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L. M. Sakata, R. Lavanya, M.-G. He, Y.-H. Chan, T. Aung; Relationship of Anterior Chamber Angle Width and Intraocular Pressure in a Community-Based Study in Singapore. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5545.
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To assess the relationship between intra-ocular pressure (IOP) and anterior chamber angle (ACA) width assessed by gonioscopy and anterior-segment OCT (AS-OCT, Carl Zeiss Meditec, Dublin, CA) in a Singapore population.
2047 subjects aged 50-years and over without ophthalmic symptoms recruited from a community polyclinic underwent gonioscopy, Goldmann applanation tonometry, and AS-OCT. On gonioscopy, a quadrant was considered to be closed if the posterior trabecular meshwork was not visible on non-indentation gonioscopy. On AS-OCT, a fellowship trained glaucoma specialist graded images obtained at the four quadrants of the eye as having an open or closed ACA (qualitative analysis). In the AS-OCT quantitative analysis, the anterior chamber depth (ACD), anterior chamber volume (ACV), angle opening distance (AOD) and trabecular-iris space area (TISA) 750 um from the scleral spur were measured using a customized computer software (Zhongshan Angle Assessment Program, Guangzhou, China). IOP values were adjusted for age, gender, diabetes, systemic hypertension, central corneal thickness, and body mass index.
Mean IOP was 14.7 mmHg (SD±2.4) (range 8-26). IOP [mean±SE] increased according to the number of quadrants closed on gonioscopy (none-14.6±0.1, one-14.8±0.2, two-15.1±0.3, three-15.0±0.2, four-15.7±0.2mmHg), and according to the number of quadrants considered closed on AS-OCT (none-14.6±0.1, one-14.9±0.1, two-14.7±0.1, three-15.0±0.2, four- 15.9±0.2mmHg). The quantitative ACA analysis excluded 587 eyes, mostly due to inability to locate the scleral spur. The IOP was significantly higher comparing the 1st vs. 4th quartile of ACD (15.3±0.1 vs. 14.4±0.1mmHg, p<0.001), ACV (15.1±0.1 vs. 14.5±0.1mmHg, p<.001), AOD750micra (15.2±0.1 vs. 14.4±0.1mmHg, p<.001), TISA750 (15.2±0.1 vs. 14.4±0.1mmHg, p<.001).
IOP tended to increase according to the number of ACA quadrants considered closed on gonioscopy and AS-OCT. IOP also increased in eyes with narrower ACA as assessed quantitatively by AS-OCT. These data suggest that the degree of ACA opening influences IOP level.
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