Factors Associated With Anterior Chamber Depth Changes in Primary Angle-Closure Suspects Over 5-Year Follow-Up

Purpose: To evaluate longitudinal changes in anterior chamber depth (ACD) in primary angle-closure suspects (PACS) over 5-year follow-up and identify factors associated with these changes. Methods: Participants aged 50 years or older were enrolled from Daxing District, Beijing, China. Anterior chamber parameters were assessed at baseline and at 5-year follow-up using anterior segment optical coherence tomography and Lenstar 900. Baseline demographics, ocular characteristics, and longitudinal changes in anterior chamber parameters were compared between groups. Univariate and multivariate linear regression analyses were performed to identify factors associated with changes in ACD. Results: A total of 101 eyes with PACS and 136 control eyes without PACS (NPACS) were analyzed. At 5-year follow-up, both groups showed significant decreases in ACD and significant increases in lens thickness, lens thickness/axial length factor (LAF), and lens vault (LV) compared with baseline (all P < 0.001). In multivariate subgroup analyses stratified by baseline age (group A: 50–60 years, n = 128; group B: >60 years, n = 109), ACD shallowing in group A was associated with hypermetropia, greater follow-up to baseline change in LAF, and greater follow-up to baseline change in LV (all P < 0.001). In group B, ACD shallowing was associated with diagnosis of PACS (P = 0.027) and greater follow-up to baseline change in LV (P < 0.001). Conclusions: ACD decreased over 5 years in participants with both PACS and NPACS. ACD shallowing was associated with both lens thickening and increased LV in relatively younger participants, whereas it was associated mainly with increased LV in relatively older participants. Translational Relevance: These findings suggest that lens enlargement and anterior lens displacement may contribute differently to ACD shallowing across age groups, which may aid in the interpretation of longitudinal anterior segment changes in PACS.