Поиски возможностей объективного критерия риска развития острого приступа глаукомы в анатомически коротких глазах

Abstract

Purpose. To assess the prognostic significance of the LAF coefficient (Lens thickness/ Axial length Factor) as risk factor for acute attack of glaucoma in anatomically short eyes of Europeans. Material and methods. 1st group consisted of 24 patients (48 eyes) with axial hyperopia. 2nd group included 24 patients (48 eyes) with primary closure of the anterior chamber angle. The 3rd group was formed by 17 patients (34 eyes) with initial stage of primary angle-closure glaucoma. The 4th group included 35 patients (35 eyes) with an acute attack of glaucoma. The studied groups did not differ in age (p = 0.97) and gender (p = 0.28). Lens thickness and axial length (AL) were measured using A-scan on biometer IOLMaster 700 (Carl Zeiss®, Germany) with calculation of LAF coefficient. Results. The LAF coefficient in the 4th (acute attack) group was statistically significantly higher than in the first 3 groups. The best separation of the 1st and 4th groups is provided by LAF coefficient compared to lens thickness and AL indexes with sensitivity, specificity and the Area Under the Curve (AUC) of 89 %, 83 % and 0.9, respectively. LAF coefficient values greater than 2.332 in patients with short AL are objectively associated with high risk of acute attack of glaucoma. The average value of the LAF coefficient (2.528) obtained by us in the 4th (acute attack of glaucoma) group significantly exceeds these indexes in works of other authors, which may be due to morphometric features of structure of eyes of Europeans compared to eyes of Asians. Conclusion. The LAF coefficient provides better separation of the 1st and 4th groups, in comparison with the lens thickness indexes, and especially the AL. LAF coefficient values greater than 2.332 in eyes with short AL objectively indicate high risk of acute attack of glaucoma, as evidenced by high sensitivity, specificity, and AUC. Keywords: acute attack of glaucoma, LAF, lens thickness, short axial length, risk factor