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Background <p>Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asian populations. However, the topographic distribution of angle narrowing across different quadrants remains incompletely characterized in primary angle-closure suspects (PACS), and routine clinical assessments often rely solely on horizontal scans. The study aims to identify the narrowest anterior chamber angle quadrant in PACS using Anterior Segment Optical Coherence Tomography (AS-OCT).</p> Methods <p>In this community-based cross-sectional study, 218 right eyes of 218 PACS subjects were recruited. All participants underwent standardized questionnaire surveys and ophthalmic examinations. AS-OCT parameters including angle opening distance (AOD), trabecular iris space area (TISA) and trabecular iris angle (TIA) were measured at 500&#xa0;μm from the sclera spur (SS) in the superior, inferior, nasal and temporal quadrants. As iridotrabecular contact (ITC) in more than one quadrant precluded identification of the narrowest quadrant, only narrow-angle eyes (ITC in &lt; 2 quadrants) were included in the analysis. Quadrant-wise comparisons and multivariate linear regression analyses were performed.</p> Results <p>Significant differences in angle width were observed across all four quadrants (<i>P</i>&lt;0.001 for AOD500, TISA500, and TIA500). The superior quadrant exhibited the narrowest angle, followed by the inferior, nasal, and temporal quadrants in narrow-angle eyes. Multivariate linear regression analysis revealed that superior anterior chamber volume (ACV- superior)was positively associated (<i>P</i>&lt;0.001), while superior iris thickness at 750&#xa0;μm (IT750-superior) was negatively associated (<i>P</i> = 0.049) to superior AOD500.</p> Conclusion <p>The superior quadrant is consistently the narrowest in PACS eyes, highlighting the necessity of including vertical cross-sectional scans in routine AS-OCT examination protocols for this population.</p> Trial registration <p>The study was registered in the Chinese Clinical Trial Registry on September 4th, 2020 (Registration Number: ChiCTR2000037944).</p>

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Quadrant-specific assessment of anterior chamber angles in primary angle-closure suspects using anterior segment-OCT: a cross-sectional observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Xiaohua Pan,
  • Ye Zhang,
  • Qing Zhang,
  • Hui Feng,
  • Fei Xiang,
  • Caixia Li,
  • Meijuan Zhang,
  • Qianqian Ji,
  • Zhi Li,
  • Na Jiang,
  • Yue Yang,
  • Zhongyin Hu,
  • Kai Cao,
  • Merry Z. C. Ruan,
  • Ning Fan,
  • Ying Han,
  • Shuning Li

摘要

Background

Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness in Asian populations. However, the topographic distribution of angle narrowing across different quadrants remains incompletely characterized in primary angle-closure suspects (PACS), and routine clinical assessments often rely solely on horizontal scans. The study aims to identify the narrowest anterior chamber angle quadrant in PACS using Anterior Segment Optical Coherence Tomography (AS-OCT).

Methods

In this community-based cross-sectional study, 218 right eyes of 218 PACS subjects were recruited. All participants underwent standardized questionnaire surveys and ophthalmic examinations. AS-OCT parameters including angle opening distance (AOD), trabecular iris space area (TISA) and trabecular iris angle (TIA) were measured at 500 μm from the sclera spur (SS) in the superior, inferior, nasal and temporal quadrants. As iridotrabecular contact (ITC) in more than one quadrant precluded identification of the narrowest quadrant, only narrow-angle eyes (ITC in < 2 quadrants) were included in the analysis. Quadrant-wise comparisons and multivariate linear regression analyses were performed.

Results

Significant differences in angle width were observed across all four quadrants (P<0.001 for AOD500, TISA500, and TIA500). The superior quadrant exhibited the narrowest angle, followed by the inferior, nasal, and temporal quadrants in narrow-angle eyes. Multivariate linear regression analysis revealed that superior anterior chamber volume (ACV- superior)was positively associated (P<0.001), while superior iris thickness at 750 μm (IT750-superior) was negatively associated (P = 0.049) to superior AOD500.

Conclusion

The superior quadrant is consistently the narrowest in PACS eyes, highlighting the necessity of including vertical cross-sectional scans in routine AS-OCT examination protocols for this population.

Trial registration

The study was registered in the Chinese Clinical Trial Registry on September 4th, 2020 (Registration Number: ChiCTR2000037944).