Determinative role of anterior segment optical coherence tomography bioparameters in the pathogenesis of asymmetrical...

This study evaluated the differences in anterior segment bioparameters between the primary angle closure glaucoma eye and the fellow eye in asymmetrical primary angle closure disease and identified the key factors linked to PACG.

We retrospectively analyzed data from Hebei Eye Hospital from September 2023 to October 2024. Anterior segment optical coherence tomography (AS-OCT) was used to assess the bioparameters in a 360-degree swept-source model. Parameters included anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber volume (ACV), lens vault (LV), angle opening distance at 500 μm and 750 μm from the scleral spur (AOD500 and AOD750), trabecular iris angle at 500 μm and 750 μm (TIA500 and TIA750), trabecular iris space area at 500 μm and 750 μm (TISA500 and TISA750), and iris parameters (iris thickness at 750 μm from the scleral spur(IT750);iris volume(IV); iris curvature(IC); iridotrabecular contact(ITC). These parameters were compared between PACG and fellow eyes.

Multivariable logistic regression showed that higher lens vault (OR: 1.224 [1.040-1.407], p = 0.017), narrower TIA750 (odds ratio(OR): 1.130 [1.021-1.238], p = 0.019), smaller AOD750 (OR: 1.985 [1.253-2.716], p = 0.009), and smaller TISA750 (OR: 1.225 [1.041-1.409], p = 0.017) were significant predictors of PACG incidence. The area under the curve (AUC) for LV, AOD750, TIA750, and TISA750 ranged from 0.807 to 0.939, with satisfactory sensitivity and specificity.

In general, the PACG eye of unilateral PACG patients exhibited a more crowded anterior segment, with AS-OCT features including higher LV, narrower TIA750, and smaller AOD750 and TISA750.