Abstract
To compare healthy eyes to the fellow eyes of acute primary angle closure (F-APAC), healthy eyes to the fellow eyes of chronic primary angle closure glaucoma (F-CPACG), and these fellow eyes to each other (F-APAC vs. F-CPACG). This study included patients with PACG (72 eyes) and healthy individuals (22 eyes). Parameters were measured on ultrasound biomicroscopy images, including anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber area (ACA), lens vault (LV), relative position lens vault (RPLV), anterior segment depth (ASD), angle opening distance at 500 μm (AOD500), trabecular iris space area at 500 μm (TISA 500), trabecular iris angle at 500 μm (TIA500), iris thickness at 500 μm (IT500), peripheral iris thickness maximum (PITMAX), iris curvature (IC). Multivariate logistic regression analysis was performed to determine the most important parameters associated with F-APAC compared with F-CPACG. In total, 94 eyes of 94 patients were included. The ACD(P < 0.001), ACW(P < 0.018), ACA(P < 0.001), ASD(P = 0.006), AOD500(P < 0.001), TIA500(P < 0.001) and TISA500(P < 0.001) of the F-APAC were smaller than the healthy, and LV(P < 0.001), RPLV(P < 0.001), IC(P < 0.001) were larger than that. The ACD(P < 0.001), ACA(P < 0.001), ASD(P < 0.001), AOD500(P < 0.001), TISA500(P < 0.001) and TIA500(P < 0.001) of the F-CPACG were smaller than the healthy, and the LV(P < 0.001), RPLV(P < 0.001), PITMAX(P = 0.030), IC(P < 0.001) were larger than that. The LV(P = 0.027), AOD500(P = 0.013), TISA500(P = 0.03), TIA500(P = 0.006), IC(P = 0.48) of F-APAC were larger than F-CPACG, and PITMAX (P = 0.037) was smaller than F-CPACG. Multivariate logistic regression showed that only larger LV was significantly associated with APAC(P = 0.017). LV (AUC, 0.643) performed relatively in distinguishing the F-APAC and the F-CPACG. Anterior shift of the lens and iris bombe promoted the occurrence of APAC, thickening of the peripheral iris played vital roles in CPACG. Additionally, the LV was an important parameter to distinguish APAC or CPACG.
Similar content being viewed by others
Data availability
The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
References
Teo, Z. L. et al. Six-Year incidence and risk factors for primary Angle-Closure disease: the Singapore epidemiology of eye diseases study. Ophthalmology 129 (7), 792–802. https://doi.org/10.1016/j.ophtha.2022.03.009 (2022).
Tham, Y. C. et al. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology 121 (11), 2081–2090. https://doi.org/10.1016/j.ophtha.2014.05.013 (2014).
Jayaram, H., Kolko, M., Friedman, D. S. & Gazzard, G. Glaucoma: now and beyond. Lancet (London England). 402 (10414), 1788–1801. https://doi.org/10.1016/S0140-6736(23)01289-8 (2023).
European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. British J. Ophthalmol. 105 (Suppl 1), 1–169. https://doi.org/10.1136/bjophthalmol-2021-egsguidelines (2021).
Wang, Z., Wiggs, J. L., Aung, T., Khawaja, A. P. & Khor, C. C. The genetic basis for adult onset glaucoma: recent advances and future directions. Prog. Retin. Eye Res. 90, 101066. https://doi.org/10.1016/j.preteyeres.2022.101066 (2022).
Wang, Y., Guo, Y., Zhang, Y., Huang, S. & Zhong, Y. Differences and similarities between primary open angle glaucoma and primary angle-Closure glaucoma. Eye Brain. 16, 39–54. https://doi.org/10.2147/EB.S472920 (2024).
Theinert, C., Wiedemann, P. & Unterlauft, J. D. Laser peripheral iridotomy changes anterior chamber architecture. Eur. J. Ophthalmol. 27 (1), 49–54. https://doi.org/10.5301/ejo.5000804 (2017).
Huang, W., Li, X., Gao, X. & Zhang, X. The anterior and posterior biometric characteristics in primary angle-closure disease: data based on anterior segment optical coherence tomography and swept-source optical coherence tomography. Indian J. Ophthalmol. 69 (4), 865–870. https://doi.org/10.4103/ijo.IJO_936_20 (2021).
You, S. et al. Novel discoveries of anterior segment parameters in fellow eyes of acute primary angle closure and chronic primary angle closure glaucoma. Investig. Ophthalmol. Vis. Sci. 62 (14), 6. https://doi.org/10.1167/iovs.62.14.6 (2021).
Shabana, N. et al. Quantitative evaluation of anterior chamber parameters using anterior segment optical coherence tomography in primary angle closure mechanisms. Clin. Exp. Ophthalmol. 40 (8), 792–801. https://doi.org/10.1111/j.1442-9071.2012.02805.x (2012).
