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Short-Term Ocular Biometric Changes as Predictors of Long-Term Angle Closure Progression
Kendra L Hong1, Benjamin Y Xu1, Wei Wang2
1Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles.
JAMA Ophthalmology
|May 29, 2025
Summary
Short-term changes in ocular biometrics like lens vault and angle width can predict long-term progression from primary angle closure suspect (PACS) to primary angle closure (PAC). Monitoring these changes enhances risk assessment for angle closure development.
Area of Science:
- Ophthalmology
- Anatomic pathology
Background:
- Anterior segment ocular biometrics predict progression from primary angle closure suspect (PACS) to primary angle closure (PAC).
- Understanding longitudinal anatomical changes is crucial for assessing progression risk in aging populations.
Purpose of the Study:
- To evaluate 18-month changes in ocular biometrics as risk factors for progression from PACS to PAC over a 36-72 month period.
Main Methods:
- Retrospective cohort study analyzing data from the prospective Zhongshan Angle Closure Prevention (ZAP) Trial.
- Participants (50-70 years) with bilateral PACS were monitored for PAC development.
- Cox regression models assessed risk factors, including baseline and 18-month ocular biometrics.
Main Results:
- Baseline trabecular-iris space area (TISA500) and 18-month changes in lens vault (ΔLV) and TISA (ΔTISA750) were associated with progression.
- Multivariable models showed baseline TISA500 combined with ΔLV or ΔTISA750 were more predictive than baseline TISA500 alone.
- Lowest quartile TISA500 and highest quartile ΔLV independently conferred greater progression risk.
Conclusions:
- Short-term (18-month) ocular biometric changes (LV, TISA750) predict long-term angle closure progression in untreated PACS eyes.
- Monitoring dynamic changes in lens vault and angle width can improve risk prediction for angle closure.
- This approach augments baseline ocular biometrics for enhanced long-term angle closure progression assessment.
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