Roski Eye Institute (A.C., B.Y.X., A.A.P.), Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Roski Eye Institute (A.C., B.Y.X., A.A.P.), Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Am J Ophthalmol. 2023 Dec;256:27-34. doi: 10.1016/j.ajo.2023.07.032. Epub 2023 Aug 6.
To assess the role of static and dynamic ocular biometric parameters measured in the dark and light for predicting progression of primary angle closure suspect (PACS) to primary angle closure (PAC).
Retrospective cohort study using prospective randomized controlled trial data from untreated, control eyes.
Zhongshan Angle Closure Prevention Trial subjects underwent anterior segment optical coherence tomography (AS-OCT) imaging in the dark and light. Static biometric parameters were measured, consisting of angle, iris, lens, and anterior chamber parameters. Dynamic change parameters were calculated by subtracting light measurements from dark measurements. Cox proportional hazards regression models were developed to assess risk factors for PACD progression.
A total of 861 eyes of 861 participants were analyzed (36 progressors). On univariable analysis, TISA500 measurements in the light and dark were associated with progression (P < .001), whereas dynamic change parameters were not (P ≥ .08). In the primary multivariable model, older age (hazard ratio [HR] = 1.09 per year), higher intraocular pressure (IOP) (HR = 1.13 per mm Hg), and smaller TISA500 in the light (HR = 1.28 per 0.01 mm) were significantly associated with greater risk of progression (P ≤ .04). Dark TISA500 had similar significance (HR = 1.28, P = .002) when replacing light TISA500. Risk of progression was more predictive among eyes in the lowest quartile of light TISA500 measurements (HR = 4.56, P < .001) compared to dark measurements (HR = 2.89, P = .003).
Static parameters measured in the light are as predictive, and possibly more so, of angle closure progression as those measured in the dark. Ocular biometrics measured under light and dark conditions may provide additional information for risk-stratifying patients for angle closure progression.
评估在暗光和亮光下测量的静态和动态眼生物测量参数在预测原发性闭角型青光眼（PAC）前房角关闭（PAC）进展中的作用。
未治疗的对照组前瞻性随机对照试验数据的回顾性队列研究。
中山闭角型青光眼防治试验受试者在暗光和亮光下接受眼前节光学相干断层扫描（AS-OCT）成像。测量静态生物测量参数，包括角度、虹膜、晶状体和前房参数。通过从暗测量中减去光测量来计算动态变化参数。采用 Cox 比例风险回归模型评估 PAC 进展的危险因素。
共分析了 861 名参与者的 861 只眼（36 只进展眼）。单变量分析显示，暗光和亮光下的 TISA500 测量与进展相关（P<.001），而动态变化参数无相关性（P≥.08）。在主要多变量模型中，年龄较大（每增加 1 岁 HR=1.09）、眼内压较高（每增加 1mmHg HR=1.13）和暗光下 TISA500 较小（每增加 0.01mm HR=1.28）与进展风险增加显著相关（P≤.04）。暗光下的 TISA500 也有类似的意义（HR=1.28，P=.002），可替代亮光下的 TISA500。与暗光 TISA500 相比，在最低四分位数的光 TISA500 测量中，进展风险的预测性更高（HR=4.56，P<.001）。
与暗光下测量的参数相比，亮光下测量的静态参数同样可以预测房角关闭进展，甚至可能更具预测性。在暗光和亮光条件下测量的眼生物测量值可能为房角关闭进展提供额外的风险分层信息。
