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Quantitative analysis of dynamic iris changes in primary angle-closure disease with long axial lengths: the Handan Eye Study

Eye (2024)Cite this article

Subjects

Abstract

Objective

To investigate dynamic iris changes in patients with primary angle-closure disease (PACD) with long axial length (AL) compared to those with short and medium AL.

Methods

This observational cross-sectional study enrolled participants aged 35 years or older from the Handan Eye Study follow-up examination who were diagnosed with PACD and underwent Visante anterior segment optical coherence tomography (ASOCT) imaging under light and dark conditions. The right eye of each participant was included in the analysis. AL was categorized as short (<22.0 mm), medium (≥22.0 to ≤23.5 mm), or long (>23.5 mm). Anterior segment parameters, including iris dynamic changes, were compared among the three groups with different ALs.

Results

Data from 448 patients with PACD were analyzed. We found that 10.9% of included eyes had a long AL with a flatter cornea; larger central anterior chamber depth, angle opening distance, anterior chamber width, anterior chamber area, and volume; and smaller lens thickness and lens vault (LV) (P < 0.05) than those with short AL. No significant difference existed between the three groups in iris thickness, iris cross-sectional area (IA), iris curvature, or pupil diameter (PD) change between light and dark (P > 0.05). The significant associated factors for IA changes were area recess area (ARA) in the dark, LV in the dark, and PD change from light to dark (P < 0.05).

Conclusions

Dynamic and static iris parameters were consistent across patients with PACD with short, medium, or long AL and may contribute to the pathogenesis of angle closure in atypical PACD.

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Fig. 1: Iris parameters on ASOCT images obtained under light and dark conditions.

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References

  1. Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol. 2002;86:238–42.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systemic review and meta-analysis. Ophthalmology. 2014;121:2081–90.

    Article  PubMed  Google Scholar 

  3. Foster PJ, Johnson GJ. Glaucoma in China: how big is the problem? Br J Ophthalmol. 2001;85:1277–82.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Marchini G, Pagliarusco A, Toscano A, Tosi R, Brunelli C, Bonomi L. Ultrasound biomicroscopic and conventional ultrasonographic study of ocular dimensions in primary angle-closure glaucoma. Ophthalmology. 1998;105:2091–8.

    Article  PubMed  CAS  Google Scholar 

  5. Lowe RF. Aetiology of the anatomical basis for primary angle-closure glaucoma. Biometrical comparisons between normal eyes and eyes with primary angle-closure glaucoma. Br J Ophthalmol. 1970;54:161–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Yong KL, Gong T, Nongpiur ME, How AC, Lee HK, Cheng L. et al. Myopia in Asian subjects with primary angle closure: implications for glaucoma trends in East Asia. Ophthalmology. 2014;121:1566–71.

    Article  PubMed  Google Scholar 

  7. Li M, Kong X, Zhu W, Chen Y, Chen J, Sun X. Changes of anterior segment parameters in primary angle closure with axial myopia: a retrospective study of 369 patients grouped by axial length. Acta Ophthalmol. 2016;94:e670–1.

    Article  PubMed  Google Scholar 

  8. Li M, Chen Y, Jiang Z, Chen X, Chen J, Sun X. What are the characteristics of primary angle closure with longer axial length? Invest Ophthalmol Vis Sci. 2018;59:1354–9.

    Article  PubMed  Google Scholar 

  9. Zhang Y, Zhang Q, Li SZ, He MG, Li SN, Wang NL. Anterior segment characteristics and risk factors for primary angle closure disease with long axial lengths: The Handan Eye Study. Invest Ophthalmol Vis Sci. 2023;64:8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Barkana Y, Shihadeh W, Oliveira C, Tello C, Liebmann JM, Ritch R. Angle closure in highly myopic eyes. Ophthalmology. 2006;113:247–54.

    Article  PubMed  Google Scholar 

  11. Su CW, Chen HY. Acute angle closure in the setting of high axial myopia: a case report. Am J Ophthalmol Case Rep. 2016;1:31–3.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chakravarti T, Spaeth GL. The prevalence of myopia in eyes with angle closure. J Glaucoma. 2007;16:642–3.

    Article  PubMed  Google Scholar 

  13. Loh CC, Kamaruddin H, Bastion MC, Husain R, Mohd Isa H, Md Din N. Evaluation of refractive status and ocular biometric parameters in primary angle closure disease. Ophthalmic Res. 2021;64:246–52.

    Article  PubMed  Google Scholar 

  14. Liang Y, Shen R, Zhou W, Fan S, Chan PP, Tham CCY. et al. Prevalence and ocular biometric characteristics of myopia in primary angle closure disease in rural China: The Handan Eye Study. Invest Ophthalmol Vis Sci. 2022;63:19

    Article  PubMed  PubMed Central  Google Scholar 

  15. Thomas R, Walland MJ. Primary angle-closure glaucoma is a multifactorial disease. Clin Exp Ophthalmol. 2011;39:593–4.

    Article  PubMed  Google Scholar 

  16. Wang B, Sakata LM, Friedman DS, Chan YH, He M, Lavanya R. et al. Quantitative iris parameters and association with narrow angles. Ophthalmology. 2010;117:11–7.

    Article  PubMed  Google Scholar 

  17. Quigley HA, Silver DM, Friedman DS, He M, Plyler RJ, Eberhart CG. et al. Iris cross-sectional area decreases with pupil dilation and its dynamic behavior is a risk factor in angle closure. J Glaucoma. 2009;18:173–9.