Wang, F., Wang, D. & Wang, L. Exploring the occurrence mechanisms of acute primary angle closure by comparative analysis of ultrasound biomicroscopic data of the attack and fellow eyes. BioMed Res. Int. 2020, 8487907 https://doi.org/10.1155/2020/8487907 (2020).
Yan, C., Yu, Y., Wang, W., Han, Y. & Yao, K. Long-term effects of mild cataract extraction versus laser peripheral iridotomy on anterior chamber morphology in primary angle-closure suspect eyes. Br. J. Ophthalmol. 108 (6), 812–817. https://doi.org/10.1136/bjo-2022-322698 (2024).
Gao, X. et al. Predictive equation for angle opening distance at 750µm after laser peripheral iridotomy in primary angle closure suspects. Front. Med. 8, 715747. https://doi.org/10.3389/fmed.2021.715747 (2021).
Guo, L. et al. Anterior segment features in neovascular glaucoma: an ultrasound biomicroscopy study. Eur. J. Ophthalmol. 11206721241252476 https://doi.org/10.1177/11206721241252476 (2024).
Xie, Q. et al. Anterior segment OCT in primary angle closure disease compared with normal subjects with similar shallow anterior chamber. J. Glaucoma. 31 (2), 84–90. https://doi.org/10.1097/IJG.0000000000001915 (2022).
Loo, Y. et al. Association of peripheral anterior synechiae with anterior segment parameters in eyes with primary angle closure glaucoma. Sci. Rep. 11 (1), 13906. https://doi.org/10.1038/s41598-021-93293-7 (2021).
Senthilkumar, V. A., Pradhan, C., Rajendrababu, S., Krishnadas, R. & Mani, I. Comparison of uveal parameters between acute primary angle-closure eyes and fellow eyes in South Indian population. Indian J. Ophthalmol. 70 (4), 1232–1238. https://doi.org/10.4103/ijo.IJO_1561_21 (2022).
Wang, B. et al. Analyzing anatomical factors contributing to angle closure based on anterior segment optical coherence tomography imaging. Curr. Eye Res. 47 (2), 256–261. https://doi.org/10.1080/02713683.2021.1978098 (2022).
Xu, B. Y. et al. Ocular biometric risk factors for progression of primary angle closure disease: the Zhongshan angle closure prevention trial. Ophthalmology 129 (3), 267–275. https://doi.org/10.1016/j.ophtha.2021.10.003 (2022).
Panda, S. K. et al. Changes in Iris stiffness and permeability in primary angle closure glaucoma. Investig. Ophthalmol. Vis. Sci. 62 (13), 29. https://doi.org/10.1167/iovs.62.13.29 (2021).
Yoshimizu, S., Hirose, F., Takagi, S., Fujihara, M. & Kurimoto, Y. Comparison of pretreatment measurements of anterior segment parameters in eyes with acute and chronic primary angle closure. Jpn J. Ophthalmol. 63 (2), 151–157. https://doi.org/10.1007/s10384-019-00651-0 (2019).
Guzman, C. P. et al. Anterior segment optical coherence tomography parameters in subtypes of primary angle closure. Investig. Ophthalmol. Vis. Sci. 54 (8), 5281–5286. https://doi.org/10.1167/iovs.13-12285 (2013).
Quigley, H. A., Friedman, D. S. & Congdon, N. G. Possible mechanisms of primary angle-closure and malignant glaucoma. J. Glaucoma. 12 (2), 167–180. https://doi.org/10.1097/00061198-200304000-00013 (2003).
Allam, R. S., Raafat, K. A. & Elmohsen, M. N. A. Nasal trabeculo-ciliary angle and relative lens vault as predictors for intraocular pressure reduction following phacoemulsification. Eur. J. Ophthalmol. 32 (5), 3019–3028. https://doi.org/10.1177/11206721211055033 (2022).
He, M. et al. Laser peripheral iridotomy for the prevention of angle closure: a single-centre, randomised controlled trial. Lancet (London England). 393 (10181), 1609–1618. https://doi.org/10.1016/S0140-6736(18)32607-2 (2019).
Chen, H. J., Wang, X., Yan, Y. J. & Wu, L. L. Postiridotomy ultrasound biomicroscopy features in the fellow eye of Chinese patients with acute primary angle-closure and chronic primary angle-closure glaucoma. J. Glaucoma. 24 (3), 233–237. https://doi.org/10.1097/IJG.0000000000000086 (2015).
Wang, B. S. et al. Increased Iris thickness and association with primary angle closure glaucoma. Br. J. Ophthalmol. 95 (1), 46–50. https://doi.org/10.1136/bjo.2009.178129 (2011).
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Liang Guo, Yan Wu, Na Wang, Qingyi Liu, Zhimin Shen, and Lu Yang. The first draft of the manuscript was written by Liang Guo, Yan Wu and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethics approval and consent to participate
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of The Affiliated Eye Hospital of Nanchang University.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Guo, L., Wu, Y., Wang, N. et al. Differences of anterior segment features in fellow eyes of primary angle closure glaucoma and healthy eyes. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35075-7
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-35075-7
