Abstract：
To assess dynamic change of iris area (Iarea) and volume (VOL) with physiologic pupil dilation for progression of primary angle closure suspects.
Participants underwent baseline examinations including gonioscopy and anterior segment OCT (AS-OCT) as part of the Zhongshan Angle Closure Prevention Trial. The AS-OCT images were obtained both in the dark and light. Progression was defined as development of primary angle closure or an acute angle closure attack. Static ocular biometrics and dynamic changes were compared between progressors and non-progressors and multivariable logistic regression was developed to assess risk factors for progression.
A mean 16.8% decrease in Iarea and a mean 6.26% decrease in VOL occurred with pupil dilation, while 22.96% non-progressors and 40% progressors presented VOL increases with pupil dilation. Iarea in light and dark and VOL in light were significantly smaller in progressors. In a multivariable logistic model, older age (p=0.008), narrower horizontal angle opening distance (AOD) 250 µm from the scleral spur (AOD250, p=0.001), flatter iris curvature (IC, p=0.006) and lower loss of iris volume (ΔVOL, p=0.04) were significantly associated with progression. With receiver operating characteristic analysis, the area under the curve for ΔVOL alone was 0.621, while that for the combined index (age, AOD250, IC and ΔVOL) was 0.824. Eyes with elevated intraocular pressure had less VOL loss compared with progressors developing peripheral anterior synechiae alone (p=0.055 for ΔVOL adjusted for pupil enlargement).
A smaller change in ΔVOL is an additive risk factor to identify eyes more likely to develop angle closure disease.
ISRCTN45213099.
Participants underwent baseline examinations including gonioscopy and anterior segment OCT (AS-OCT) as part of the Zhongshan Angle Closure Prevention Trial. The AS-OCT images were obtained both in the dark and light. Progression was defined as development of primary angle closure or an acute angle closure attack. Static ocular biometrics and dynamic changes were compared between progressors and non-progressors and multivariable logistic regression was developed to assess risk factors for progression.
A mean 16.8% decrease in Iarea and a mean 6.26% decrease in VOL occurred with pupil dilation, while 22.96% non-progressors and 40% progressors presented VOL increases with pupil dilation. Iarea in light and dark and VOL in light were significantly smaller in progressors. In a multivariable logistic model, older age (p=0.008), narrower horizontal angle opening distance (AOD) 250 µm from the scleral spur (AOD250, p=0.001), flatter iris curvature (IC, p=0.006) and lower loss of iris volume (ΔVOL, p=0.04) were significantly associated with progression. With receiver operating characteristic analysis, the area under the curve for ΔVOL alone was 0.621, while that for the combined index (age, AOD250, IC and ΔVOL) was 0.824. Eyes with elevated intraocular pressure had less VOL loss compared with progressors developing peripheral anterior synechiae alone (p=0.055 for ΔVOL adjusted for pupil enlargement).
A smaller change in ΔVOL is an additive risk factor to identify eyes more likely to develop angle closure disease.
ISRCTN45213099.
摘要：
目的：评估虹膜面积（Iarea）和体积（VOL）随生理性瞳孔扩张的动态变化，以评估原发性闭角可疑者的进展。
方法：作为中山角封闭预防试验的一部分，参与者接受了基线检查，包括房角镜检查和眼前节OCT（AS-OCT）。AS-OCT图像是在黑暗和光照下获得的。进展定义为原发性闭角或急性闭角发作的发展。比较了进展者和非进展者之间的静态眼部生物特征和动态变化，并开发了多变量逻辑回归来评估进展的危险因素。
结果：瞳孔扩张时，I区平均减少16.8%，VOL平均减少6.26%，而22.96％的非进展者和40％的进展者的VOL随着瞳孔扩张而增加。在进步因子中，明暗的Iarea和明暗的VOL明显较小。在多变量逻辑模型中，年龄较大（p=0.008），与巩膜骨刺相距更窄的水平角度开口距离(AOD)250µm(AOD250,p=0.001),更平坦的虹膜曲率(IC，p=0.006)和较低的虹膜体积损失(ΔVOL，p=0.04）与进展显着相关。通过接收机工作特性分析,单独ΔVOL的曲线下面积为0.621，而综合指数(年龄，AOD250、IC和ΔVOL)为0.824。与单独发展外周前粘连的进步者相比，眼内压升高的眼睛的VOL损失较少（p=0.055，ΔVOL调整为瞳孔扩大）。
结论：ΔVOL的较小变化是确定眼睛更有可能发展为闭角型疾病的附加危险因素。
背景：ISRCTN45213099。
方法：作为中山角封闭预防试验的一部分，参与者接受了基线检查，包括房角镜检查和眼前节OCT（AS-OCT）。AS-OCT图像是在黑暗和光照下获得的。进展定义为原发性闭角或急性闭角发作的发展。比较了进展者和非进展者之间的静态眼部生物特征和动态变化，并开发了多变量逻辑回归来评估进展的危险因素。
结果：瞳孔扩张时，I区平均减少16.8%，VOL平均减少6.26%，而22.96％的非进展者和40％的进展者的VOL随着瞳孔扩张而增加。在进步因子中，明暗的Iarea和明暗的VOL明显较小。在多变量逻辑模型中，年龄较大（p=0.008），与巩膜骨刺相距更窄的水平角度开口距离(AOD)250µm(AOD250,p=0.001),更平坦的虹膜曲率(IC，p=0.006)和较低的虹膜体积损失(ΔVOL，p=0.04）与进展显着相关。通过接收机工作特性分析,单独ΔVOL的曲线下面积为0.621，而综合指数(年龄，AOD250、IC和ΔVOL)为0.824。与单独发展外周前粘连的进步者相比，眼内压升高的眼睛的VOL损失较少（p=0.055，ΔVOL调整为瞳孔扩大）。
结论：ΔVOL的较小变化是确定眼睛更有可能发展为闭角型疾病的附加危险因素。
背景：ISRCTN45213099。
