Lens factor as an underlying mechanism in primary angle closure with gonioscopically-visualized ciliary body...

Area of Science:

• Ophthalmology
• Anterior Segment Imaging
• Glaucoma Research

Background:

• Primary angle closure (PAC) is a significant cause of irreversible blindness.
• Understanding the anatomical factors contributing to PAC is crucial for effective management.
• Ciliary body processes (CBP) visualization during gonioscopy may offer insights into PAC mechanisms.

Purpose of the Study:

• To compare anterior segment parameters in primary angle closure (PAC) eyes with and without gonioscopically visualized ciliary body processes (CBP).
• To identify anatomical differences associated with visible CBP in PAC patients.

Main Methods:

• Prospective, observational, comparative clinical study involving 89 PAC patients.
• Detailed ocular examinations including gonioscopy and ultrasound biomicroscopy.
• Measurement of anterior chamber depth (ACD), anterior chamber width, lens thickness (LT), lens vault (LV), pupil diameter, lens-axial length factor (LAF), and relative lens position (RLP).

Main Results:

• Eyes with visible CBP (PAC+CBP group) had significantly smaller axial length and ACD compared to the PAC-CBP group.
• The PAC+CBP group exhibited significantly greater LT, LV, and LAF.
• LAF showed the strongest association with visible CBP (Odds ratio = 141.70, p = 0.002).

Conclusions:

• Gonioscopic visualization of CBP in PAC eyes suggests anterior segment crowding, particularly lens-related factors, as a primary underlying mechanism.
• Visible CBP may serve as a practical gonioscopic marker for predicting PAC pathophysiology.