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Transl Vis Sci TechnolSeptember 20230 citations

Classification of Angle Closure Severity by Hierarchical Cluster Analysis of Ocular Biometrics in the Dark and Light.

Cho Austin, Lewinger Juan Pablo, Pardeshi Anmol A, Aroca Galo Apolo, Torres Mina, Nongpiur Monisha, Jiang Xuejuan, McKean-Cowdin Roberta, Varma Rohit, Xu Benjamin Y


AI Summary

This study classified angle closure eyes using AS-OCT biometrics, finding that measurements, particularly in light, can distinguish disease severity and predict primary angle closure glaucoma, aiding risk stratification.

Abstract

Purpose

The purpose of this study was to investigate the classification of angle closure eyes based on hierarchical cluster analysis of ocular biometrics measured in the dark and light using anterior segment optical coherence tomography (AS-OCT).

Methods

Participants of the Chinese American Eye Study received complete eye examinations to identify primary angle closure suspects (PACS) and primary angle closure without/with glaucoma (PAC/G). AS-OCT was performed in the dark and light. Biometric parameters describing the angle, iris, lens, and anterior chamber were analyzed. Hierarchical clustering was performed using Ward's method. Post hoc logistic regression models were developed to identify biometric predictors of angle closure staging.

Results

Analysis of 159 eyes with PACS (N = 120) or PAC/G (N = 39) produced 2 clusters in the dark and light. In both analyses, cluster 1 (N = 132 in the dark and N = 126 in the light) was characterized by smaller angle opening distance (AOD)750 and trabecular iris space area (TISA)750, greater iris curvature (IC), and greater lens vault (LV; P < 0.001) than cluster 2. The proportion of PAC/PACG to PACS eyes was significantly higher in cluster 1 than 2 in the light (36:90 and 3:30, respectively; P = 0.02), but not the dark (36:96 and 3:24, respectively; P = 0.08). On multivariable regression analyses, smaller TISA750 (odds ratio [OR] = 0.84 per 0.01 mm2) and AOD750 (OR = 0.93 per 0.01 mm) in the light and smaller TISA750 (OR = 0.86 per 0.01 mm2) in the dark conferred higher risk of PAC/G (P ≤ 0.02).

Conclusions

Unsupervised cluster analysis of ocular biometrics can classify angle closure eyes by severity. Static biometrics measured in the light and dark are both predictive of PAC/G.

Translational relevance: Clustering of biometrics measured in the light could provide an alternative source of information to risk-stratify angle closure eyes for more severe disease.


MeSH Terms

HumansAnterior ChamberGlaucomaTomography, Optical CoherenceBiometryCluster Analysis

Key Concepts4

In both dark and light analyses of 159 eyes with PACS or PAC/G, cluster 1 (N = 132 in the dark and N = 126 in the light) was characterized by smaller angle opening distance (AOD)750 and trabecular iris space area (TISA)750, greater iris curvature (IC), and greater lens vault (LV) (P < 0.001) compared to cluster 2.

DiagnosisCross-sectionalCross-sectional studyn=159 eyes (120 PACS, 39 PAC/G)Ch3Ch4Ch8

The proportion of primary angle closure without/with glaucoma (PAC/PACG) to primary angle closure suspects (PACS) eyes was significantly higher in cluster 1 than 2 in the light (36:90 and 3:30, respectively; P = 0.02), but not in the dark (36:96 and 3:24, respectively; P = 0.08) in a study of 159 eyes.

PrognosisCross-sectionalCross-sectional studyn=159 eyes (120 PACS, 39 PAC/G)Ch8Ch10Ch13

On multivariable regression analyses in 159 eyes with PACS or PAC/G, smaller trabecular iris space area (TISA)750 (odds ratio [OR] = 0.84 per 0.01 mm2) and angle opening distance (AOD)750 (OR = 0.93 per 0.01 mm) in the light, and smaller TISA750 (OR = 0.86 per 0.01 mm2) in the dark conferred a higher risk of primary angle closure without/with glaucoma (PAC/G) (P ≤ 0.02).

PrognosisCross-sectionalCross-sectional studyn=159 eyes (120 PACS, 39 PAC/G)Ch3Ch4Ch8Ch10

Hierarchical cluster analysis of ocular biometrics in 159 eyes with primary angle closure suspects (PACS, N=120) or primary angle closure without/with glaucoma (PAC/G, N=39) produced two clusters in both dark and light conditions.

MethodologyCross-sectionalCross-sectional studyn=159 eyes (120 PACS, 39 PAC/G)Ch3Ch4

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