Dataset Information

Correlation between Intraocular Pressure and Angle Configuration Measured by OCT: The Chinese American Eye Study.

ABSTRACT:

Purpose

To characterize the relationship between angle configuration measured by anterior segment optical coherence tomography (AS-OCT) and intraocular pressure (IOP).

Design

Cross-sectional study.

Participants

Subjects aged 50 years or older were identified from the Chinese American Eye Study (CHES), a population-based epidemiological study in Los Angeles, CA.

Methods

Each subject underwent a complete ocular exam including Goldmann applanation tonometry, gonioscopy, and AS-OCT imaging. Four AS-OCT images were analyzed per eye and parameters describing angle configuration were measured, including angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), trabecular iris angle (TIA), and scleral spur angle (SSA). The relationship between AS-OCT measurements and IOP was assessed using locally-weighted scatterplot smoothing (LOWESS) regression and change-point analyses.

Main outcome measures

Correlation between AS-OCT measurements and IOP.

Results

702 eyes (382 closed angle and 320 open angle) from 555 subjects were analyzed. Mean IOP for angle closure eyes was 16.3 ± 3.9 mmHg and open angle eyes was 15.3 ± 2.7 mmHg. Mean IOP increased as AS-OCT measurements decreased for all parameters except TIA750. Once measurement values dropped below parameter-specific threshold values, AS-OCT measurements and IOP were significantly correlated (p < 0.05) for AOD500 (r = -0.416), AOD750 (r = -0.213), ARA500 (r = -0.669), ARA750 (r = -0.680), TISA500 (r = -0.655), TISA750 (r = -0.641), SSA500 (r = -0.538), and SSA750 (r = -0.208). There was no correlation between AS-OCT measurements and IOP in open angle eyes (p > 0.40).

Conclusions

There is an anatomic threshold for angle configuration below which IOP is strongly related to the degree of angle closure. This finding suggests reconsideration of current definitions of angle closure and may be relevant for developing new OCT-based methods to identify patients at higher risk for elevated IOP and glaucoma.

SUBMITTER: Xu BY

PROVIDER: S-EPMC6475915 | biostudies-literature | 2018 Nov-Dec

REPOSITORIES: biostudies-literature

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Publications

Correlation between Intraocular Pressure and Angle Configuration Measured by OCT: The Chinese American Eye Study.

Xu Benjamin Y BY Burkemper Bruce B Lewinger Juan Pablo JP Jiang Xuejuan X Pardeshi Anmol A AA Richter Grace G Torres Mina M McKean-Cowdin Roberta R Varma Rohit R

Ophthalmology. Glaucoma 20180929 3

<h4>Purpose</h4>To characterize the relationship between angle configuration measured by anterior segment optical coherence tomography (AS-OCT) and intraocular pressure (IOP).<h4>Design</h4>Cross-sectional study.<h4>Participants</h4>Subjects aged 50 years or older were identified from the Chinese American Eye Study (CHES), a population-based epidemiological study in Los Angeles, CA.<h4>Methods</h4>Each subject underwent a complete ocular exam including Goldmann applanation tonometry, gonioscopy, ...[more]

PMID: 31025032

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Project description:PurposeTo characterize the relationship between mean and sectoral variation of anterior chamber angle (ACA) width using anterior segment optical coherence tomography (AS-OCT).MethodsSubjects aged 50 years or older were identified from the Chinese American Eye Study (CHES), a population-based epidemiological study in Los Angeles, CA. Each subject underwent a complete ocular examination including gonioscopy and AS-OCT imaging. Primary angle closure disease (PACD) was defined as inability to visualize pigmented trabecular meshwork in 3 or more quadrants. Four AS-OCT images from one eye per subject were analyzed and parameters describing ACA width were measured at 500 and 750 μm from the scleral spur: angle opening distance (AOD), trabecular iris space area (TISA), and scleral spur angle (SSA). The relationship between mean and sectoral variation of ACA width was assessed using locally-weighted scatterplot smoothing (LOWESS) regression and change-point analyses and Spearman correlation coefficients.Results674 eyes (337 with PACD, 337 without PACD) from 674 subjects were analyzed. Overall, sectoral variation of ACA width decreased as mean ACA width decreased. This relationship was divided into two phases based on the change-point analysis. Sectoral variation of ACA width was strongly and significantly correlated (P < 0.001) with mean ACA width with below parameter-specific change points for most parameters: AOD500 (r = 0.599), AOD750 (r = 0.246), TISA500 (r = 0.734), TISA750 (r = 0.664), SSA500 (r = 0.661), SSA750 (r = 0.394). Correlations were weaker but still significant (P < 0.004) above these change points for most parameters: AOD500 (r = 0.321), AOD750 (r = 0.550), TISA500 (r = 0.122), TISA750 (r = 0.275), SSA500 (r = -0.036), SSA750 (r = 0.313). Correlations to the left and right of the change points strengthened when sectoral variation of ACA width was adjusted for mean ACA width.ConclusionsCorrelations between mean and sectoral variation of ACA width strengthen as the severity of angle narrowing worsens. This relationship likely reflects anatomical changes related to chronic angle closure and may be relevant for refining current definitions and management of PACD.

