Ocular Biometric Determinants of Intraocular Pressure and Risk Factors for Ocular Hypertension: The Chinese American Eye Study.
Rajagopalan Archeta, Pardeshi Anmol, Apolo Galo, Burkemper Bruce, Jiang Xuejuan, McKean-Cowdin Roberta, Torres Mina, Varma Rohit, Xu Benjamin Y
AI Summary
AS-OCT angle width and iris area strongly predict IOP and ocular hypertension as angles narrow, unlike gonioscopy. This helps identify angle closure patients at higher risk for elevated IOP.
Abstract
Precis: Angle width and iris area measured by anterior OCT are increasingly predictive of intraocular pressure and ocular hypertension below parameter-specific angle width cutoffs. Cumulative gonioscopy score is weakly predictive below all score cutoffs.
Purpose
To assess ocular biometric determinants of intraocular pressure (IOP) and risk factors for ocular hypertension (OHTN).
Methods
CHES participants underwent Goldmann applanation tonometry, gonioscopy, ultrasound A-scan, and anterior segment OCT (AS-OCT) imaging. Biometric data from one eye per participant were used to develop linear and logistic regression models of IOP and OHTN (IOP >21 mm Hg), respectively, below different angle width cutoffs adjusted for central cornea thickness (CCT).
Results
2,360 eyes of 2,360 eligible participants (1,518 female, 842 male) were analyzed. Mean age was 60.2±7.8 years. Multivariable stepwise linear regression models and changepoint analysis showed that below a trabecular iris space area (TISA750) measurement of 0.08 mm2, models became increasingly predictive of IOP up to an adjusted R2 of 0.84. Smaller TISA750 and iris area (IA) were the only parameters consistently associated (P≤0.04) with higher IOP for TISA750 below 0.20, 0.10, and 0.05 mm2. In multivariable models of OHTN (AUC≤0.95), smaller TISA750 was associated with OHTN for TISA750 less than 0.20, 0.10, and 0.05 mm2 (P≤0.03) while IA was associated with OHTN for TISA750 less than 0.05 mm2 (P≤0.03). Cumulative gonioscopy score (sum of gonioscopy grades) was weakly predictive of IOP at all cutoffs (adjusted R2≤0.08).
Conclusion
TISA750 and IA become strongly predictive of IOP when angle width decreases below a TISA750 cutoff of 0.08 mm2. The relationship between cumulative gonioscopy score and IOP is weak below all gonioscopy score cutoffs. AS-OCT measurements could supplement gonioscopy by helping identify individuals at higher risk for elevated IOP from angle closure.
Key Concepts6
Multivariable stepwise linear regression models and changepoint analysis showed that below a trabecular iris space area (TISA750) measurement of 0.08 mm2, models became increasingly predictive of intraocular pressure (IOP) up to an adjusted R2 of 0.84.
Smaller trabecular iris space area (TISA750) and iris area (IA) were consistently associated (P≤0.04) with higher intraocular pressure (IOP) for TISA750 below 0.20, 0.10, and 0.05 mm2 in 2,360 eyes of 2,360 Chinese American Eye Study participants.
In multivariable models of ocular hypertension (OHTN) (AUC≤0.95), smaller trabecular iris space area (TISA750) was associated with OHTN for TISA750 less than 0.20, 0.10, and 0.05 mm2 (P≤0.03) in 2,360 eyes of 2,360 Chinese American Eye Study participants.
Smaller iris area (IA) was associated with ocular hypertension (OHTN) for trabecular iris space area (TISA750) less than 0.05 mm2 (P≤0.03) in 2,360 eyes of 2,360 Chinese American Eye Study participants.
Cumulative gonioscopy score (sum of gonioscopy grades) was weakly predictive of intraocular pressure (IOP) at all cutoffs (adjusted R2≤0.08) in 2,360 eyes of 2,360 Chinese American Eye Study participants.
The Chinese American Eye Study (CHES) involved 2,360 participants who underwent Goldmann applanation tonometry, gonioscopy, ultrasound A-scan, and anterior segment OCT (AS-OCT) imaging, with biometric data from one eye per participant used for analysis.
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