Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
Am J Ophthalmol. 2012 Jul;154(1):39-46. doi: 10.1016/j.ajo.2012.01.015. Epub 2012 Apr 1.
To describe the distribution and determinants of lens vault and to investigate the association of lens vault with narrow angles.
Prospective cross-sectional study.
Phakic subjects 50 years and older were evaluated at a primary healthcare clinic with gonioscopy, partial laser interferometry, and anterior segment optical coherence tomography (AS-OCT). Narrow angles were defined as posterior trabecular meshwork not visible for ≥2 quadrants on non-indentation gonioscopy. Lens vault was defined as the perpendicular distance between the anterior pole of the crystalline lens and the horizontal line joining the 2 scleral spurs on horizontal AS-OCT scans. Analysis of covariance, multivariate logistic regression, and area under the receiver operating characteristic curves (AUC) were performed.
Of the 2047 subjects recruited, 582 were excluded because of poor image quality or inability to locate scleral spurs, leaving 1465 subjects for analysis. Eyes with narrow angles had greater lens vault compared to eyes with open angles (775.6 µm vs 386.5 µm, P < .0001). Women had significantly greater lens vault than men (497.28 µm vs 438.56 µm, P < .001), and lens vault increased significantly with age (P for trend <.001). Adjusted for age and sex, significant associations with greater lens vault were shorter axial length, shallower anterior chamber depth(ACD), higher intraocular pressure, and more hyperopic spherical equivalent (all P < .001). On multivariate analysis, subjects with lens vault >667.6 µm were more likely to have narrow angles (OR 2.201, 95% CI: 1.070-4.526) compared to those with lens vault ≤462.7 µm. The AUC for lens vault (0.816) and ACD (0.822) for detecting narrow angles were similar (P = .582).
Lens vault was independently associated with narrow angles and may be useful in screening to detect eyes with narrow angles.
描述晶状体拱顶的分布和决定因素，并研究晶状体拱顶与窄角之间的关系。
前瞻性横断面研究。
在初级保健诊所，对 50 岁及以上的有晶状体眼受试者进行房角镜检查、部分激光干涉测量和眼前节光学相干断层扫描（AS-OCT）。窄角定义为非压陷房角镜检查时后小梁网在≥2 个象限不可见。晶状体拱顶定义为水平 AS-OCT 扫描中晶状体前极与连接 2 个巩膜突的水平线之间的垂直距离。进行协方差分析、多变量逻辑回归和接收者操作特征曲线下面积（AUC）分析。
在纳入的 2047 名受试者中，有 582 名因图像质量差或无法定位巩膜突而被排除，1465 名受试者被纳入分析。窄角眼的晶状体拱顶明显大于宽角眼（775.6 µm 对 386.5 µm，P <.0001）。女性的晶状体拱顶明显大于男性（497.28 µm 对 438.56 µm，P <.001），且晶状体拱顶随年龄显著增加（趋势 P <.001）。调整年龄和性别后，与较大晶状体拱顶显著相关的因素有较短的眼轴、较浅的前房深度（ACD）、较高的眼压和更远视等效球镜（均 P <.001）。多变量分析显示，晶状体拱顶>667.6 µm 的受试者更有可能患有窄角（OR 2.201，95%CI：1.070-4.526），而晶状体拱顶≤462.7 µm 的受试者则不然。晶状体拱顶（0.816）和 ACD（0.822）检测窄角的 AUC 相似（P =.582）。
晶状体拱顶与窄角独立相关，在筛查中可能有助于发现窄角眼。
