Comparative Study of Accommodative Function and Binocular Vision in Patients With Primary Angle-Closure Disease

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Age-related accommodative decline is linked to primary angle-closure disease (PACD).
• The relationship between refractive error and accommodation in the elderly, crucial for PACD, is not well understood.
• Previous research on refractive error and accommodation has primarily focused on pediatric populations.

Purpose of the Study:

• To evaluate visual functions, including accommodation and vergence, in patients with PACD.
• To investigate the association between refractive error and accommodative function in elderly individuals with PACD.
• To explore the link between accommodative function and PACD pathophysiology.

Main Methods:

• Prospective study of 51 patients (102 eyes) with PACD, categorized into primary angle-closure/primary angle-closure glaucoma (PAC/PACG), primary angle-closure suspect (PACS), and control groups.
• Measurement of best-corrected near visual acuity, refractive error, Worth's 4 Dot test, stereoacuity, vergence facility, accommodative facility (AF), and amplitude of accommodation (AMP).
• Comparative analysis of visual parameters across the three patient groups.

Main Results:

• A significant negative correlation was found between amplitude of accommodation (AMP) and refractive error (p < 0.001).
• Patients with PACS and PAC/PACG demonstrated significantly stronger accommodative facility (AF) compared to controls (p=0.002 and p=0.048, respectively).
• No significant differences were observed in best-corrected near visual acuity, binocular vision, or vergence facility among the groups.

Conclusions:

• Primary angle-closure suspect (PACS) and primary angle-closure/primary angle-closure glaucoma (PAC/PACG) patients exhibit enhanced accommodative facility.
• A negative correlation exists between amplitude of accommodation and refractive error in the elderly population.
• Accommodative function is a critical factor in primary angle-closure disease (PACD) pathogenesis and warrants further investigation.