[New criteria to assess the risk of acute angle closure]

ABSTRACT

To compare anterior segment and ocular biometric parameters of unaffected fellow eyes of patients with a previous attack of acute angle closure [AAC], primary angle closure suspect [PACS] eyes, and normal eyes; and to assess the risk of developing AAC in PACS. In this prospective comparative observational case series, 16 unaffected fellow eyes of patients with a previous attack of AAC [group I], 40 PACS eyes [group II] and 32 normal eyes [group III] were evaluated. Pentacam and A-scan echography were performed in all cases. Anterior chamber angle [ACA], anterior chamber volume [ACV], anterior chamber depth [ACD], central corneal thickness [CCT], keratometry [KR], lens thickness [LT] and axial length [AL] were measured in all eyes as main outcome measures. Age, CCT and LT were comparable among the study groups [all P values>0.05]. Mean ACA was 24.8, 22.9 and 35.4 in groups I, II, and III respectively [P<0.001]. Corresponding values for ACV were 72, 76 and 172 microl, respectively [P<0.001]. Central ACD measured from the endothelium was 1.80, 1.91, and 3.09 mm in groups I, II, and III respectively [P<0.001]. Using receiver operating characteristic [ROC] curves, ACVrisk of AAC with sensitivity of 91.7% [95% Confidence Interval [CI]70 to 99] and specificity of 100% [95% CI 89 to 100]. Corresponding values for ACAeye can be considered at high risk for an attack of AAC with sensitivity of 93.3% [95% CI 70 to 99] and specificity of 100% [95% CI 89 to 100]. Eyes with ACVrisk for developing acute angle closure and can be considered for prophylactic laser peripheral iridotomy [LPI]