TY - JOUR
T1 - Longitudinal changes of angle configuration in primary angle-closure suspects
T2 - The Zhongshan angle-closure prevention trial
AU - Jiang, Yuzhen
AU - Chang, Dolly S.
AU - Zhu, Haogang
AU - Khawaja, Anthony P.
AU - Aung, Tin
AU - Huang, Shengsong
AU - Chen, Qianyun
AU - Munoz, Beatriz
AU - Grossi, Carlota M.
AU - He, Mingguang
AU - Friedman, David S.
AU - Foster, Paul J.
N1 - Funding Information:
Supported by Fight for Sight (grant no. 1655 ) (United Kingdom) and the Sun Yat-sen University 5010 Project Fund (grant no. 2007033 ) (China). Y.J. receives additional support from the British Council for Prevention of Blindness PhD Scholarship and UCL Overseas Research Scholarship . A.P.K. is supported by a Wellcome Trust Clinical Research Fellowship (grant no. 094791/Z/10/Z ). P.J.F. receives additional support from the NIHR Biomedical Research Centre at Moorfields Eye Hospital, London, United Kingdom ( NIHR-BRC2 009 ; Moorfields/UCL-IOO), and the Richard Desmond Charitable Foundation (via Fight for Sight UK). The sponsors or funding organizations had no roles in the design or conduct of this research.
PY - 2014/9
Y1 - 2014/9
N2 - Objective To determine longitudinal changes in angle configuration in the eyes of primary angle-closure suspects (PACS) treated by laser peripheral iridotomy (LPI) and in untreated fellow eyes. Design Longitudinal cohort study. Participants Primary angle-closure suspects aged 50 to 70 years were enrolled in a randomized, controlled clinical trial. Methods Each participant was treated by LPI in 1 randomly selected eye, with the fellow eye serving as a control. Angle width was assessed in a masked fashion using gonioscopy and anterior segment optical coherence tomography (AS-OCT) before and at 2 weeks, 6 months, and 18 months after LPI. Main Outcome Measures Angle width in degrees was calculated from Shaffer grades assessed under static gonioscopy. Angle configuration was also evaluated using angle opening distance (AOD250, AOD500, AOD750), trabecular-iris space area (TISA500, TISA750), and angle recess area (ARA) measured in AS-OCT images. Results No significant difference was found in baseline measures of angle configuration between treated and untreated eyes. At 2 weeks after LPI, the drainage angle on gonioscopy widened from a mean of 13.5° at baseline to a mean of 25.7° in treated eyes, which was also confirmed by significant increases in all AS-OCT angle width measures (P<0.001 for all variables). Between 2 weeks and 18 months after LPI, a significant decrease in angle width was observed over time in treated eyes (P<0.001 for all variables), although the change over the first 5.5 months was not statistically significant for angle width measured under gonioscopy (P = 0.18), AOD250 (P = 0.167) and ARA (P = 0.83). In untreated eyes, angle width consistently decreased across all follow-up visits after LPI, with a more rapid longitudinal decrease compared with treated eyes (P values for all variables ≤0.003). The annual rate of change in angle width was equivalent to 1.2°/year (95% confidence interval [CI], 0.8-1.6) in treated eyes and 1.6°/year (95% CI, 1.3-2.0) in untreated eyes (P<0.001). Conclusions Angle width of treated eyes increased markedly after LPI, remained stable for 6 months, and then decreased significantly by 18 months after LPI. Untreated eyes experienced a more consistent and rapid decrease in angle width over the same time period.
AB - Objective To determine longitudinal changes in angle configuration in the eyes of primary angle-closure suspects (PACS) treated by laser peripheral iridotomy (LPI) and in untreated fellow eyes. Design Longitudinal cohort study. Participants Primary angle-closure suspects aged 50 to 70 years were enrolled in a randomized, controlled clinical trial. Methods Each participant was treated by LPI in 1 randomly selected eye, with the fellow eye serving as a control. Angle width was assessed in a masked fashion using gonioscopy and anterior segment optical coherence tomography (AS-OCT) before and at 2 weeks, 6 months, and 18 months after LPI. Main Outcome Measures Angle width in degrees was calculated from Shaffer grades assessed under static gonioscopy. Angle configuration was also evaluated using angle opening distance (AOD250, AOD500, AOD750), trabecular-iris space area (TISA500, TISA750), and angle recess area (ARA) measured in AS-OCT images. Results No significant difference was found in baseline measures of angle configuration between treated and untreated eyes. At 2 weeks after LPI, the drainage angle on gonioscopy widened from a mean of 13.5° at baseline to a mean of 25.7° in treated eyes, which was also confirmed by significant increases in all AS-OCT angle width measures (P<0.001 for all variables). Between 2 weeks and 18 months after LPI, a significant decrease in angle width was observed over time in treated eyes (P<0.001 for all variables), although the change over the first 5.5 months was not statistically significant for angle width measured under gonioscopy (P = 0.18), AOD250 (P = 0.167) and ARA (P = 0.83). In untreated eyes, angle width consistently decreased across all follow-up visits after LPI, with a more rapid longitudinal decrease compared with treated eyes (P values for all variables ≤0.003). The annual rate of change in angle width was equivalent to 1.2°/year (95% confidence interval [CI], 0.8-1.6) in treated eyes and 1.6°/year (95% CI, 1.3-2.0) in untreated eyes (P<0.001). Conclusions Angle width of treated eyes increased markedly after LPI, remained stable for 6 months, and then decreased significantly by 18 months after LPI. Untreated eyes experienced a more consistent and rapid decrease in angle width over the same time period.
KW - AOD
KW - ARA
KW - AS-OCT
KW - Abbreviations and Acronyms
KW - CI
KW - IOP
KW - IT750
KW - LPI
KW - PACG
KW - PACS
KW - TISA
KW - ZAP
KW - Zhongshan Angle-Closure Prevention
KW - angle opening distance
KW - angle recess area
KW - anterior segment optical coherence tomography
KW - confidence interval
KW - intraocular pressure
KW - iris thickness measured at 750 μm from the scleral spur
KW - laser peripheral iridotomy
KW - primary angle-closure glaucoma
KW - primary angle-closure suspects
KW - trabecular-iris space area
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U2 - 10.1016/j.ophtha.2014.03.039
DO - 10.1016/j.ophtha.2014.03.039
M3 - Article
C2 - 24835757
AN - SCOPUS:84906940545
SN - 0161-6420
VL - 121
SP - 1699
EP - 1705
JO - Ophthalmology
JF - Ophthalmology
IS - 9
ER -