Correlation between Intraocular Pressure and Angle Configuration Measured by OCT: The Chinese American Eye Study

To characterize the relationship between angle configuration measured by anterior segment optical coherence tomography (AS-OCT) and intraocular pressure (IOP).

Cross-sectional study.

Subjects aged 50 years or older were identified from the Chinese American Eye Study (CHES), a population-based epidemiological study in Los Angeles, CA.

Each subject underwent a complete ocular exam including Goldmann applanation tonometry, gonioscopy, and AS-OCT imaging. Four AS-OCT images were analyzed per eye and parameters describing angle configuration were measured, including angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), trabecular iris angle (TIA), and scleral spur angle (SSA). The relationship between AS-OCT measurements and IOP was assessed using locally-weighted scatterplot smoothing (LOWESS) regression and change-point analyses.

Correlation between AS-OCT measurements and IOP.

702 eyes (382 closed angle and 320 open angle) from 555 subjects were analyzed. Mean IOP for angle closure eyes was 16.3 ± 3.9 mmHg and open angle eyes was 15.3 ± 2.7 mmHg. Mean IOP increased as AS-OCT measurements decreased for all parameters except TIA750. Once measurement values dropped below parameter-specific threshold values, AS-OCT measurements and IOP were significantly correlated (p < 0.05) for AOD500 (r = -0.416), AOD750 (r = -0.213), ARA500 (r = -0.669), ARA750 (r = -0.680), TISA500 (r = -0.655), TISA750 (r = -0.641), SSA500 (r = -0.538), and SSA750 (r = -0.208). There was no correlation between AS-OCT measurements and IOP in open angle eyes (p > 0.40).

There is an anatomic threshold for angle configuration below which IOP is strongly related to the degree of angle closure. This finding suggests reconsideration of current definitions of angle closure and may be relevant for developing new OCT-based methods to identify patients at higher risk for elevated IOP and glaucoma.