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      Evaluation of Refractive Status and Ocular Biometric Parameters in Primary Angle Closure Disease

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          Abstract

          Introduction: The aim of the study was to evaluate the refractive status and ocular biometric parameters in subjects with angle closure in Malaysia. Methods: This cross-sectional study was conducted on 171 primary angle closure patients (268 eyes). Visual acuity, refraction, and ocular biometry (central anterior chamber depth [ACD], axial length [AL], and lens thickness) were recorded. Vitreous cavity length (VL) and relative lens position (RLP) were calculated. Results: A total of 92 Primary Angle Closure Suspect (PACS), 30 Primary Angle Closure (PAC), and 146 Primary Angle Closure Glaucoma (PACG) eyes were included. Chinese ethnicity formed the majority ( n = 197, 73.5%), followed by Malay ( n = 57, 21.3%) and Indian ( n = 14, 5.2%). There was a significant female preponderance with a female to male ratio of 1.85. Mean age was 65.7 ± 7.7 years. Mean spherical equivalent was +0.33 ± 1.29 D. Approximately half ( n = 137, 51%) of the eyes were hyperopic (spherical power ≥+0.5), with PACG having the highest percentage of hyperopia ( n = 69, 50.4%). Myopia and emmetropia were present in 48 (17.9) and 83 (31%) eyes, respectively. Although AL and VL in myopia patients were significantly longer than emmetropic and hyperopic eyes ( p < 0.001), the ACD was not significantly different ( p = 0.427). While the RLP is smaller in myopic eyes, lens thickness was increased in hyperopic eyes. PACG was significantly higher in elderly patients compared to PACS and PAC ( p = 0.005). A total of 37 (13.8%) eyes were blind (vision worse than 3/60) and 19 of them (51.3%) were female patients. Conclusion: A decrease in RLP is predictive of angle closure disease in myopic eyes, whereas increased lens thickness contributes to angle closure disease in hyperopic eyes.

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          Most cited references 32

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          Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050.

          Myopia is a common cause of vision loss, with uncorrected myopia the leading cause of distance vision impairment globally. Individual studies show variations in the prevalence of myopia and high myopia between regions and ethnic groups, and there continues to be uncertainty regarding increasing prevalence of myopia.
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            The Association of Refractive Error with Glaucoma in a Multiethnic Population.

            To evaluate the association between refractive error and the prevalence of glaucoma by race or ethnicity.
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              Ocular Biometry in Acute and Chronic Angle-Closure Glaucoma

              Aim: To evaluate the biometric difference between eyes with acute angle-closure (AAC) attack, their uninvolved fellow eyes and eyes with chronic angle-closure glaucoma (CACG). Methods: Patients with prior laser iridotomy on both eyes for unilateral AAC attack or CACG were recruited. We compared ocular biometric parameters by A-scan ultrasonography of the acutely affected eyes with those of the uninvolved fellow eyes and with eyes affected by CACG. Results: Thirty-three patients with unilateral AAC attack and 41 patients with CACG were included. The eyes with AAC attack had a significantly shallower anterior chamber depth (ACD), thicker lens, shorter axial length, higher lens/axial length factor and more anteriorly positioned lens than the eyes with CACG. The uninvolved fellow eyes had a significantly shallower ACD, shorter axial length and higher lens/axial length factor compared with the eyes with CACG. Acutely affected eyes had a shallower ACD and more anteriorly positioned lens than did the uninvolved fellow eyes. Conclusion: Eyes with AAC attack had a more crowded anterior segment compared with uninvolved fellow eyes and those affected by CACG. In addition to ACD, relative lens size, represented by the lens/axial length factor, and relative lens position appear to play important roles in the development of AAC attack.
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                Author and article information

                Journal
                ORE
                Ophthalmic Res
                10.1159/issn.0030-3747
                Ophthalmic Research
                S. Karger AG
                0030-3747
                1423-0259
                2021
                March 2021
                18 August 2020
                : 64
                : 2
                : 246-252
                Affiliations
                aDepartment of Ophthalmology, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Malaysia
                bDepartment of Ophthalmology, Hospital Selayang Lebuh Raya, Batu Caves, Malaysia
                cSingapore National Eye Centre, Singapore, Singapore
                dGleneagles Hospital, Kuala Lumpur, Malaysia
                Author notes
                *Norshamsiah Md. Din, Ophthalmology, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Cheras 56000 (Malaysia), shamsiahdr@hotmail.com
                Article
                510925 Ophthalmic Res 2021;64:246–252
                10.1159/000510925
                32810853
                © 2020 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 4, Pages: 7
                Categories
                Research Article

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