    Article  PubMed  Google Scholar 

  18. Wang BS, Narayanaswamy A, Amerasinghe N, Zheng C, He M, Chan Y-H. et al. Increased iris thickness and association with primary angle closure glaucoma. Br J Ophthalmol. 2011;95:46–50.

    Article  PubMed  Google Scholar 

  19. Zhang Y, Li SZ, Li L, He MG, Thomas R, Wang NL. Quantitative analysis of iris changes after physiologic and pharmacologic mydriasis in a rural Chinese population. Invest Ophthalmol Vis Sci. 2014;55:4405–12.

    Article  PubMed  Google Scholar 

  20. Zhang Y, Li SZ, Li L, He MG, Thomas R, Wang NL. Quantitative analysis of iris changes following mydriasis in subjects with different mechanisms of angle closure. Invest Ophthalmol Vis Sci. 2015;56:563–70.

    Article  PubMed  Google Scholar 

  21. Seager FE, Jefferys JL, Quigley HA. Comparison of dynamic changes in anterior ocular structures examined with anterior segment optical coherence tomography in a cohort of various origins. Invest Ophthalmol Vis Sci. 2014;55:1672–83.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Liang YB, Friedman DS, Wong TY, Wang FH, Duan XR, Yang XH. et al. Rationale, design, methodology, and baseline data of a population-based study in rural China: the Handan Eye Study. Ophthalmic Epidemiol. 2009;16:115–27.

    Article  PubMed  Google Scholar 

  23. Cao K, Hao J, Zhang Y, Hu A-L, Yang X-H, Li S-Z. et al. Design, methodology, and preliminary results of the follow-up of a population-based cohort study in rural area of northern China: Handan Eye Study. Chin Med J (Engl). 2019;132:2157–67.

    Article  PubMed  Google Scholar 

  24. Console JW, Sakata LM, Aung T, Friedman DS, He M. Quantitative analysis of anterior segment optical coherence tomography images: the Zhongshan Angle Assessment Program. Br J Ophthalmol. 2008;92:1612–6.

    Article  PubMed  CAS  Google Scholar 

  25. Nongpiur ME, He M, Amerasinghe N, Friedman DS, Tay WT, Baskaran M. et al. Lens vault, thickness, and position in Chinese subjects with angle closure. Ophthalmology. 2011;118:474–9.

    Article  PubMed  Google Scholar 

  26. Moghimi S, Vahedian Z, Zandvakil N, Mohammdi M, Fakhraie G, Nassiri N. et al. Role of lens vault in subtypes of angle closure in Iranian subjects. Eye (Lond). 2014;28:337–43.

    Article  PubMed  CAS  Google Scholar 

  27. Tarongoy P, Ho CL, Walton DS. Angle-closure glaucoma: the role of the lens in the pathogenesis, prevention, and treatment. Surv Ophthalmol. 2009;54:211–25.

    Article  PubMed  Google Scholar 

  28. Park SH, Park KH, Kim JM, Choi CY. Relation between axial length and ocular parameters. Ophthalmologica. 2010;224:188–93.

    Article  PubMed  Google Scholar 

  29. Atalay E, Nongpiur ME, Baskaran M, Sharma S, Perera SA, Aung T. Biometric factors associated with acute primary angle closure: comparison of the affected and fellow eye. Invest Ophthalmol Vis Sci. 2016;57:5320–5.

    Article  PubMed  Google Scholar 

  30. Zhang Y, Li SZ, Li L, He MG, Thomas R, Wang NL. Dynamic iris changes as a risk factor in primary angle closure disease. Invest Ophthalmol Vis Sci. 2016;57:218–26.

    Article  PubMed  CAS  Google Scholar 

  31. He M, Lu Y, Liu X, Ye T, Foster PJ. Histologic changes of the iris in the development of angle closure in Chinese eyes. J Glaucoma. 2008;17:386–92.

    Article  PubMed  Google Scholar 

  32. Gazzard G, Friedman DS, Devereux JG, Chew P, Seah SK. A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology after laser iridotomy in Asian eyes. Ophthalmology. 2003;110:630–8.

    Article  PubMed  Google Scholar 

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Funding

This study was supported by the Dongcheng District Outstanding Talent Nurturing Program (Grant Number 2022-dchrcpyzz-63), the Research Special Fund of the Ministry of Health of the People’s Republic of China (Grant Number 201002019), and the Beijing Hospitals Authority Youth Program (Grant Number QML20210201). The funding organization had no role in the design or conduct of the study.

Author information

Author notes

  1. These authors contributed equally: Jin Wang, Yue Wang.

Authors and Affiliations

  1. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China

    Jin Wang, Yue Wang, Ningli Wang & Ye Zhang

  2. Beijing Institute of Ophthalmology, Beijing, China

    Jin Wang, Yue Wang, Qing Zhang & Ningli Wang

  3. Nanjing Tongren Hospital, Jiangsu, China

    Si Zhen Li

  4. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China

    Ming Guang He

  5. Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia

    Ming Guang He

  6. Centre for Eye and Vision Research (CEVR), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China

    Ming Guang He

Authors
  1. Jin Wang
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Contributions

NW and Ye Zhang contributed to the design, acquisition of funding, and general supervision of the research group. JW and YW contributed to the design, results analysis, and manuscript drafting. QZ and SZL contributed to the data collection. MGH contributed to the manuscript revision. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

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Correspondence to Ningli Wang or Ye Zhang.

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Wang, J., Wang, Y., Zhang, Q. et al. Quantitative analysis of dynamic iris changes in primary angle-closure disease with long axial lengths: the Handan Eye Study. Eye (2024). https://doi.org/10.1038/s41433-023-02905-1

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  • DOI: https://doi.org/10.1038/s41433-023-02905-1

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