Peripheral anterior chamber depth and screening techniques for primary angle closure disease in community elderly Chines
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RESEARCH ARTICLE
Open Access
Peripheral anterior chamber depth and screening techniques for primary angle closure disease in community elderly Chinese Qin Luo1,2†, Wenwen Xue1†, Yin Yuan1, Chaowei Fu3, Jiangnan He1, Haidong Zou1,2, Xiaowei Tong1, Richard K. Lee4 and Ling Ge1,2*
Abstract Background: To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening. We performed a population-based survey in Pudong New District of Shanghai, China, in 2011. Methods: Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results: Two thousand five hundred twenty-eight adults participated in the study with 91 patients diagnosed with PACD. Two thousand four hundred sixty-three subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04 ± 0.46 (range 0.11–2.93) CT and 0.87 ± 0.41 (range 0.12–2.96) CT respectively (t = − 4.18; P 0.5 in either eye, VCDR asymmetry ≥0.2, or a neuroretinal rim width reduced to < 0.1 CDR (between 11 and 1 o’clock or 5 and 7 o’clock), optic disk hemorrhage, notching in the optic disc rim or RNFL defects on the superior or inferior temporal near the disc in the fundus photograph, or IOP ≥21 mmHg [19]. Glaucoma cases were diagnosed using ISGEO criteria [21]. Glaucoma was identified in accordance with three levels of evidence. The division of glaucoma into PACG versus primary open angle glaucoma (POAG) was based on gonioscopic finding of a narrow angle. PACS was defined as an eye with appositional contact between the peripheral iris and posterior trabecular meshwork [21]. In epidemiological research, a narrow angle has most often been defined as an angle in which > 270° of the posterior trabecular meshwork (the part which is often pigmented) cannot be seen during a static examination. PAC was regarded as an eye with an occludable drainage angle and features indicating that trabecular obstruction by the peripheral iris have occurred, such as peripheral anterior synechiae (PAS), elevated IOP, iris whorling (distortion of the radially orientated iris fibers), “glaucomfleken” lens opacities, or excessive pigment deposition on the trabecular surface and and the optic disc does not have glaucomatous damage [21]. Statistical analys
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