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Purpose <p>To investigate the role of choroidal thickness (CT) in primary angle-closure disease (PACD).</p> Study design <p>Retrospective study.</p> Methods <p>This retrospective observational study included fifty-one eyes—thirteen with acute primary angle-closure (APAC) with resolved glaucoma attack, twelve with primary angle-closure suspect (PACS), and twenty-six age- and sex-matched controls. Two blinded observers independently measured CT using swept-source optical coherence tomography (SS-OCT) at the subfovea and eight peripheral locations following the Margolis and Spaide method. In addition to routine ophthalmic examinations, the axial length (AL), anterior chamber depth (ACD), and lens vault (LV) were analyzed. Multivariable regression was used to identify associated factors, and the most effective parameters for discriminating PACD were investigated.</p> Results <p>Subfoveal CT (SFCT) was significantly greater in the APAC (293.4&#xa0;±&#xa0;103.7&#xa0;µm) and PACS (283.8&#xa0;±&#xa0;71.9&#xa0;µm) groups than in the control group (210.8&#xa0;±&#xa0;77.2&#xa0;µm; <i>p</i>&#xa0;&lt;&#xa0;0.05). AL and age were each independently negatively associated with SFCT (<i>p</i>&#xa0;&lt;&#xa0;0.05). The CT/AL ratio was significantly greater in both PACD groups than in the control group. This ratio demonstrates superior discriminatory performance compared with absolute CT values in distinguishing eyes affected by PACD from normal eyes. The combination of ACD and LV yielded the highest diagnostic performance (area under the curve: 0.96), with a similar level of performance observed for the combination of the AL and the CT/AL ratio (area under the curve: 0.93).</p> Conclusion <p>Compared with normal eyes, eyes affected by PACD exhibit increased CT and a significantly higher CT/AL ratio. The CT/AL ratio, a novel anatomical index, may provide a normalized metric reflecting choroidal expansion relative to globe size and may serve as a potential structural marker for PACD risk assessment.</p>

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The potential role of the choroidal thickness–to–axial length ratio in primary angle-closure disease

  • 期刊论文

  • 发表日期：

    2026年4月22日

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  • Mika Suda,
  • Daphne Viel Tsuru,
  • Kenji Kashiwagi

摘要

Purpose

To investigate the role of choroidal thickness (CT) in primary angle-closure disease (PACD).

Study design

Retrospective study.

Methods

This retrospective observational study included fifty-one eyes—thirteen with acute primary angle-closure (APAC) with resolved glaucoma attack, twelve with primary angle-closure suspect (PACS), and twenty-six age- and sex-matched controls. Two blinded observers independently measured CT using swept-source optical coherence tomography (SS-OCT) at the subfovea and eight peripheral locations following the Margolis and Spaide method. In addition to routine ophthalmic examinations, the axial length (AL), anterior chamber depth (ACD), and lens vault (LV) were analyzed. Multivariable regression was used to identify associated factors, and the most effective parameters for discriminating PACD were investigated.

Results

Subfoveal CT (SFCT) was significantly greater in the APAC (293.4 ± 103.7 µm) and PACS (283.8 ± 71.9 µm) groups than in the control group (210.8 ± 77.2 µm; p < 0.05). AL and age were each independently negatively associated with SFCT (p < 0.05). The CT/AL ratio was significantly greater in both PACD groups than in the control group. This ratio demonstrates superior discriminatory performance compared with absolute CT values in distinguishing eyes affected by PACD from normal eyes. The combination of ACD and LV yielded the highest diagnostic performance (area under the curve: 0.96), with a similar level of performance observed for the combination of the AL and the CT/AL ratio (area under the curve: 0.93).

Conclusion

Compared with normal eyes, eyes affected by PACD exhibit increased CT and a significantly higher CT/AL ratio. The CT/AL ratio, a novel anatomical index, may provide a normalized metric reflecting choroidal expansion relative to globe size and may serve as a potential structural marker for PACD risk assessment.