Morphologic Features of Crystalline Lens in Patients with Primary Angle Closure Disease Observed by CASIA 2 Optical Coherence Tomography

Morphologic Features of Crystalline Lens in Patients with Primary Angle Closure Disease Observed by CASIA 2 Optical Coherence Tomography

PURPOSE. To investigate the morphologic features of crystalline lens in primary angle closure disease (PACD) by the swept-source anterior segment optical coherence tomography.METHODS. This cross-sectional observational study included 125 consecutive eyes from 125 patients who underwent anterior segment optical coherence tomography (CASIA 2, Tomey, Nagoya, Japan) examination, including 38 eyes of normal controls, 57 eyes of PAC suspects (PACS), and 30 eyes with PAC or PAC glaucoma (PACG). Crystalline lens parameters were compared among the three groups. Spearman correlation analysis and multiple linear regression models were performed to evaluate the relationships between the lens parameters and related factors.RESULTS. Significant differences were found for anterior chamber depth, axial length, iridotrabecular contact index, lens vault, lens thickness (all P < 0.001), the anterior radius curvature of lens (normal vs PACS vs PAC/PACG: 9.35 +/- 1.29 mm vs 8.40 +/- 0.62 mm vs 8.12 +/- 0.54 mm; P < 0.001), lens decentration (normal vs PACS vs PAC/PACG: 0.14 +/- 0.07 mm vs 0.19 +/- 0.09 mm vs 0.22 +/- 0.12 mm; P = 0.004), and tilt (normal vs PACS vs PAC/PACG: 4.9 +/- 1.0 degrees vs 5.3 +/- 1.2 degrees vs 5.8 +/- 1.8 degrees; P = 0.033) among the three groups. The multivariate regression analysis found that both iridotrabecular contact index and the stage of the PACD were negatively correlated with the anterior radius curvature of lens, positively correlated with lens thickness and decentration after adjustment for age, sex, and axial length (all P < 0.05).CONCLUSIONS. Steep anterior curvature and decentration of the crystalline lens may be another anatomic characteristic of eyes with PACD. These findings support that the crystalline lens morphologic features may have great contribution to the development of PACD.

目的：利用扫频眼前节光学相干断层扫描技术研究原发性闭角型疾病（PACD）中晶状体的形态特征。 方法：这项横断面观察性研究纳入了125例患者的125只连续眼，这些患者均接受了眼前节光学相干断层扫描（日本名古屋拓美公司的CASIA 2）检查，其中包括38只正常对照眼、57只原发性闭角型青光眼疑似眼（PACS）以及30只原发性闭角型青光眼（PAC）或原发性闭角型青光眼合并青光眼（PACG）眼。对三组的晶状体参数进行了比较。采用斯皮尔曼相关分析和多元线性回归模型评估晶状体参数与相关因素之间的关系。 结果：三组间在前房深度、眼轴长度、虹膜小梁接触指数、晶状体矢高、晶状体厚度（均P < 0.001）、晶状体前表面曲率半径（正常组 vs PACS组 vs PAC/PACG组：9.35 ± 1.29 mm vs 8.40 ± 0.62 mm vs 8.12 ± 0.54 mm；P < 0.001）、晶状体偏心（正常组 vs PACS组 vs PAC/PACG组：0.14 ± 0.07 mm vs 0.19 ± 0.09 mm vs 0.22 ± 0.12 mm；P = 0.004）以及倾斜度（正常组 vs PACS组 vs PAC/PACG组：4.9 ± 1.0° vs 5.3 ± 1.2° vs 5.8 ± 1.8°；P = 0.033）方面存在显著差异。多元回归分析发现，在调整年龄、性别和眼轴长度后，虹膜小梁接触指数和PACD的分期均与晶状体前表面曲率半径呈负相关，与晶状体厚度和偏心呈正相关（均P < 0.05）。 结论：晶状体前表面陡峭和偏心可能是原发性闭角型疾病眼的另一个解剖学特征。这些发现支持晶状体形态特征可能对原发性闭角型疾病的发展有重要作用。