Dataset Information

Differences in Ocular Biometric Measurements among Subtypes of Primary Angle Closure Disease: The Chinese American Eye Study.

ABSTRACT:

Purpose

To assess differences in ocular biometric measurements between primary angle closure suspect (PACS) eyes and primary angle closure (PAC) and primary angle closure glaucoma (PACG) eyes.

Design

Cross-sectional study.

Participants

Patients with primary angle closure disease (PACD) were identified from the Chinese American Eye Study, a population-based study in Los Angeles, California.

Methods

Patients previously underwent complete ocular examinations including gonioscopy and anterior segment (AS)-OCT imaging with the Tomey CASIA SS-1000 (Tomey Corporation). Four AS-OCT images were analyzed per eye. Averaged and sectoral measurements of biometric parameters, including angle recess area (ARA), trabecular iris space area (TISA), iris area, iris curvature, lens vault, anterior chamber depth, and anterior chamber area, were compared between early PACD (PACS) and late PACD (PAC and PACG) groups. Machine learning classifiers that attempt to differentiate between early and late PACD eyes were developed by applying different regression algorithms to a training dataset of sectoral parameter measurements. Classifier performance was assessed using an independent test dataset.

Main outcome measures

Averaged and sectoral measurements of biometric parameters.

Results

Two hundred ninety-eight eyes (231 PACS, 67 PAC or PACG) of 298 patients were analyzed. No difference was found in averaged biometric measurements between the 2 groups before (P > 0.09) or after (P > 0.14) adjusting for age and gender. Differences (P < 0.04) between the 2 groups were found for 11 sectoral parameter measurements, including ARA and TISA. The performance of machine learning classifiers developed using sectoral parameter measurements was poor on the independent test dataset for all regression algorithms (area under the receiver operating characteristic curve, 0.529-0.628).

Conclusions

Differences in biometric measurements between subtypes of PACD eyes were small in a population-based cohort of Chinese Americans. The poor performance of classifiers based on these measurements highlights potential challenges of developing quantitative methods to detect late PACD.

SUBMITTER: Xu BY

PROVIDER: S-EPMC7956120 | biostudies-literature | 2021 Mar-Apr

REPOSITORIES: biostudies-literature

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Publications

Differences in Ocular Biometric Measurements among Subtypes of Primary Angle Closure Disease: The Chinese American Eye Study.

Xu Benjamin Y BY Liang Siqi S Pardeshi Anmol A AA Lifton Jacob J Moghimi Sasan S Lewinger Juan Pablo JP Varma Rohit R

Ophthalmology. Glaucoma 20200914 2

<h4>Purpose</h4>To assess differences in ocular biometric measurements between primary angle closure suspect (PACS) eyes and primary angle closure (PAC) and primary angle closure glaucoma (PACG) eyes.<h4>Design</h4>Cross-sectional study.<h4>Participants</h4>Patients with primary angle closure disease (PACD) were identified from the Chinese American Eye Study, a population-based study in Los Angeles, California.<h4>Methods</h4>Patients previously underwent complete ocular examinations including g ...[more]

PMID: 32942063

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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.

Project description:PurposeTo assess baseline ocular biometric risk factors for progression from primary angle closure suspect (PACS) to primary angle closure (PAC) or acute angle closure (AAC).DesignProspective, observational study.ParticipantsSix hundred forty-three mainland Chinese with untreated PACS.MethodsParticipants underwent baseline clinical examinations, including gonioscopy, anterior segment OCT (AS-OCT) imaging, and A-scan ultrasound biometry as part of the Zhongshan Angle Closure Prevention (ZAP) Trial. Primary angle closure suspect was defined as an inability to visualize pigmented trabecular meshwork in 2 or more quadrants based on static gonioscopy. Primary angle closure was defined as development of intraocular pressure above 24 mmHg or peripheral anterior synechiae. Progression was defined as development of PAC or an AAC attack. Multivariable logistic regression models were developed to assess biometric risk factors for progression.Main outcome measuresSix-year progression from PACS to PAC or AAC.ResultsSix hundred forty-three untreated eyes (609 nonprogressors, 34 progressors) of 643 participants were analyzed. In a multivariable model with continuous parameters, narrower horizontal angle opening distance of 500 μm from the scleral spur (AOD500; odds ratio [OR], 1.10 per 0.01-mm decrease; P = 0.03), flatter horizontal iris curvature (IC; OR, 1.96 per 0.1-mm decrease; P = 0.01), and older age (OR, 1.11 per 1-year increase; P = 0.01) at baseline were associated significantly with progression (area under the receiver operating characteristic curve [AUC], 0.73). Smaller cumulative gonioscopy score was not associated with progression (OR, 1.03 per 1-modified Shaffer grade decrease; P = 0.85) when replacing horizontal AOD500 in the multivariable model. In a separate multivariable model with categorical parameters, participants in the lowest quartile of horizontal AOD500 (OR, 3.10; P = 0.002) and IC (OR, 2.48; P = 0.014) measurements and 59 years of age or older (OR, 2.68; P = 0.01) at baseline showed higher odds of progression (AUC, 0.72).ConclusionsOcular biometric measurements can help to risk-stratify patients with early angle closure for more severe disease. Anterior segment OCT measurements of biometric parameters describing the angle and iris are predictive of progression from PACS to PAC or AAC, whereas gonioscopy grades are not.

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Dataset Information

Differences in Ocular Biometric Measurements among Subtypes of Primary Angle Closure Disease: The Chinese American Eye Study.

Purpose

Design

Participants

Methods

Main outcome measures

Results

Conclusions

Publications

Differences in Ocular Biometric Measurements among Subtypes of Primary Angle Closure Disease: The Chinese American Eye Study.

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