Jacob Lifton1, Bruce Burkemper2, Xuejuan Jiang2, Anmol A Pardeshi2, Grace Richter2, Roberta McKean-Cowdin3, Rohit Varma4, Benjamin Y Xu5. 1. From the Keck School of Medicine (J.L.), at the University of Southern California, Los Angeles, California, USA. 2. USC Roski Eye Institute, Department of Ophthalmology (B.B., X.J., A.A.P., G.R., R.M.-C.), Keck School of Medicine at the University of Southern California, Los Angeles, California, USA. 3. USC Roski Eye Institute, Department of Ophthalmology (B.B., X.J., A.A.P., G.R., R.M.-C.), Keck School of Medicine at the University of Southern California, Los Angeles, California, USA; Department of Preventive Medicine (R.M.-C.), Keck School of Medicine at the University of Southern California, Los Angeles, California, USA. 4. Southern California Eye Institute (R.V.), CHA Hollywood Presbyterian Medical Center, Los Angeles, California, USA. 5. From the Keck School of Medicine (J.L.), at the University of Southern California, Los Angeles, California, USA; USC Roski Eye Institute, Department of Ophthalmology (B.B., X.J., A.A.P., G.R., R.M.-C.), Keck School of Medicine at the University of Southern California, Los Angeles, California, USA; Department of Preventive Medicine (R.M.-C.), Keck School of Medicine at the University of Southern California, Los Angeles, California, USA; Southern California Eye Institute (R.V.), CHA Hollywood Presbyterian Medical Center, Los Angeles, California, USA. Electronic address: benjamin.xu@med.usc.edu.
Abstract
PURPOSE: To assess ocular biometric determinants of dark-to-light change in anterior chamber angle width and identify dynamic risk factors in primary angle closure disease (PACD). DESIGN: Population-based cross-sectional study. METHODS: Chinese American Eye Study (CHES) participants underwent anterior segment optical coherence tomography imaging in the dark and light. Static dark and light biometric parameters, including angle opening distance, 750 µm (AOD750), anterior chamber width (ACW), lens vault (LV), and pupillary diameter (PD) were measured, and dynamic dark-to-light changes were calculated. Contributions by static and dynamic parameters to dark-to-light changes in AOD750 were assessed using multivariable linear regression models with standardized regression coefficients (SRCs) and semipartial correlation coefficients squared (SPCC2). PACD was defined as ≥3 quadrants of gonioscopic angle closure. RESULTS: The analysis included 1011 participants. All biometric parameters differed between dark and light (P < .05). On multivariable regression analysis, change in ACW (SRC = -0.35, SPCC2 = 0.081) and PD (SRC = -0.46, SPCC2 = 0.072) were the strongest determinants of dark-to-light change in AOD750 (overall R2 = 0.40). Dark-to-light increase in AOD750 was less in eyes with than without PACD (0.081 mm and 0.111 mm, respectively; P < .001). ACW increased in eyes with PACD and decreased in eyes without PACD from dark to light (P < .025), whereas change in PD was similar (P = .28). CONCLUSIONS: Beneficial angle widening effects of transitioning from dark to light are attenuated in eyes with PACD, which appears related to aberrant dark-to-light change in ACW. These findings highlight the importance of assessing the angle in both dark and light to identify potential dynamic mechanisms of angle closure.
PURPOSE: To assess ocular biometric determinants of dark-to-light change in anterior chamber angle width and identify dynamic risk factors in primary angle closure disease (PACD). DESIGN: Population-based cross-sectional study. METHODS: Chinese American Eye Study (CHES) participants underwent anterior segment optical coherence tomography imaging in the dark and light. Static dark and light biometric parameters, including angle opening distance, 750 µm (AOD750), anterior chamber width (ACW), lens vault (LV), and pupillary diameter (PD) were measured, and dynamic dark-to-light changes were calculated. Contributions by static and dynamic parameters to dark-to-light changes in AOD750 were assessed using multivariable linear regression models with standardized regression coefficients (SRCs) and semipartial correlation coefficients squared (SPCC2). PACD was defined as ≥3 quadrants of gonioscopic angle closure. RESULTS: The analysis included 1011 participants. All biometric parameters differed between dark and light (P < .05). On multivariable regression analysis, change in ACW (SRC = -0.35, SPCC2 = 0.081) and PD (SRC = -0.46, SPCC2 = 0.072) were the strongest determinants of dark-to-light change in AOD750 (overall R2 = 0.40). Dark-to-light increase in AOD750 was less in eyes with than without PACD (0.081 mm and 0.111 mm, respectively; P < .001). ACW increased in eyes with PACD and decreased in eyes without PACD from dark to light (P < .025), whereas change in PD was similar (P = .28). CONCLUSIONS: Beneficial angle widening effects of transitioning from dark to light are attenuated in eyes with PACD, which appears related to aberrant dark-to-light change in ACW. These findings highlight the importance of assessing the angle in both dark and light to identify potential dynamic mechanisms of angle closure.
Authors: Benjamin Y Xu; Bruce Burkemper; Juan Pablo Lewinger; Xuejuan Jiang; Anmol A Pardeshi; Grace Richter; Mina Torres; Roberta McKean-Cowdin; Rohit Varma Journal: Ophthalmol Glaucoma Date: 2018-09-29
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