Abstract：
To investigate longitudinal changes in the anterior segment (AS) using serial optical coherence tomography (OCT) images and determine the impact of these changes on the anterior chamber angle (ACA) in eyes with primary angle closure disease (PACD) treated with laser peripheral iridotomy (LPI).
Retrospective clinical cohort study.
This study included 103 patients with PACD who underwent LPI and were followed up by a mean 6.7 ± 1.7 AS-OCT examinations for a mean 6.5 ± 2.9 years. Temporal changes in AS-OCT parameters, including anterior chamber depth (ACD), angle opening distance (AOD750), angle recess area (ARA750), iris thickness (IT750), lens vault (LV), and pupil diameter (PD), were analyzed by multivariate linear mixed effects models (LMEMs).
Multivariate LMEMs showed that decrease in AOD750 was not significant (-1.59 µm/y, P = .222); however, ARA750 decreased over time (-2.3 × 103 µm2/y, P = .033) and SSA showed marginal significance (-0.20°/y, P = .098), and LV increased significantly (11.6 µm/y, P < .001) after LPI. Mean LV change was negatively associated with AOD750, ARA750, and SSA, whereas PD was negatively associated with ARA750 (P < .001 each). PD decreased with aging (-13.7 µm/y, P = .036), accompanied by thinning of IT750 (-1.7 µm/y, P = .063).
LV tends to increase with aging, which contributes to the shallowing of the anterior chamber and narrowing of ACA in PACD eyes treated with LPI. In the meantime, pupillary constriction and subsequent peripheral iris thinning associated with aging could possibly offset the effect of ACA narrowing.
Retrospective clinical cohort study.
This study included 103 patients with PACD who underwent LPI and were followed up by a mean 6.7 ± 1.7 AS-OCT examinations for a mean 6.5 ± 2.9 years. Temporal changes in AS-OCT parameters, including anterior chamber depth (ACD), angle opening distance (AOD750), angle recess area (ARA750), iris thickness (IT750), lens vault (LV), and pupil diameter (PD), were analyzed by multivariate linear mixed effects models (LMEMs).
Multivariate LMEMs showed that decrease in AOD750 was not significant (-1.59 µm/y, P = .222); however, ARA750 decreased over time (-2.3 × 103 µm2/y, P = .033) and SSA showed marginal significance (-0.20°/y, P = .098), and LV increased significantly (11.6 µm/y, P < .001) after LPI. Mean LV change was negatively associated with AOD750, ARA750, and SSA, whereas PD was negatively associated with ARA750 (P < .001 each). PD decreased with aging (-13.7 µm/y, P = .036), accompanied by thinning of IT750 (-1.7 µm/y, P = .063).
LV tends to increase with aging, which contributes to the shallowing of the anterior chamber and narrowing of ACA in PACD eyes treated with LPI. In the meantime, pupillary constriction and subsequent peripheral iris thinning associated with aging could possibly offset the effect of ACA narrowing.
摘要：
目的：使用连续光学相干断层扫描（OCT）图像研究眼前段（AS）的纵向变化，并确定这些变化对原发性闭角型疾病（PACD）进行激光周边虹膜切开术（LPI）治疗的前房角（ACA）的影响。
方法：回顾性临床队列研究。
方法：本研究纳入了103例接受LPI治疗的PACD患者，平均随访6.7±1.7AS-OCT检查，平均随访6.5±2.9年。AS-OCT参数的时间变化,包括前房深度（ACD），角开距离(AOD750),角槽区域（ARA750），虹膜厚度（IT750），镜头拱顶（LV），和瞳孔直径（PD），采用多元线性混合效应模型(LMEM)进行分析。
结果：多变量LMEMs显示AOD750的减少不明显（-1.59μm/yr，p=0.222)，然而,ARA750随时间下降(-2.3×103μm2/年，p=0.033)，SSA显示出边际显著性(-0.20°/yr，p=0.098),LV显著增加(11.6μm/年，LPI后p<0.001)。平均LV变化与AOD750、ARA750和SSA呈负相关，而PD与ARA750呈负相关(各p<0.001)。PD随老化而降低(-13.7μm/年，p=0.036)伴随IT750变薄(-1.7μm/年，p=0.063)。
结论：LV随着年龄的增长而增加，这有助于接受LPI治疗的PACD眼前房变浅和ACA变窄。同时,与衰老相关的瞳孔收缩和随后的周边虹膜变薄可能会抵消ACA变窄的影响。
方法：回顾性临床队列研究。
方法：本研究纳入了103例接受LPI治疗的PACD患者，平均随访6.7±1.7AS-OCT检查，平均随访6.5±2.9年。AS-OCT参数的时间变化,包括前房深度（ACD），角开距离(AOD750),角槽区域（ARA750），虹膜厚度（IT750），镜头拱顶（LV），和瞳孔直径（PD），采用多元线性混合效应模型(LMEM)进行分析。
结果：多变量LMEMs显示AOD750的减少不明显（-1.59μm/yr，p=0.222)，然而,ARA750随时间下降(-2.3×103μm2/年，p=0.033)，SSA显示出边际显著性(-0.20°/yr，p=0.098),LV显著增加(11.6μm/年，LPI后p<0.001)。平均LV变化与AOD750、ARA750和SSA呈负相关，而PD与ARA750呈负相关(各p<0.001)。PD随老化而降低(-13.7μm/年，p=0.036)伴随IT750变薄(-1.7μm/年，p=0.063)。
结论：LV随着年龄的增长而增加，这有助于接受LPI治疗的PACD眼前房变浅和ACA变窄。同时,与衰老相关的瞳孔收缩和随后的周边虹膜变薄可能会抵消ACA变窄的影响。
