Analysis on the clinical correlation of lens parameters and choroidal thickness with the severity of primary angle closure disease

Abstract Purpose: The purpose of this study is to investigate the correlation of lens parameters and choroidal thickness(RCS) with the severity of primary angle closure disease(PACD) and also to compare those parameters with the normal population. Methods: Prospective, cross-sectional hospital-based study. A total of 86 subjects(162 eyes) including 71 study patients(132 eyes) and 15 age-matched controls(30 eyes) were included in the study.The parameters studied were anterior chamber depth(ACD),lens thickness(LT),anterior vault(AV),lens axial factor(LAF),lens position(LP),relative lens position(RLP),lens vault(LV) and RCS thickness. Results: The mean ACD was significantly shallow in all subtypes of PACG (mean±SD =2.53±0.34mm) compared to controls (4.05±0.16; p=0.0001). Likewise, the mean lens thickness was more in all subtypes of PACD (mean ± SD=4.67 ± 0.26mm) than in normal controls (4.17±0.17mm; p=0.0001). Additionally, PACD patients had higher LV (mean±SD=1174.29±247.87) than in controls (778.23±37.95; p=0.0001), particularly in eyes with AACG (1328.86±77.13). Other biometric parameters like AV, LAF, LP, RLP and RCS thickness revealed a statistically significant difference in PACD compared to the control population(p<0.00001). Pairwise comparison also revealed significant difference in all ocular biometric parameters in AACG compared to other subtypes of PACD. Conclusion: Lens parameters and choroidal thickness correlated significantly with the severity of PACD.Additionally, patients with AACG represented the most severe variety of PACD with significantly increased LV, critically shallow ACD, much anteriorly placed lens with relatively short AL and increased RCS thickness. Our study highlights the interplay of multiple ocular biometric parameters with the disease severity, suggesting the individualised surgical options in patients with PACD.