June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
The Impact of Lens Vault on Visual Acuity and Refractive Error in Subjects with Angle Closure
Author Affiliations & Notes
  • Shweta Singhal
    Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
  • Stephen Stewart
    University College London, London, United Kingdom
  • Monisha Nongpiur
    Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
    Duke-NUS Graduate Medical School, Singapore, Singapore
  • Hla Htoon
    Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
    Duke-NUS Graduate Medical School, Singapore, Singapore
  • Shamira Perera
    Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
  • Tin Aung
    Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
    Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • Footnotes
    Commercial Relationships Shweta Singhal, None; Stephen Stewart, None; Monisha Nongpiur, None; Hla Htoon, None; Shamira Perera, Carl Zeiss Meditec (R), Allergan (R), Pfizer (R); Tin Aung, Alcon (R), Alcon (C), Alcon (F), Allergan (R), Allergan (C), Carl Zeiss Meditec (F), Carl Zeiss Meditec (R), Ellex (F), Ellex (R), Santen (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1889. doi:
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      Shweta Singhal, Stephen Stewart, Monisha Nongpiur, Hla Htoon, Shamira Perera, Tin Aung; The Impact of Lens Vault on Visual Acuity and Refractive Error in Subjects with Angle Closure. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1889.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To investigate the relationship between lens vault (LV) and visual acuity in subjects with angle closure.

Methods: This was a cross-sectional study of 2047 subjects aged 50 years or more who were recruited from a community polyclinic. All participants underwent a standardized ocular examination and anterior segment optical coherence tomography (ASOCT). Customised software was used to measure LV, defined as the perpendicular distance between the anterior pole of the crystalline lens and the horizontal line joining the 2 scleral spurs, on horizontal ASOCT scans. Visual acuity was measured using a logarithm of minimum angle of resolution chart (logMAR chart, Lighthouse Inc, Long Island, New York). Visual acuity was classified as normal (logMAR<0.3), mild impairment (0.3<logMAR<0.6) and moderate/severe impairment (logMAR>0.6). Refracction was measured with an autorefractor machine (Topcon Auto K KR7100D, Topcon Corp, Tokyo, Japan). Spherical equivalent was defined as sphere plus half cylinder. An eye was defined as having angle closure if the posterior pigmented trabecular meshwork was not visualized for at least 180° on gonioscopy.

Results: Complete data on 1453 subjects including 311 with angle closure were available for analysis. Eyes with angle closure were significantly older (p< 0.001), with shorter axial length (AL, p< 0.001) and shallower anterior chamber depth (ACD, p< 0.001). However, although eyes with angle closure had a significantly greater LV (p< 0.001), there was no significant difference in visual acuity (p=0.14) compared to those with open angles. The majority of angle closure subjects had normal visual acuity or mild visual impairment (85.2%). No significant trend was noted in visual acuity (p=0.12) or spherical equivalent (p=0.63) with increasing magnitude of LV. After adjusting for age, gender, AL, ACD, and spherical equivalent, there was no significant correlation between LV and visual acuity (p = 0.35). Similarly, no significant association was found between LV and spherical equivalent (p=0.06).

Conclusions: No association was found between lens vault and visual acuity or refractive error. Subjects with angle closure may have large LV but good visual acuity.

Keywords: 754 visual acuity • 420 anterior chamber • 550 imaging/image analysis: clinical  
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