Abstract：
To investigate the correlation between the opening and closing states of anterior chamber angle (ACA) and the density of limbal epithelial basal cells (LEBCs) in subjects with primary angle-closure glaucoma (PACG).
Cross-sectional observational study.
A total of 54 eyes of 29 patients diagnosed with PACG were included in the study. Fifty-four eyes from normal subjects were included as control. Automatic evaluation system for ultrasound biomicroscopy images of anterior chamber angle was used to assist ophthalmologists in identifying the opening or closing state of ACA, and the in vivo confocal microscopy (IVCM) was used to evaluate the density of LEBCs in different directions.
(1) The average density of LEBCs in the superior, inferior, nasal, and temporal limbus of the eyes in the PACG group was lower than that in the control group, and this pattern did not align with the density distribution observed in the control group. (2) In the early, moderate and advanced PACG, the density of LEBCs corresponding to the closed angle was lower than that in the control group (P < .05). Compared with the density of LEBCs corresponding to the closed angle and the open angle, the closed angle of PACG in the early, moderate and advanced stages was less than that in the open angle (P < .05 in the early and moderate stages; advanced stage P > .05). (3) The basal cell density was processed by dimensionless analysis. In the data calculated by averaging and minimizing, both closed angle dimensionless values were smaller than the open angle (P < .05). (4) Comparative analysis was conducted among the normal, open-angle, and closed-angle conditions in the superior, inferior, nasal, and temporal limbus. In the early stage of PACG, significant differences were observed in 4 limbal regions (P < .05), while in the moderate PACG stage, this difference was noted in 3 limbal regions (P < .05). In advanced PACG, 2 limbal regions exhibited significant differences (P < .05). These findings suggest that during the early PACG stage, angle closure is the predominant influencing factor on LEBCs density, while in the advanced stage, the decrease in density is attributed to a combination of angle closure and the natural progression of the disease.
There is a significant correlation between anterior chamber angle status and LEBCs. Advanced PACG and angle closure should be highly suspected of the occurrence of limbal stem cell deficiency (LSCD).
Cross-sectional observational study.
A total of 54 eyes of 29 patients diagnosed with PACG were included in the study. Fifty-four eyes from normal subjects were included as control. Automatic evaluation system for ultrasound biomicroscopy images of anterior chamber angle was used to assist ophthalmologists in identifying the opening or closing state of ACA, and the in vivo confocal microscopy (IVCM) was used to evaluate the density of LEBCs in different directions.
(1) The average density of LEBCs in the superior, inferior, nasal, and temporal limbus of the eyes in the PACG group was lower than that in the control group, and this pattern did not align with the density distribution observed in the control group. (2) In the early, moderate and advanced PACG, the density of LEBCs corresponding to the closed angle was lower than that in the control group (P < .05). Compared with the density of LEBCs corresponding to the closed angle and the open angle, the closed angle of PACG in the early, moderate and advanced stages was less than that in the open angle (P < .05 in the early and moderate stages; advanced stage P > .05). (3) The basal cell density was processed by dimensionless analysis. In the data calculated by averaging and minimizing, both closed angle dimensionless values were smaller than the open angle (P < .05). (4) Comparative analysis was conducted among the normal, open-angle, and closed-angle conditions in the superior, inferior, nasal, and temporal limbus. In the early stage of PACG, significant differences were observed in 4 limbal regions (P < .05), while in the moderate PACG stage, this difference was noted in 3 limbal regions (P < .05). In advanced PACG, 2 limbal regions exhibited significant differences (P < .05). These findings suggest that during the early PACG stage, angle closure is the predominant influencing factor on LEBCs density, while in the advanced stage, the decrease in density is attributed to a combination of angle closure and the natural progression of the disease.
There is a significant correlation between anterior chamber angle status and LEBCs. Advanced PACG and angle closure should be highly suspected of the occurrence of limbal stem cell deficiency (LSCD).
摘要：
目的：探讨原发性闭角型青光眼(PACG)患者前房角(ACA)的开闭状态与角膜缘上皮基底细胞(LEBCs)密度的相关性。
方法：横断面观察性研究。
方法：29例诊断为PACG的患者共54只眼纳入研究。包括来自正常受试者的54只眼作为对照。利用前房角超声生物显微镜图像自动评价系统,辅助眼科医生识别ACA的开启或关闭状态,并使用体内共聚焦显微镜（IVCM）评估不同方向LEBC的密度。
结果：1.LEBCs的平均密度优越，劣等,PACG组眼的鼻和颞缘低于对照组，并且该模式与对照组中观察到的密度分布不一致。2.在早期，中度和高级PACG，与闭合角度对应的LEBCs密度低于对照组(P<0.05)。与闭合角和打开角对应的LEBC密度相比，早期PACG的闭合角，中度和晚期小于开角（早期和中度P<0.05；晚期P>0.05）。3.通过无量纲分析处理基底细胞密度。在通过平均和最小化计算的数据中，两个闭合角的无量纲值均小于开放角(P<0.05)。4.在正常人之间进行了比较分析，开角,和上级的闭合角条件，劣等,鼻部,和颞叶缘。在PACG的早期阶段，在4个角膜缘区域观察到显著差异(P<0.05)，而在温和的PACG阶段，在3个角膜缘区域发现了这种差异（P<0.05）。在先进的PACG中,2个角膜缘区域表现出显著差异(P<0.05)。这些发现表明，在PACG早期阶段，闭角是LEBC密度的主要影响因素，在高级阶段，密度的下降归因于闭角和疾病的自然进展。
结论：前房角状态与LEBC之间存在显著相关性。应高度怀疑晚期PACG和闭角型角膜缘干细胞缺乏症（LSCD）的发生。
方法：横断面观察性研究。
方法：29例诊断为PACG的患者共54只眼纳入研究。包括来自正常受试者的54只眼作为对照。利用前房角超声生物显微镜图像自动评价系统,辅助眼科医生识别ACA的开启或关闭状态,并使用体内共聚焦显微镜（IVCM）评估不同方向LEBC的密度。
结果：1.LEBCs的平均密度优越，劣等,PACG组眼的鼻和颞缘低于对照组，并且该模式与对照组中观察到的密度分布不一致。2.在早期，中度和高级PACG，与闭合角度对应的LEBCs密度低于对照组(P<0.05)。与闭合角和打开角对应的LEBC密度相比，早期PACG的闭合角，中度和晚期小于开角（早期和中度P<0.05；晚期P>0.05）。3.通过无量纲分析处理基底细胞密度。在通过平均和最小化计算的数据中，两个闭合角的无量纲值均小于开放角(P<0.05)。4.在正常人之间进行了比较分析，开角,和上级的闭合角条件，劣等,鼻部,和颞叶缘。在PACG的早期阶段，在4个角膜缘区域观察到显著差异(P<0.05)，而在温和的PACG阶段，在3个角膜缘区域发现了这种差异（P<0.05）。在先进的PACG中,2个角膜缘区域表现出显著差异(P<0.05)。这些发现表明，在PACG早期阶段，闭角是LEBC密度的主要影响因素，在高级阶段，密度的下降归因于闭角和疾病的自然进展。
结论：前房角状态与LEBC之间存在显著相关性。应高度怀疑晚期PACG和闭角型角膜缘干细胞缺乏症（LSCD）的发生。
