Biometric indicators of eyes with occult lens subluxation inducing secondary acute angle closure

Xiaoli Xing,Liangyu Huang,Fang Tian,Aihua Liu,Wei Liu,Yan Zhang,Yingjuan Lv

doi:10.1186/s12886-020-01355-7

Abstract

BackgroundTo compare the anterior biometrics in eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), misdiagnosed as acute primary angle closure (APAC) at the first visit with APAC, chronic primary angle closure glaucoma (CPACG), and cataract.MethodsThis retrospective case study included 17 eyes with angel closure due to occult LS, who were misdiagnosed as APAC on their first visit, 56 APAC eyes, 54 CPACG eyes, and 56 cataract eyes. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of ocular biometrics.ResultsThe ASAC-LS patients had a longer ocular axial length than APAC and CPACG patients. Central corneal thickness of the ASAC-LS patients was not significantly different from APAC patients, but was significantly different from CPACG and cataract patients. The APAC patients had the smallest ACD, while the ASAC-LS patients had the smallest AD. The ASAC-LS patients had the largest lens thickness. According to ROC curve analysis, RLP, ACD, AD, CLP, LP had high power of discrimination.ConclusionsThis study revealed that LS secondary PAC patients had a shallower AD, thicker CCT comparing to those of APAC, CPACG and cataract patients. For patients with acute angle-closure glaucoma, it is necessary to exclude lens zonula relaxation.Trial registrationNCT03752710, retrospectively registered.

Highlights

To compare the anterior biometrics in eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-Lens subluxation (LS)), misdiagnosed as acute primary angle closure (APAC) at the first visit with APAC, chronic primary angle closure glaucoma (CPACG), and cataract
Whenacute secondary angle closure is misdiagnosed as APAC, miotic agents might be administered, andtrabeculectomy may even beperformed
Clinical features and demographic of the patients were retrieved from the patient’s medical records from Jan 10, 2016 to Mar, 2016. 56 eyes of 56 patients diagnosed with APAC, 54 eyes of 54 patients diagnosedwith CPACG, and 56 eyes of 56 patients diagnosed with cataract in patientswere consecutively included (All the patients had vision in both eyes)

Summary

Introduction

To compare the anterior biometrics in eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), misdiagnosed as acute primary angle closure (APAC) at the first visit with APAC, chronic primary angle closure glaucoma (CPACG), and cataract. The biometric characteristics of patients with APAC includesmall corneal diameter, short ocular axial length, shallow central and peripheral anterior chamber [3, 4], lens thickening [5], and anterior displacement of the lens. To this end, we analyzed anterior segment biometric characteristics in a group of patients with ASAC-LS, and compared these biometric characteristics withthe patients with APAC and chronic primary angleclosure glaucoma (CPACG). It is hoped that this study can be helpful for the diagnosis and differential diagnosis of these ocular diseases

Methods

Results

Discussion

Conclusion