Anatomo-topographical characteristics of the eye in the early stages of primary angle closure disease

Purpose. To determine the anatomical and topographic features of the anterior and posterior segments of the eye in the primary angle closure (PAC) and compare them with those in the primary angle closure suspects (PACs) and in control.

MATERIAL AND METHODS. The prospective study included 120 patients aged 41 to 80 years (60 eyes – PAC, 30 – PACs, 30 eyes – without ophthalmopathology). The studied parameters included: spheroequivalent (SE), intraocular pressure (IOP), choroidal thickness in the fovea (CTf), axial length (AL), anterior chamber depth (ACD), lens volume (LV), iris curvature and its thickness, anterior chamber angle profile of anterior chamber: AOD500, AOD750, TISA500, TISA750.

RESULTS. The PAC eyes differed from the control eyes by increased SE, LV, IOP, iris curvature, CTf, reduced ACD, AL, and the profile of the anterior chamber (AOD500, AOD750, TISA500, TISA750) in vertical sectors (p<0.01). The iris thickness in the groups was comparable. The PAC eyes differed from the PACs by increased SE, LV, IOP, reduced ACD, AL, AOD500 in the upper sector, and the parameters characterized the profile of the anterior chamber in the lower sector (p<0.01). The iris thickness, its curvature, as well as the profile of the anterior chamber in the upper sector and the CTf were comparable. Threshold values that distinguish the PAC and PACs were determined: LV – 0.656 mm, AOD500 – 0.131 mm, TISA500 – 0.051 mm², TISA750 – 0.093 mm² in the lower sector and IOP 21 mm Hg. In the multifactor model, adjusted for age, gender and AL, the inverse relationship of iris thickness with CTf was established both in PAC and with PACs (all p<0.01), but not in control (all p>0.01).

CONCLUSION. The parameters of PAC and PACs eyes significantly differ from the norm. LV and the profile of the anterior chamber in the lower sector are the most informative in the differentiating the PAC eyes from PACs. The inverse relationship between the iris and choroidal thickness suggests the role of the choroid in the pathogenesis of primary angle closure disease.

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