Is increased choroidal thickness association with primary angle closure?

Abstract

Purpose: To investigate whether increased choroidal thickness is a risk factor for primary angle closure.

Methods: The study consisted of 162 patients with primary angle-closure (primary angle-closure suspect [PACS], 73 eyes; primary angle closure [PAC], 33 eyes; and primary angle-closure glaucoma [PACG], 56 eyes) and 87 healthy controls with no ophthalmic symptoms. EDI-OCT was used to measure and to compare the macular choroidal thickness between the primary angle-closure and normal eyes. The association between the choroidal thickness and the presence of primary angle closure was evaluated using logistic regression models to determine the odds ratio.

Results: The primary angle-closure eyes had a thicker choroid than the control eyes at all macular locations (all p < 0.05). It remained significantly thicker after controlling for age, axial length (AL) and gender, except at 1 mm, 3 mm superior and 3 mm nasal from the fovea. Univariate analysis showed that the subfoveal choroidal thickness (SFCT) was significantly associated with primary angle closure. After adjustment for the anterior chamber depth (ACD), vitreous chamber depth (VCD) and lens thickness (LT), the SFCT was still significantly associated with primary angle closure. The odds ratio (OR) and 95% confidence interval (CI) was 1.008 (1.003, 1.014). The choroidal thickness at most macular locations was positively associated with primary angle closure. The area under the curve (AUC) for detecting primary angle closure was 0.619 with SFCT, and the result was statistically significant (p = 0.002).

Conclusions: Primary angle-closure eyes have a higher level of macular choroidal thickness than normal eyes. Increased choroidal thickness might be association with primary angle closure. However, the SFCT showed only low specificity in screening for primary angle closure.

Keywords: association; choroidal thickness; primary angle closure; risk factor.