In vivo assessment of Berger's space in primary angle closure disease using AS-OCT: a comparative study

To observe Berger's space in vivo in eyes with primary angle closure disease (PACD) and to identify factors associated with its visibility.

This cross-sectional observational study was conducted at a tertiary center and included 81 participants (109 eyes) diagnosed with PACD. Anterior segment optical coherence tomography (AS-OCT, CASIA2) images were used to evaluate the visibility of the Berger's space, and ocular biometric parameters were measured. The visibility of the Berger's space was compared among acute primary angle closure (APAC), fellow eyes of APAC (F-APAC), and chronic primary angle closure (glaucoma) (CPAC[G]). Additionally, ocular biometric parameters were compared between groups with visible and invisible Berger's space, and generalized estimating equations (GEEs) were employed in the regression analysis to account for inter-eye correlations.

The APAC group exhibited the highest prevalence of visible Berger's space at 36.67%, which was significantly greater than the rates of 9.38% in the F-APAC group and 17.02% in the CPAC(G) group (p = 0.028). The visible Berger's space group was younger (p = 0.008) with narrower anterior chamber angle, and anteriorly shifted lens position (p = 0.031) compared to the invisible Berger's space group. Factors associated with visible Berger's space included acute angle closure (p = 0.017, odds ratio = 5.650, 95% CI: 1.325-24.084) and younger age (p = 0.017, odds ratio = 0.937, 95% CI: 0.889-0.989).

Acute angle closure and younger age were both associated with higher visibility of the Berger's space. Eyes with visible Berger's space are younger, have narrower anterior chamber angles and more anteriorly shifted lens positions.