Identification of eyes at risk of acute primary angle-closure in elderly Japanese patients

Figures & data

Figure 1 Biometric variables, including central anterior chamber depth (ACD), peripheral ACD, anterior chamber angle (ACA), and anterior chamber volume (ACV), were measured with a Pentacam (A). Representative images for a normal eye, an eye with APAC, and an eye with PACS (B).

Abbreviations: APAC, acute primary angle- closure; PACS, primary angle-closure suspect.

Table 1 Demographic and clinical characteristics of the studied patients

Group	Variable	IOP (mmHg)	AL (mm)	PD (mm)
	Age (years)
APAC men	73.6±8.7	35.6±16.3	22.88±0.99	3.81±0.90
APAC women	74.1±7.4	25.7±14.8	22.24±0.78	3.75±1.34
PACS men	73.7±8.2	12.6±3.9	22.51±0.73	2.48±0.66
PACS women	74.3±7.6	13.4±4.2	22.24±0.85	2.48±0.71
Control men	74.2±6.8	13.1±3.4	24.14±1.44	2.41±0.52
Control women	73.0±7.0	12.8±2.9	23.71±1.62	2.58±0.50

Abbreviations: APAC, acute primary angle-closure; PACS, primary angle-closure suspect; IOP, intraocular pressure; AL, axial length; PD, pupil diameter.

Figure 2 Bar graphs showing central ACD (A), peripheral ACD (B), ACA (C) and ACV (D). Bars represent means of values with 95% confidence intervals.

Abbreviations: ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; APAC, acute primary angle-closure; PACS, primary angle-closure suspect.

Table 2 AUC and optimal anterior segment biometric variable cutoff values determined by ROC curves to identify eyes with APAC

Variable	AUC (95%CI)	P-value	Optimal cutoff value
Men (n=11)
Central ACD	1.000 (1.000–1.000)		1.82 mm
Peripheral ACD	0.982 (0.961–1.002)	0.37	1.27 mm
ACA	0.916 (0.803–1.028)	0.14	26.5 degrees
ACV	0.992 (0.981–1.003)	0.49	71.5 mm^3
Women (n=29)
Central ACD	0.997 (0.993–1.001)		1.97 mm
Peripheral ACD	0.942 (0.888–0.996)	0.029	1.18 mm
ACA	0.922 (0.867–0.996)	0.021	23.9 degrees
ACV	0.946 (0.901–0.992)	0.027	73.5 mm^3

Abbreviations: AUC, area under the curve; ROC, receiver operating characteristic curve; APAC, acute primary angle-closure; CI, confidence interval; ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; P, values obtained by comparison with AUC of the central ACD.

Figure 3 Receiver operating characteristic curves for central ACD, peripheral ACD, ACA, and ACV to identify eyes with APAC in men.

Abbreviations: ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; APAC, acute primary angle-closure.

Figure 4 Receiver operating characteristic curves for central ACD, peripheral ACD, ACA, and ACV to identify eyes with APAC in women.

Abbreviations: ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; APAC, acute primary angle-closure.

Figure 5 Receiver operating characteristic curves for central ACD, peripheral ACD, ACA, and ACV to identify eyes with PACS in men.

Abbreviations: ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; PACS, primary angle-closure suspect.

Table 3 AUC and optimal anterior segment biometric variable cutoff values determined by ROC curves to identify eyes with PACS

Variable	AUC (95%CI)	P-value	Optimal cutoff value
Men (n=13)
Central ACD	0.933 (0.859–1.006)		1.97 mm
Peripheral ACD	0.930 (0.870–0.989)	0.91	1.47 mm
ACA	0.887 (0.786–0.989)	0.61	24.9 degrees
ACV	0.937 (0.888–0.986)	0.89	96.5 mm^3
Women (n=35)
Central ACD	0.960 (0.913–1.008)		1.97 mm
Peripheral ACD	0.957 (0.921–0.993)	0.84	1.18 mm
ACA	0.937 (0.889–0.984)	0.14	23.5 degrees
ACV	0.937 (0.886–0.986)	0.12	79.5 mm^3

Abbreviations: AUC, area under the curve; ROC, receiver operating characteristic curve; PACS, primary angle-closure suspect; CI, confidence interval; ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; P, values obtained in comparison with the AUC of the central ACD.