Project description:PurposeWe sought to investigate anatomic mechanisms of angle narrowing by assessing ocular biometric determinants of anterior chamber angle width.DesignPopulation-based cross-sectional study.MethodsSubjects ≥50 years of age from the Chinese American Eye Study underwent a comprehensive ocular examination, including anterior segment optical coherence tomography imaging and ultrasound A-scan. Independent variables, including anterior chamber depth (ACD), lens vault (LV), iris curvature (IC), anterior chamber width, lens thickness, vitreous cavity depth, and axial length, and dependent variables, including angle opening distance, were measured in 1 randomly selected eye per subject. Univariable and multivariable regression models with standardized regression coefficients (SRCs) and semipartial correlation coefficients squares (SPCC2) were used to assess relative and unique contributions by independent variables to angle width.ResultsTwo thousand two hundred twenty-five subjects (1433 women and 834 men) were included in the analysis. All biometric parameters except lens thickness differed between men and women (age-adjusted P < .001). In model 1A (R2 = 0.66), which included ACD, lens thickness, and vitreous cavity depth, ACD (SRC = 0.64, SPCC2 = 0.19) and IC (SRC = -0.26, SPCC2 = 0.041) were the strongest determinants of angle opening distance. In model 1B (R2 = 0.58), which included LV and axial length, LV (SRC = -0.46, SPCC2 = 0.1) and IC (SRC = -0.3, SPCC2 = 0.047) were the strongest determinants of angle opening distance. Determinants of angle width were similar in separate multivariable models for men and women.ConclusionsACD, LV, and IC are the strongest determinants of angle width in Chinese Americans. Sex-related differences in angle width are explained by differences among biometric measurements. These results provide insights into anatomic mechanisms of angle narrowing and have important implications for quantitative assessments of angle closure eyes.

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Project description:BackgroundThe involvement of local and systemic oxidative stress in intraocular pressure (IOP) elevation and optic nerve damage has been hypothesized in the pathogenesis of glaucoma. We reported previously that the level of systemic antioxidative capacity is lower in patients with open-angle glaucoma than controls without glaucoma. Here, we assessed the correlation between IOP and systemic levels of prooxidants and antioxidants by analyzing the blood biochemistry in patients with glaucoma.MethodsPeripheral blood samples were collected from Japanese patients with primary open-angle glaucoma (n = 206), exfoliation syndrome (n = 199), and controls (n = 126). Serum levels of lipid peroxides, ferric-reducing activity, and thiol antioxidant activity were measured by diacron reactive oxygen metabolite (dROM), biological antioxidant potential (BAP), and sulfhydryl (SH) tests, respectively, using a free radical analyzer. To test the possible effect of oxidative stress on IOP levels, the patients were classified into one of four groups (Q1, Q2, Q3, and Q4, with Q1 having the lowest IOP) based on the quartile value of IOP. For this classification, the known highest IOP value in both the right and left eyes was regarded as each subject's IOP. For comparisons among the IOP groups, the differences were calculated using one-way analysis of variance followed by post-hoc unpaired t-tests. To adjust for differences in demographic characteristic distributions, the dROM, BAP, and SH test values were compared among the IOP groups using multiple logistic regression analysis; the odds ratio (OR) of each variable was calculated with the Q1 group as the reference.ResultsThe dROM and the SH levels did not differ significantly (p = 0.6704 and p = 0.6376, respectively) among the four IOP groups. The BAP levels differed significantly (p = 0.0115) among the four IOP groups; the value was significantly lower in the Q4 group (1,932 μmol/L) compared with the Q1 (2,023 μmol/L, p = 0.0042) and Q2 (2,003 μmol/L, p = 0.0302) groups and significantly lower in the Q3 group (1,948 μmol/L) than the Q1 (p = 0.0174) group. After adjustment for differences in various demographic characteristics, lower BAP values were significantly associated with the classification into higher IOP groups (Q3 group, p = 0.0261 and OR = 0.06/range; Q4 group, p = 0.0018 and OR = 0.04/range). The dROM and SH values did not reach significance in any comparisons.ConclusionsLower systemic antioxidant capacity measured by ferric-reducing activity is involved in the pathogenesis of open-angle glaucoma via its roles in IOP elevation.

Dataset Information

Correlation between Intraocular Pressure and Angle Configuration Measured by OCT: The Chinese American Eye Study.

Purpose

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Publications

Correlation between Intraocular Pressure and Angle Configuration Measured by OCT: The Chinese American Eye Study.

Similar Datasets

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