Comparison of pretreatment measurements of anterior segment parameters in eyes with acute and chronic primary angle closure

  • Satoru YoshimizuEmail author
  • Fumitaka Hirose
  • Seiji Takagi
  • Masashi Fujihara
  • Yasuo Kurimoto
Clinical Investigation



To compare pretreatment anterior segment parameters between eyes with acute primary angle closure (APAC) and chronic primary angle closure (CPAC), and to identify the characteristics of eyes with APAC.

Study design



We measured pretreatment anterior chamber depth (ACD), iris convexity (IC), and pupil diameter in eyes with APAC and CPAC using anterior segment optical coherence tomography. The risk of APAC associated with anterior segment parameters was investigated using multiple logistic regression. Eyes with APAC were discriminated from eyes with CPAC using the receiver-operating characteristic (ROC) curve and area under the curve (AUC). The best cutoff for these variables was determined.


Thirty-four eyes with APAC and 60 eyes with CPAC were included. The mean intraocular pressure was 52.3 ± 12.6 mmHg in APAC and 15.5 ± 3.5 mmHg in CPAC (P < .001). Eyes with APAC had a shallower ACD (1.407 ± 0.301 mm vs. 1.960 ± 0.205 mm, P < .001) and less IC (0.233 ± 0.087 mm vs. 0.294 ± 0.068 mm, P < .001) than eyes with CPAC. In multivariate analysis, significant variables associated with APAC were ACD (P < .001) and IC (P = .001). The AUC for ACD was 0.931 and for IC, 0.742. The best cutoff for ACD was 1.699 mm (sensitivity 0.824, specificity 0.917) and for IC, 0.282 mm (sensitivity 0.853, specificity 0.533).


Eyes with APAC had a shallower ACD and less IC. Eyes with an ACD < 1.7 mm may be at risk for APAC.


Acute primary angle closure Angle closure Anterior chamber depth Anterior segment optical coherence tomography Iris convexity 


Conflicts of interest

S Yoshimizu, None; F. Hirose, None; S. Takagi; None, M. Fujihara; None, Y. Kurimoto; Grant (Alcon, AMO, Bayer, Canon, HOYA, Kowa, Novartis, Otsuka, Pfizer, Santen, Senju).


  1. 1.
    Moghimi S, Vahedian Z, Fakhraie G, Ghaffari R, Eslami Y, Jabarvand M, et al. Ocular biometry in the subtypes of angle closure: an anterior segment optical coherence tomography study. Am J Ophthalmol. 2013;155:664–673, 673.e1.CrossRefGoogle Scholar
  2. 2.
    Guzman CP, Gong T, Nongpiur ME, Perera SA, How AC, Lee HK, et al. Anterior segment optical coherence tomography parameters in subtypes of primary angle closure. Investig Ophthalmol Vis Sci. 2013;54:5281–6.CrossRefGoogle Scholar
  3. 3.
    Atalay E, Nongpiur ME, Baskaran M, Sharma S, Perera SA, Aung T. Biometric factors associated with acute primary angle closure: comparison of the affected and fellow eye. Investig Ophthalmol Vis Sci. 2016;57:5320–5.CrossRefGoogle Scholar
  4. 4.
    Sng CCA, Aquino MCD, Liao J, Ang M, Zheng C, Loon SC, et al. Pretreatment anterior segment imaging during acute primary angle closure: insights into angle closure mechanisms in the acute phase. Ophthalmology. 2014;121:119–25.CrossRefGoogle Scholar
  5. 5.
    Lee JR, Sung KR, Han S. Comparison of anterior segment parameters between the acute primary angle closure eye and the fellow eye. Investig Ophthalmol Vis Sci. 2014;55:3646–50.CrossRefGoogle Scholar
  6. 6.
    Aung T, Friedman DS, Chew PTK, Ang LP, Gazzard G, Lai Y-F, et al. Long-term outcomes in asians after acute primary angle closure. Ophthalmology. 2004;111:1464–9.CrossRefGoogle Scholar
  7. 7.
    Weinreb RN. Angle closure and angle closure glaucoma. Amsterdam: Kugler Publications; 2006. p. 21.Google Scholar
  8. 8.
    Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol. 2002;86:238–42.CrossRefGoogle Scholar
  9. 9.
    Nonaka A, Iwawaki T, Kikuchi M, Fujihara M, Nishida A, Kurimoto Y. Quantitative evaluation of iris convexity in primary angle closure. Am J Ophthalmol. 2007;143:695–7.CrossRefGoogle Scholar
  10. 10.
    Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988;240:1285–93.CrossRefGoogle Scholar
  11. 11.
    Radhakrishnan S, Chen PP, Junk AK, Nouri-Mahdavi K, Chen TC. Laser peripheral iridotomy in primary angle closure: a report by the American Academy of Ophthalmology. Ophthalmology. 2018;125:1110–20.CrossRefGoogle Scholar
  12. 12.
    Azuara-Blanco A, Burr J, Ramsay C, Cooper D. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet. 2016;388:1389–97.CrossRefGoogle Scholar
  13. 13.
    Moghimi S, Zandvakil N, Vahedian Z, Mohammadi M, Fakhraie G, Coleman AL, et al. Acute angle closure: qualitative and quantitative evaluation of the anterior segment using anterior segment optical coherence tomography. Clin Exp Ophthalmol. 2014;42:615–22.CrossRefGoogle Scholar
  14. 14.
    Matsuki T, Hirose F, Ito S-I, Hata M, Hirami Y, Kurimoto Y. Influence of anterior segment biometric parameters on the anterior chamber angle width in eyes with angle closure. J Glaucoma. 2015;24:144–8.CrossRefGoogle Scholar
  15. 15.
    Sakai H, Morine-Shinjyo S, Shinzato M, Nakamura Y, Sakai M, Sawaguchi S. Uveal effusion in primary angle-closure glaucoma. Ophthalmology. 2005;112:413–9.CrossRefGoogle Scholar
  16. 16.
    Tan GS, He M, Zhao W, Sakata LM, Li J, Nongpiur ME, et al. Determinants of Lens Vault and Association With Narrow Angles in Patients From Singapore. Ophthalmology. 2012;154:39–46.Google Scholar

Copyright information

© Japanese Ophthalmological Society 2019

Authors and Affiliations

  • Satoru Yoshimizu
    • 1
    • 2
    Email author
  • Fumitaka Hirose
    • 1
    • 2
  • Seiji Takagi
    • 1
    • 2
    • 3
  • Masashi Fujihara
    • 1
    • 2
  • Yasuo Kurimoto
    • 1
    • 2
  1. 1.Department of OphthalmologyKobe City Eye HospitalKobeJapan
  2. 2.Department of OphthalmologyKobe City Medical Center General HospitalKobeJapan
  3. 3.Department of OphthalmologyToho University, Ohashi Medical CenterTokyoJapan

Personalised recommendations