Ocular Biometry of Primary Angle-Closure Disease in Younger Patients

Abstract

Background: The purpose of this study was to analyze the ocular biometric parameters of primary angle-closure disease (PACD) in younger patients and compare them with those of elderly patients.Methods: This clinic-based, cross-sectional study included 154 eyes of 154 patients with PACD, consisting of 77 eyes of patients aged 40 years or younger and 77 eyes of patients older than 40. The PACD case definition was compatible with the ISGEO definition. Anterior segment parameters were measured by ultrasound biomicroscopy, axial length (AL) and lens thickness (LT) were measured by A-scan ultrasonography measurements, and the thickness of the retina and choroid were measured by optical coherence tomography. The differences in ocular biometric parameters between different age groups were compared by independent sample t-tests or Mann-Whitney U tests, and the correlation between the parameters and age was analyzed.Results: Compared to older PACD patients, the lens vault(LV),LV/LT and subfoveal choroidal thickness (SFCT) of younger patients were larger, while the peripheral and mean iris thickness (IT), trabecular-ciliary angle (TCA), ciliary body thickness (CBT), AL and LT were smaller (all P < 0.01). There was no significant difference in anterior chamber depth, anterior chamber width, pupil diameter, angle opening distance at 500 μm from the scleral spur, anterior chamber angle and iris convexity between the two groups (all P > 0.05). AL, LT, IT, TCA and CBT were positively associated with age (all P < 0.001), while LV and SFCT were negatively associated with age (P = 0.027 and P < 0.001, respectively).Conclusions: Compared with elderly patients, younger PACD patients had more anteriorly positioned lenses, thinner and more anteriorly rotated ciliary bodies, thicker choroids, and shorter axial length. These characteristics might be important anatomical bases for the earlier onset of PACD and the higher risk of malignant glaucoma after filtering surgery.

Ultrasound biomicroscopic imaging demonstrate thinner ciliary body thickness in eyes with angle closure

“…Thus thinner ciliary body in eyes with PAC/PACG might be a manifestation of ciliary muscle atrophy related to aging, as showed in histological [20] and biometric [21][22] studies. However, thinner ciliary body thickness has been found in younger patients with PAC disease [15] , which indicates age might not be major factor. Therefore, we applied PSM to diminish the effect of age in this study, and thinner ciliary body was still observed in eyes with PAC/PACG.…”

“…Another study indicated the younger patients with PAC disease presented thinner and more anteriorly rotated ciliary body than the older ones [15] . These studies indicated that thinner ciliary body thickness might also be a predisposing factor for special kinds of angle closure glaucoma such as APAC and malignant glaucoma.…”

Combined versus sequential penetrating keratoplasty and cataract surgery for herpes simplex keratitis: a retrospective study

“…HSK is a common, potentially blinding corneal diseases characterized by recurrent infection (9). Recurrent HSK can lead to stromal inflammation or neurotrophic keratitis, resulting in corneal perforation or full-thickness corneal scarring that requires PK (15). Combined or sequential PK and cataract surgery are well-established surgical treatments for corneal diseases coexisting with cataract due to their own advantages.…”

Incidence and characteristics of aqueous misdirection after glaucoma surgery in Chinese patients with primary angle-closure glaucoma

“…However, the mechanism of age-related variations in AM onset is not clearly understood. Young PACG patients always demonstrate characteristics of more anteriorly located lenses, thinner and anteriorly rotated ciliary bodies, thicker choroids, and shorter axial length compared with older patients [ 38 ]. These anatomic features are now consistently perceived as risk factors for AM [ 37 ].…”