Abstract：
BACKGROUND: To compare intraocular pressure (IOP) and anterior segment parameters between eyes with unilateral primary angle closure glaucoma (PACG) and their fellow eyes with primary angle closure (PAC) or primary angle closure suspect (PACS).
METHODS: Subjects underwent anterior segment imaging using 360-degree swept-source optical coherence tomography (SS-OCT, CASIA Tomey, Nagoya, Japan) and ocular investigations including gonioscopy and IOP measurement. Each SS-OCT scan (divided into 8 frames, 22.5 degrees apart) was analysed and an average was obtained for the following anterior segment parameters: iridotrabecular contact (ITC), angle opening distance (AOD750), iris thickness and curvature, anterior chamber width, depth and area (ACW, ACD and ACA) and lens vault (LV).
RESULTS: Among 132 unilateral PACG subjects (mean age: 62.91 ± 7.2 years; 59.1% male), eyes with PACG had significantly higher presenting IOP (24.81 ± 0.94 vs. 18.43 ± 0.57 mmHg, p < 0.001), smaller gonioscopic Shaffer grade (2.07 ± 0.07 vs. 2.31 ± 0.07, p < 0.001) and a greater extent of peripheral anterior synechiae (PAS, 1.21 ± 0.21 vs. 0.54 ± 0.16 clock hours, p = 0.001). PACG eyes also exhibited increased ITC, ITC area, greater LV and smaller AOD750, ACD and ACA (all p < 0.05). Using the forward stepwise regression model, an increase in 1 mmHg in presenting IOP before laser peripheral iridotomy (LPI) increases the odds of having PACG by 9% (95% confidence interval 5%-14%).
CONCLUSIONS: PACG eyes have higher presenting IOP, smaller anterior segment parameters, greater extent of PAS, and larger LV compared to their fellow eyes with angle closure. Narrower anterior chamber dimensions and higher presenting IOP before LPI may increase risk of chronic elevated IOP and glaucomatous optic neuropathy after LPI.
METHODS: Subjects underwent anterior segment imaging using 360-degree swept-source optical coherence tomography (SS-OCT, CASIA Tomey, Nagoya, Japan) and ocular investigations including gonioscopy and IOP measurement. Each SS-OCT scan (divided into 8 frames, 22.5 degrees apart) was analysed and an average was obtained for the following anterior segment parameters: iridotrabecular contact (ITC), angle opening distance (AOD750), iris thickness and curvature, anterior chamber width, depth and area (ACW, ACD and ACA) and lens vault (LV).
RESULTS: Among 132 unilateral PACG subjects (mean age: 62.91 ± 7.2 years; 59.1% male), eyes with PACG had significantly higher presenting IOP (24.81 ± 0.94 vs. 18.43 ± 0.57 mmHg, p < 0.001), smaller gonioscopic Shaffer grade (2.07 ± 0.07 vs. 2.31 ± 0.07, p < 0.001) and a greater extent of peripheral anterior synechiae (PAS, 1.21 ± 0.21 vs. 0.54 ± 0.16 clock hours, p = 0.001). PACG eyes also exhibited increased ITC, ITC area, greater LV and smaller AOD750, ACD and ACA (all p < 0.05). Using the forward stepwise regression model, an increase in 1 mmHg in presenting IOP before laser peripheral iridotomy (LPI) increases the odds of having PACG by 9% (95% confidence interval 5%-14%).
CONCLUSIONS: PACG eyes have higher presenting IOP, smaller anterior segment parameters, greater extent of PAS, and larger LV compared to their fellow eyes with angle closure. Narrower anterior chamber dimensions and higher presenting IOP before LPI may increase risk of chronic elevated IOP and glaucomatous optic neuropathy after LPI.
摘要：
背景：比较单侧原发性闭角型青光眼（PACG）的眼与患有原发性闭角型青光眼（PAC）或疑似原发性闭角型青光眼（PACS）的对侧眼的眼压（IOP）和眼前节参数。
方法：使用360度扫频光源光学相干断层扫描（SS-OCT，卡西亚·托米,名古屋,日本）和眼科检查，包括房角镜检查和眼压测量。每次SS-OCT扫描（分为8帧，分开22.5度）进行分析，并获得以下眼前节参数的平均值：虹膜接触（ITC），角开距离(AOD750),虹膜厚度和曲率，前房宽度,深度和面积(ACW，ACD和ACA)和镜头拱顶(LV)。
结果：在132名单侧PACG受试者中（平均年龄：62.91±7.2岁；男性占59.1％），PACG患者的眼内压明显升高（24.81±0.94vs.18.43±0.57mmHg，p<0.001)，较小的头镜检查Shaffer等级（2.07±0.07vs.2.31±0.07，p<0.001）和更大程度的外周前粘连（PAS，1.21±0.21vs.0.54±0.16小时，p=0.001)。PACG眼睛也表现出ITC增加，ITC区,大LV和小AOD750，ACD和ACA（均p<0.05）。使用前向逐步回归模型，激光周边虹膜切开术(LPI)前眼压升高1mmHg,患者发生PACG的几率增加9%(95%置信区间5%-14%).
结论：PACG眼有较高的眼压，较小的眼前段参数，更大程度的PAS，与闭角的眼睛相比，LV更大。LPI前狭窄的前房尺寸和较高的眼压可能会增加LPI后慢性眼压升高和青光眼视神经病变的风险。
方法：使用360度扫频光源光学相干断层扫描（SS-OCT，卡西亚·托米,名古屋,日本）和眼科检查，包括房角镜检查和眼压测量。每次SS-OCT扫描（分为8帧，分开22.5度）进行分析，并获得以下眼前节参数的平均值：虹膜接触（ITC），角开距离(AOD750),虹膜厚度和曲率，前房宽度,深度和面积(ACW，ACD和ACA)和镜头拱顶(LV)。
结果：在132名单侧PACG受试者中（平均年龄：62.91±7.2岁；男性占59.1％），PACG患者的眼内压明显升高（24.81±0.94vs.18.43±0.57mmHg，p<0.001)，较小的头镜检查Shaffer等级（2.07±0.07vs.2.31±0.07，p<0.001）和更大程度的外周前粘连（PAS，1.21±0.21vs.0.54±0.16小时，p=0.001)。PACG眼睛也表现出ITC增加，ITC区,大LV和小AOD750，ACD和ACA（均p<0.05）。使用前向逐步回归模型，激光周边虹膜切开术(LPI)前眼压升高1mmHg,患者发生PACG的几率增加9%(95%置信区间5%-14%).
结论：PACG眼有较高的眼压，较小的眼前段参数，更大程度的PAS，与闭角的眼睛相比，LV更大。LPI前狭窄的前房尺寸和较高的眼压可能会增加LPI后慢性眼压升高和青光眼视神经病变的风险。
