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Abstract #61706 Published in IGR 17-1

The Impact of Lens Vault on Visual Acuity and Refractive Error: Implications for Management of Primary Angle-Closure Glaucoma

Nongpiur ME; Singhal S; Stewart S; Htoon HM; Narayanaswamy AK; Wong TY; Perera SA; Aung T
Journal of Glaucoma 2016; 25: e236-e240

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PURPOSE: To investigate the relationship between lens vault (LV), visual acuity (VA), and refraction. METHODS: This was a cross-sectional study of 2047 subjects aged 50 years and older recruited from a community polyclinic. Anterior segment optical coherence tomography was performed, and customized software was used to measure LV. VA was measured using a logarithm of minimum angle of resolution chart (logMAR chart; Lighthouse Inc.), and was classified as normal (logMAR<0.3), mild impairment (0.30.6). Refraction was measured with an autorefractor machine and spherical equivalent was defined as sphere plus half cylinder. Angle closure was defined as posterior trabecular meshwork not visible for ≥2 quadrants on nonindentation gonioscopy. RESULTS: Complete data were available for 1372 subjects including 295 (21.5%) with angle closure. Angle-closure subjects were significantly older (P<0.001), with shorter axial length (P<0.001), shallower anterior chamber depth (P<0.001), and greater LV (P<0.001). There was no significant difference in VA (P=0.12) compared with those without angle closure. After adjusting for age, sex, axial length, anterior chamber depth, and spherical equivalent, there was no significant association between LV and VA (P=0.35) or between LV and spherical equivalent (P=0.06). CONCLUSIONS: The magnitude of LV was not associated with VA or spherical equivalent. Lens extraction may be a consideration in eyes with angle closure with large LV in the absence of visually significant cataract.

*Singapore National Eye Centre, Singapore Eye Research Institute †Duke-NUS Graduate Medical School §Yong Loo Lin School of Medicine, National University of Singapore, Singapore ‡University College London Medical School, London, UK.

Full article

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Classification:

9.3.5 Primary angle closure (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
2.10 Lens (Part of: 2 Anatomical structures in glaucoma)
8.5 Other (Part of: 8 Refractive errors in relation to glaucoma)
6.9.2.1 Anterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)

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