Peripheral Anterior Chamber Depth and Screening Techniques for Primary Angle Closure Disease in Community Elderly Chinese

Abstract

Background: To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening. Methods: We performed a population-based survey in Pudong New District of Shanghai, China, in 2011. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). Results: 2528 adults participated in the study with 91 patients diagnosed with PACD. 2463 subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04±0.46 (range 0.11-2.93) CT and 0.87±0.41 (range 0.12-2.96) CT respectively (t=-4.18; P＜0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P<0.0001) per diopter of SE and was 0.19 CT (P<0.0001) shallower in women than in men (r2=0.1304, P<0.0001). Peripheral ACD performed best in screening for PACD. Conclusions: Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.