Abstract
PurposeTo investigate the diagnostic capability of scleral spur length in discriminating eyes with primary open-angle glaucoma (POAG) from healthy eyes.MethodsSeventy-eight eyes of 78 patients with POAG and 93 eyes of 93 age-, sex- and axial length-matched healthy subjects were included. The scleral spur length was measured using swept-source optical coherence tomography. Receiver operating characteristic (ROC) curves were derived based on the measurements.ResultsThe scleral spur length was significantly shorter in POAG eyes compared with healthy eyes (Method I, 164.91 ± 23.36 vs. 197.60 ± 25.32 μm; Method II, 145.15 ± 16.59 vs. 166.95 ± 19.31 μm; Method III, 162.33 ± 22.83 vs. 185.12 ± 23.58 μm, respectively; all p < 0.001). The areas under ROC curves were 0.841 (Method I), 0.810 (Method II), and 0.753 (Method III) for the scleral spur length. Moreover, Schlemm’s canal area was significantly associated with the scleral spur length (Method I) in both POAG (β = 0.027; p < 0.001) and healthy (β = 0.016; p = 0.009) groups.ConclusionsThe scleral spur length had a good discriminating capability between POAG and healthy eyes, and it could be a novel biomarker for POAG evaluation clinically.
Highlights
Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide [1]
There were no significant differences in age, sex, central corneal thickness (CCT), refractive error (RE), and axial length (AL) between POAG and healthy eyes
We have performed multivariate regression equation to determine the association between s canal (SC) area and scleral spur length, and the results showed that irrespective in POAG or in healthy group, the SC area was significantly associated with the scleral spur length; the longer scleral spur could better support SC, resulting in the larger SC area
Summary
Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide [1]. Nesterov et al found that the posterior SC, where received the most force from scleral spur, is wider than the anterior SC This result confirmed the importance of scleral spur on the morphology of SC [21]. In consideration of the close relationship between SC and scleral spur [16,17,18,19,20,21], and the close relationship between SC and aqueous humor outflow resistance [5,6,7,8,9], previous studies have suggested that short scleral spur could be engaged in the pathogenesis of POAG [16, 22, 23]
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