Abstract
Purpose :
Detection of acute angle closure secondary to lens subluxation is crucial for its management. However, there are currently few accurate and quantitative diagnostic methods. To explore stable and sensitive indicators for clinical diagnosis of acute angle closure secondary to lens subluxation through quantitative analysis of anterior segment optical coherence tomography imaging.
Methods :
Participants underwent ophthalmologic examinations including slit-lamp biomicroscope, best corrected visual acuity, intraocular pressure, central corneal thickness measurement, axial length, gonioscopy, ultrasound biomicroscope and anterior segment optical coherence tomography. Lens subluxation was confirmed by ultrasound biomicroscope diagnosis. The contralateral eyes served as fellow control group. The cataract eyes were enrolled in blank control group. Automated circumferential anterior segment and lens morphological parameters under anterior segment optical coherence tomography were analyzed via three-dimensional analysis.
Results :
Significant differences were found in the front and back radius of the lens, the front and back radius of steep curvature of the lens, lens thickness, lens decentration, lens diameter, iris-trabecular contact index, iris-trabecular contact area, anterior chamber depth, lens vault, and iris volume between lens subluxation group and controls. Among them, lens vault, the anterior radius of steep curvature of the lens, anterior chamber depth demonstrated the highest prediction power (AUC=0.87, 0.89, and 0.86, respectively). The prediction power of tilt/axis was much higher in the Gaussian Naive Bayes model (AUC = 0.90) than in the logistic model (AUC = 0.74). Combination of lens vault_mean, lens vault_std, tilt and tilt axis in Gaussian Naive Bayes model presented as most stable and excellent diagnostic markers for acute angle closure secondary to lens subluxation (AUCs = 0.98).
Conclusions :
This combination of markers including lens tilt and lens vault in the mathematic model facilitates clinical work as it not only provides novel diagnostic indications and possible prompt treatment for acute angle closure secondary to lens subluxation, but also improves our understanding of the pathogenic role of zonulopathy in angle closure glaucoma.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.