Figure 6 Receiver operating characteristic curves for central ACD, peripheral ACD, ACA, and ACV to identify eyes with PACS in women.

Abbreviations: ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume; PACS, primary angle-closure suspect.

Table 4 Sensitivity, specificity, and positive and negative predictive values of anterior segment biometric variables to identify eyes with APAC

Variable	Sensitivity % (95%CI)	Specificity % (95%CI)	Positive predictive value % (95%CI)	Negative predictive value % (95%CI)
Men (n=11)
Central ACD	100 (71.5–100)	100 (98.3–100)	100 (97.3–100)	100 (98.2–100)
Peripheral ACD	100 (71.5–100)	90.1 (85.3–93.7)	33.3 (15.4–48.1)	100 (97.9–100)
ACA	90.9 (58.7–99.7)	82.6 (76.9–87.5)	26.8 (12.8–41.2)	100 (97.8–100)
ACV	100 (66.4–100)	93.9 (89.8–96.7)	50.0 (35.1–66.5)	100 (98.2–100)
Women (n=29)
Central ACD	100 (86.3–100)	90.3 (86.0–93.6)	84.8 (68.4–97.5)	100 (98.9–100)
Peripheral ACD	88.0 (68.8–97.5)	88.7 (84.2–92.3)	59.1 (44.3–73.7)	98.7 (96.4–99.9)
ACA	80.0 (59.3–93.2)	89.9 (85.5–93.3)	62.9 (48.4–79.1)	97.1 (94.6–99.1)
ACV	84.0 (63.9–95.5)	91.4 (87.3–94.6)	66.7 (51.3–82.5)	97.9 (95.6–99.3)

Abbreviations: APAC, acute primary angle-closure; CI, confidence interval; ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume.

Table 5 Sensitivity, specificity, and positive and negative predictive values of anterior segment biometric variables to identify eyes with PACS

Variable	Sensitivity % (95%CI)	Specificity % (95%CI)	Positive predictive value % (95%CI)	Negative predictive value % (95%CI)
Men (n=13)
Central ACD	76.9 (46.2–95.0)	98.6 (95.9–99.7)	76.9 (43.1–99.7)	98.6 (95.9–99.7)
Peripheral ACD	100 (73.5–100)	73.2 (66.8–79.1)	19.4 (12.4–29.1)	100 (97.7–100)
ACA	76.9 (46.2–94.9)	90.1 (85.3–93.8)	32.3 (20.8–50.1)	98.5 (95.5–99.7)
ACV	92.3 (64.0–99.8)	81.7 (75.8–86.6)	24.5 (17.1–34.3)	99.4 (97.1–99.8)
Women (n=35)
Central ACD	91.4 (76.9–98.2)	98.0 (95.3–99.3)	86.5 (69.5–99.7)	98.8 (96.3–99.9)
Peripheral ACD	91.4 (76.9–98.2)	92.2 (88.2–95.2)	64.7 (49.2–76.8)	99.1 (96.7–99.8)
ACA	79.4 (62.1–91.3)	95.9 (92.6–98.0)	67.4 (51.2–82.8)	97.5 (95.4–99.3)
ACV	88.6 (73.3–96.8)	89.0 (84.4–92.6)	56.1 (41.7–72.1)	98.2 (95.5–99.6)

Abbreviations: PACS, primary angle-closure suspect; CI, confidence interval; ACD, anterior chamber depth; ACA, anterior chamber angle; ACV, anterior chamber volume.