Chen Jiawei, Yuan Xiang-Ling, Zhang Xinyue, Huang Yanjun, Huang Xiaona, Duan Xuanchu
Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China.
Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China.
PeerJ. 2025 Apr 18;13:e19330. doi: 10.7717/peerj.19330. eCollection 2025.
Whether occult zonulopathy contributes to the development of acute primary angle closure (APAC) remains elusive. This study aimed to determine the association between occult zonulopathy detected during cataract surgery and APAC and to investigate the biometric characteristics of APAC patients with or without occult zonulopathy.
Retrospective case-control study. A total of 27 Chinese unilateral APAC subjects and 132 control subjects with comprehensive ophthalmic examinations were recruited. Occult zonulopathy was identified with the intraoperative signs during cataract surgery. The proportion of occult zonulopathy was compared between the APAC and control groups. A multivariate logistic analysis was conducted to determine the association between occult zonulopathy and APAC. The ocular biometric parameters were compared between APAC and the contralateral eyes in APAC patients with or without occult zonulopathy.
APAC patients (63.0%) had a significantly larger proportion of occult zonulopathy than control subjects (1.5%, < 0.001). In the multivariate logistic analysis, occult zonulopathy was significantly associated with APAC after adjusting the axial length (AL) and sex (OR = 126.49, 95% CI [20.89-766.02]; < 0.001). Compared to contralateral eyes, shallower central anterior chamber depth, more anterior lens position and relative lens position were found in APAC eyes both with and without occult zonulopathy (all < 0.05), but no difference in AL and lens thickness.
A larger proportion of occult zonulopathy was significantly associated with APAC. Occult zonulopathy could be a risk factor for APAC by inducing forward shifting of the lens.
隐匿性小带病变是否会导致急性原发性闭角型青光眼（APAC）的发生仍不清楚。本研究旨在确定白内障手术中检测到的隐匿性小带病变与APAC之间的关联，并调查有或无隐匿性小带病变的APAC患者的生物测量特征。
回顾性病例对照研究。共招募了27例中国单侧APAC受试者和132例接受全面眼科检查的对照受试者。在白内障手术中通过术中体征识别隐匿性小带病变。比较APAC组和对照组隐匿性小带病变的比例。进行多因素逻辑分析以确定隐匿性小带病变与APAC之间的关联。比较有或无隐匿性小带病变的APAC患者患眼与对侧眼的眼部生物测量参数。
APAC患者隐匿性小带病变的比例（63.0%）显著高于对照受试者（1.5%，P<0.001）。在多因素逻辑分析中，调整眼轴长度（AL）和性别后，隐匿性小带病变与APAC显著相关（OR=126.49，95%CI[20.89-766.02]；P<0.001）。与对侧眼相比，有和无隐匿性小带病变的APAC患眼中央前房深度均较浅，晶状体位置更靠前且相对晶状体位置更靠前（均P<0.05），但AL和晶状体厚度无差异。
隐匿性小带病变比例较高与APAC显著相关。隐匿性小带病变可能通过导致晶状体前移成为APAC的危险因素。
