Choroidal Thickness in the Subtypes of Angle Closure: An EDI-OCT Study

Abstract

PURPOSE. To evaluate choroidal thickness (CT) in the subtypes of angle-closure (AC) disease compared with CT in a healthy control. METHODS.A total of 297 subjects (eyes) were enrolled in the study: 87 were nonglaucoma controls and 210 were AC subtype eyes (primary AC suspect [PACS] Enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) was used to measure the macular CT in the subtypes of AC disease and in healthy control subjects. The average CT was compared among the five groups.RESULTS. Thinner CT was associated with older age and longer axial length (AL) (all P < 0.001). All AC groups had thicker subfoveal CT (SFCT) compared with the control eyes (all P < 0.05), even after controlling for age and the AL factor. Acute primary angle-closure eyes had the thickest SFCT and were 61.9-lm thicker than healthy eyes, while PACS, PAC, and PACG eyes were 32.9-, 30.9-, and 25.4-lm thicker than healthy eyes, respectively. No significant difference was observed among the PACS, PAC, and PACG groups.CONCLUSIONS. Increased CT might be another anatomic characteristic of AC eyes. These findings may support the hypotheses that choroidal expansion is a contributing factor to the development of AC disease.

Measurement of Structural Parameters of the Lamina Cribrosa in Primary Open-Angle Glaucoma and Chronic Primary Angle-Closure Glaucoma by Optical Coherence Tomography and Its Correlations with Ocular Parameters

“…Third, recent findings revealed that BMO location alters because the progressive choroidal change can affect measurement values, especially in a longitudinal manner [44]. Primary angle-closure glaucoma eyes have a higher level of choroidal thickness [45]. Future studies should be mindful of the effect of the choroid when interpreting data on BMO-referenced LC depth.…”

Quantitative Measurements of the Ciliary Body in Eyes With Acute Primary-Angle Closure

“…Several factors may contribute, including pupil block, plateau iris, thick peripheral iris roll, thick and anteriorly located lens, [3][4][5][6][7][8] and increased choroidal thickness. 9,10 Recently, more and more studies have found that shallower ACD and greater LV may predispose to acute angle closure. [5][6][7]21 In addition, greatest choroidal thickness was found in APAC compared to other types of PAC.…”

“…[5][6][7]21 In addition, greatest choroidal thickness was found in APAC compared to other types of PAC. 9 Quigley and his colleagues [22][23][24] hypothesized that choroidal expansion was a potential initiator of PAC, especially for APAC and malignant glaucoma. Acute choroidal expansion coincident with increased intravitreal pressure may cause immediate increase in IOP and the forward movement of the lens, worsening pupillary block.…”

“…The diagnosis of APAC was based on several criteria similar to those in previous studies. 7,9 These included the presence of any two of the following symptoms: ocular or periocular pain, nausea and/or vomiting; an antecedent history of intermittent blurring of vision with haloes; IOP > 21 mm Hg measured by Goldmann applanation tonometry; the presence of conjunctival injection, shallow anterior chamber, and middilated fixed pupil with or without corneal epithelial edema; and the presence of an occludable angle in the affected eye, as determined by gonioscopy. Exclusion criteria were secondary acute attack due to lens subluxation, uveitis, iris neovascularization, trauma, tumor, nanophthalmos, or any obvious cataract leading to an intumescent lens; diabetes or systemic hypertension; history of intraocular surgery; and inability to tolerate gonioscopy or UBM examination.…”

“…Anatomic factors such as shorter axial length, more crowded anterior segment, and more anteriorly located lens have been reported to be associated with APAC. [3][4][5][6][7] In addition, altered dynamic factors such as physiological changes of the iris 8 and choroidal expansion 9,10 have also been suggested as risk factors. However, few studies have focused on the status of the ciliary body in APAC eyes.…”