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Accommodative Demand and Near Addition in Early-Onset Primary Angle-Closure Disease: A Comparative Study.
Suresh Kumar Yadav1, Arnav Panigrahi2, Anand Kumar Pathak1
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Summary
Early-onset primary angle-closure disease (EOPACD) eyes show better accommodation and require less near-addition than healthy eyes. This suggests a potential optical advantage from their unique anterior segment structure.
Area of Science:
- Ophthalmology
- Optometry
- Anterior Segment Imaging
Background:
- Early-onset primary angle-closure disease (EOPACD) is characterized by a crowded anterior segment and anteriorly positioned lens.
- These anatomical features may influence the eye's accommodative function and visual performance.
Purpose of the Study:
- To compare accommodative function and near-addition requirements in EOPACD patients versus age-matched healthy controls.
- To investigate the relationship between anterior segment biometry and accommodative outcomes in EOPACD.
Main Methods:
- A prospective case-control study involving 164 eyes from 90 participants (85 EOPACD, 79 controls).
- Standardized clinical methods assessed refraction, amplitude of accommodation (AA), negative relative accommodation (NRA), positive relative accommodation (PRA), and near-addition.
- Group differences were analyzed using linear regression, adjusting for age, sex, and refractive error.
Main Results:
- EOPACD eyes exhibited significantly higher amplitude of accommodation (AA) compared to controls (adjusted p=0.02).
- Near-addition requirements were significantly lower in EOPACD eyes (adjusted p=0.009).
- No significant differences were found in NRA, PRA, or best-corrected distance visual acuity between groups.
Conclusions:
- Eyes with EOPACD demonstrate preserved or enhanced accommodative amplitude and reduced near-addition demand.
- These findings support the hypothesis of a relative optical advantage conferred by the specific anterior segment configuration in EOPACD.
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