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M. E. Nongpiur, M.-G. He, N. Amerasinghe, L. M. Sakata, D. S. Friedman, W.-T. Tay, S. D. Smith, T.-Y. Wong, T. Aung; Association Between Increased Lens Vault and Angle Closure in Chinese Singaporeans. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5534.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the relationship between lens vault and angle closure in Chinese Singaporeans.
This comparative study examined 102 Chinese subjects with angle closure (consisting of primary angle closure [PAC] and primary angle closure glaucoma [PACG]) attending a glaucoma clinic; and 176 Chinese subjects with open angles and no evidence of glaucoma recruited from an ongoing population-based cross-sectional study. PAC was defined as the presence of appositional angle closure for ≥180 degrees with peripheral anterior synechiae and/ or raised intraocular pressure; PACG was defined as eyes with PAC associated with glaucomatous optic neuropathy. All participants underwent gonioscopy, A-scan biometry, and anterior-segment OCT (ASOCT, Carl Zeiss Meditec, Dublin, CA). Customized software (Zhongshan Angle Assessment Program, Guangzhou, China) was used to measure Lens Vault (LV) on horizontal ASOCT scans. LV was defined as the perpendicular distance between the anterior pole of the crystalline lens and the horizontal line joining the two scleral spurs. A-scan results were used to calculate Lens Position (LP - defined as anterior chamber depth [ACD] +1/2 lens thickness [LT]), and Relative LP (RLP - defined as LP/axial length [AL]).
Significant differences between normal and angle closure eyes were found for LV (315.5±271.8 vs 901.3±264.8µm, p=<0.001), LT (3.90±0.73 vs 4.20±0.92mm, p=0.01), ACD (2.95±0.37 vs 2.66±0.37mm, p<0.001) and AL (23.92±1.37 vs 22.86±0.93mm, p<0.001), but no significant differences were found for LP (4.90±0.54 vs 4.76±0.51mm, p=0.34) or RLP (0.20±0.02 vs 0.21±0.02, p=0.14). After adjusting for age, gender, ACD, LT and RLP, increased LV was significantly associated with angle closure (odds ratio [OR] 48.1, 95% confidence interval [CI] 12.8-181.3 - comparing lowest quartile to the highest quartile). There was no significant association of LV with RLP or LT.
Increased LV is independently associated with angle closure in Chinese Singaporeans.
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