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Monisha Esther Nongpiur, Tina Wong, Tin Aung; Association of Peripheral Anterior Synechiae with Anterior Segment Parameters in Eyes with Primary Angle Closure. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3899.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the association of peripheral anterior synechiae (PAS) with anterior segment parameters in subjects with angle closure including primary angle closure (PAC), primary angle closure glaucoma (PACG), and previous acute primary angle closure (APAC)
We analyzed a total of 500 subjects (154 PAC, 267 PACG and 79 with previous APAC). All participants underwent gonioscopy, biometry and anterior-segment optical coherence tomography (ASOCT; Carl Zeiss Meditec, Dublin, CA). Customized software was used to measure ASOCT parameters, including angle opening distance (AOD750), anterior chamber depth, width, area and volume (ACD, ACW, ACA, ACV), iris thickness (IT750), iris area (IAREA), and lens vault (LV). All subjects had undergone laser peripheral iridotomy prior to study recruitment.
The mean age of the 500 subjects was 63.8±8.4 years, 55.1% were female, and 92.6% were of Chinese ethnicity. Peripheral anterior synechiae was present in 240 (48.0%) subjects including 69 (44.8%) PAC, 122 (45.7%) PACG and 49 (62.0%) APAC (p=0.24), and it was most frequently found in the superior quadrant at 63.8% in PAC, 79.5% in PACG and 89.8% in APAC. Subjects with PAS were significantly younger (62.9±8.5 vs 64.6±8.2 years, p=0.03), had greater presenting intraocular pressure (IOP, 32.6±16.0 vs 26.6±14.7 mmHg, p<0.001), narrower AOD (p<0.001), smaller ACD (p=0.003), ACW (p=0.02), ACA (p=0.001) and larger LV (p=0.005) compared to those without PAS. No significant differences were noted for iris parameters and lens thickness. A sub-group analysis comprising only of eyes with PAS ≥3 clock hours showed no significant differences in any of the anterior segment parameters between PAC, PACG and APAC. A multivariate logistic regression analysis incorporating PAC and PACG showed that greater presenting IOP (P= 0.02) was a significant determinant of PAS.
Angle closure eyes with PAS are characterized by smaller anterior segment dimensions and a large LV. Greater presenting IOP in eyes with PAC/PACG may lead to a greater predisposition towards development of PAS.
This is a 2020 ARVO Annual Meeting abstract.
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