design:** Prospective observational study * **Location:** Aljawareh Eye Hospital * **Population:** Patients ≥18 years with diagnosed or suspected glaucoma * **Exclusions:** Corneal opacities or poor image quality * **Data Collection:** History, clinical exam, visual acuity, intraocular pressure, gonioscopy, visual fields, AS-OCT imaging (measuring AOD, TISA, anterior chamber depth, iris thickness) * **Follow-up:** Every 3–6 months * **Analysis:** SPSS; descriptive stats, Kappa for agreement, sensitivity/specificity, paired t-tests/ANOVA for follow-up changes ### **Expected Results** * High sensitivity of AS-OCT in detecting angle closure * Strong agreement with gonioscopy * Reliable monitoring of structural changes over time ### **Significance** * Provides objective and reproducible diagnostics * Reduces reliance on subjective gonioscopy * Enhances early detection and follow-up of glaucoma ### **Ethics** * Approval from Ministry of Health, Northern State, Sudan * Informed consent and patient confidentiality maintained ### **Limitations** * Operator-dependent imaging * Single-center study may limit generalizability ### **Timeline** * Proposal approval: 1 week * Data collection: 4–6 months * Data analysis: 1 month * Report writing: 1 month

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