Angle Closure in Caucasians—A Pilot, General Ophthalmology Clinic-based Study

Barkana, Yaniv; Dekel, Inbal; Goldich, Yakov; Morad, Yair; Avni, Isaac; Zadok, David

doi:10.1097/ijg.0b013e31820d7e89

Cited by 10 publications

(5 citation statements)

References 37 publications

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“…14,15 However, several other studies incorporating ocular parameters (e.g., axial length) in their statistical models were not able to confirm this association. [16][17][18][19][20] Nevertheless, the goodness of fit for our model was low, and its measurement corresponds to r 2 ¼ 0.13 in the unilateral analysis, meaning that only 13% of the variance of ACA width is explained by these factors.…”

Section: Discussionmentioning

confidence: 99%

Distribution of Anterior Chamber Angle Width and Correlation With Age, Refraction, and Anterior Chamber Depth—The Gutenberg Health Study

Schuster

Pfeiffer

Nickels

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE.Scheimpflug imaging allows quantitative analysis of the width of the anterior chamber angle. We report the population-based distribution of the anterior chamber angle width using this noncontact imaging technique and investigate associated factors. METHODS.A population-based cross-sectional study was carried out in Germany. A comprehensive ophthalmologic examination including refraction, biometry, and Scheimpflug imaging was performed. Automated measurement of the anterior chamber angle was performed in each anterior chamber quadrant. Exclusion criteria were previous ocular surgery or inadequate image quality. Association analyses were carried out to determine independently associated systemic and ocular factors for anterior chamber angle width using a generalized estimating equation model. RESULTS.A total of 3014 subjects (48% female) with a mean age of 58.6 6 10.4 years were included in this study. The mean anterior chamber angle width was 32.68 6 5.58. Statistical analysis revealed an independent association between a smaller anterior chamber angle and female sex, higher age, and more hyperopic refraction. When including biometric parameters, shallow anterior chamber depth, shorter axial length, higher central corneal thickness, and lower corneal power were independently associated with a narrower mean anterior chamber angle width.CONCLUSIONS. These parameters are considered risk factors for angle-closure glaucoma.Keywords: Scheimpflug photography, epidemiology, anterior chamber angle, refraction, anterior chamber depth A nterior chamber angle and depth have been identified as an important risk factor for angle-closure glaucoma 1 and progression of open-angle glaucoma.2 For almost a century, gonioscopy has been used to semiquantitatively analyze anterior chamber angle width. [3][4][5] More recently, quantitative imaging modalities including ultrasound biomicroscopy, optical coherence tomography, and Scheimpflug imaging have been developed. [6][7][8] In contrast to ultrasound biomicroscopy, optical coherence tomography and Scheimpflug imaging offer noncontact imaging of the anterior segment and make these methods attractive for patients and doctors alike. 9 To interpret measurements from Scheimpflug imaging and to integrate the results into a clinical context, it is important to know the distribution of anterior chamber angle width and to understand associations with clinical factors. The underlying idea is that a narrower anterior chamber angle width is associated with clinically suspicious risk factors for acute angle closure, namely female sex, older age, hyperopic refraction, shorter axial length, and thicker crystalline lens.Hence, the focus of this study is to derive normative values of the anterior chamber angle width. Using Scheimpflug imaging we investigate, for the first time, correlations between anterior chamber angle width and systemic and ocular parameters in a very large population-based setting. MATERIALS AND METHODSThe Gutenberg Health Study (GHS) is a prospective, populationbased, obs...

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Section: Discussionmentioning

confidence: 99%

Distribution of Anterior Chamber Angle Width and Correlation With Age, Refraction, and Anterior Chamber Depth—The Gutenberg Health Study

Schuster

Pfeiffer

Nickels

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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show abstract

“…While several studies investigated anterior chamber angle width using Scheimpflug imaging, AS-OCT, or ultrasound biomicroscopy [ 14 – 19 ], little is known about the iris position in the anterior segment. The anterior chamber angle is formed by the posterior corneal surface and the peripheral anterior iris surface and therefore a close association between a steeper forward inclination of the iris profile and a smaller anterior chamber angle may appear likely.…”

Section: Discussionmentioning

confidence: 99%

Steeper Iris Conicity Is Related to a Shallower Anterior Chamber: The Gutenberg Health Study

Schuster

Pfeiffer

Nickels

et al. 2017

Journal of Ophthalmology

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Purpose To report the distribution of iris conicity (steepness of the iris cone), investigate associated factors, and test whether pseudophakia allows the iris to sink back. Methods A population-based cross-sectional study was carried out. Ophthalmological examination including objective refraction, biometry, noncontact tonometry, and Scheimpflug imaging (Pentacam®, Oculus) was performed including automated measurement of iris conicity. 3708 phakic subjects, 144 subjects with bilateral and 39 subjects with unilateral pseudophakia were included. Multivariable analyses were carried out to determine independently associated systemic and ocular factors for iris conicity in phakic eyes. Results Mean iris conicity was 8.28° ± 3.29° (right eyes). Statistical analysis revealed associations between steeper iris conicity and shallower anterior chamber depth, thicker human lens and higher corneal power in multivariable analysis, while older age was related to a flatter iris conicity. Refraction, axial length, central corneal thickness, pupil diameter, and intraocular pressure were not associated with iris conicity. Pseudophakia resulted in a 5.82° flatter iris conicity than in the fellow phakic eyes. Conclusions Associations indicate a correlation between iris conicity with risk factors for angle-closure, namely, shallower anterior chamber depth and thicker human lens. In pseudophakic eyes, iris conicity is significantly lower, indicating that cataract surgery flattens the iris.

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“…It is important to know more about the pathophysiology and risk factors of PACG to improve prevention. Several risk factors have been identified for PACG, including female gender, older age, race, family history and ocular risk factors as shallow anterior chamber depth (ACD), hyperopia, short axial length, thick crystalline lens, steep corneal curvature (11,12). New findings suggest iris volume and choroidal thickness to have a key role in the mechanisms of angle closure (13).…”

Section: Discussionmentioning

confidence: 99%

Mistakes in the diagnosis and treatment of primary angle-closure glaucoma: Case report

Maric

Markovic

Božić

et al. 2016

SANAMED

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Primary angle-closure glaucoma (PACG) is a leading cause of blindness globally. It is a condition that is responsible for nearly half of patients who have a bilateral blindness caused by glaucoma. PACG is highly prevalent in Asian countries, as compared with Primary open-angle glaucoma (POAG), which is reported as the predominant disease among Whites, but prevalence of PACG in Europe has been underestimated previously. Early detection by effective screening and appropriate prophylaxis and treatment may prevent blindness from angle-closure glaucoma. The purpose of this study was to present through the cases of 3 patients with PACG the importance of each phase of glaucoma: diagnosis, treatment and follow-up.

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Angle Closure in Caucasians—A Pilot, General Ophthalmology Clinic-based Study

Abstract: Clinically significant angle closure, mandating close follow-up or preventive procedures, may be more common in Caucasians than currently thought. We recommend that gonioscopy should be included in the routine ophthalmic examination of all adults with hyperopia.

Cited by 10 publications

References 37 publications

Distribution of Anterior Chamber Angle Width and Correlation With Age, Refraction, and Anterior Chamber Depth—The Gutenberg Health Study

Distribution of Anterior Chamber Angle Width and Correlation With Age, Refraction, and Anterior Chamber Depth—The Gutenberg Health Study

Steeper Iris Conicity Is Related to a Shallower Anterior Chamber: The Gutenberg Health Study

Mistakes in the diagnosis and treatment of primary angle-closure glaucoma: Case report

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