Diagnostic power of scleral spur length in primary open-angle glaucoma

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 258; no. 6; pp. 1253 - 1260
• Main Authors: Li, Mu, Luo, Zhaoxia, Yan, Xiaoqin, Zhang, Hong
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2020; Springer Nature B.V
• Subjects: Adult; Eye; Female; Glaucoma; Glaucoma, Open-Angle - diagnosis; Gonioscopy; Healthy Volunteers; Humans; Intraocular Pressure - physiology; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; ROC Curve; Sclera - diagnostic imaging; Sclera - pathology; Tomography, Optical Coherence; Tonometry, Ocular; Trabecular Meshwork - pathology; Visual Acuity - physiology; Scleral spur length; Swept-source optical coherence tomography; Receiver operating characteristic curve; Primary open-angle glaucoma; Schlemm’s canal
• ISSN: 0721-832X; 1435-702X; 1435-702X
• DOI: 10.1007/s00417-020-04637-4

Purpose To investigate the diagnostic capability of scleral spur length in discriminating eyes with primary open-angle glaucoma (POAG) from healthy eyes. Methods Seventy-eight eyes of 78 patients with POAG and 93 eyes of 93 age-, sex- and axial length-matched healthy subjects were included. The scleral spur length was measured using swept-source optical coherence tomography. Receiver operating characteristic (ROC) curves were derived based on the measurements. Results The scleral spur length was significantly shorter in POAG eyes compared with healthy eyes (Method I, 164.91 ± 23.36 vs. 197.60 ± 25.32 μm; Method II, 145.15 ± 16.59 vs. 166.95 ± 19.31 μm; Method III, 162.33 ± 22.83 vs. 185.12 ± 23.58 μm, respectively; all p  < 0.001). The areas under ROC curves were 0.841 (Method I), 0.810 (Method II), and 0.753 (Method III) for the scleral spur length. Moreover, Schlemm’s canal area was significantly associated with the scleral spur length (Method I) in both POAG (β = 0.027; p  < 0.001) and healthy (β = 0.016; p  = 0.009) groups. Conclusions The scleral spur length had a good discriminating capability between POAG and healthy eyes, and it could be a novel biomarker for POAG evaluation clinically.