title: Determinants of lens vault and association with narrow angles in patients from Singapore.
abstract: OBJECTIVE
  To describe the distribution and determinants of lens vault and to investigate the association of lens vault with narrow angles.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  Phakic subjects 50 years and older were evaluated at a primary healthcare clinic with gonioscopy, partial laser interferometry, and anterior segment optical coherence tomography (AS-OCT). Narrow angles were defined as posterior trabecular meshwork not visible for ≥2 quadrants on non-indentation gonioscopy. Lens vault was defined as the perpendicular distance between the anterior pole of the crystalline lens and the horizontal line joining the 2 scleral spurs on horizontal AS-OCT scans. Analysis of covariance, multivariate logistic regression, and area under the receiver operating characteristic curves (AUC) were performed.
  
  
  RESULTS
  Of the 2047 subjects recruited, 582 were excluded because of poor image quality or inability to locate scleral spurs, leaving 1465 subjects for analysis. Eyes with narrow angles had greater lens vault compared to eyes with open angles (775.6 µm vs 386.5 µm, P < .0001). Women had significantly greater lens vault than men (497.28 µm vs 438.56 µm, P < .001), and lens vault increased significantly with age (P for trend <.001). Adjusted for age and sex, significant associations with greater lens vault were shorter axial length, shallower anterior chamber depth(ACD), higher intraocular pressure, and more hyperopic spherical equivalent (all P < .001). On multivariate analysis, subjects with lens vault >667.6 µm were more likely to have narrow angles (OR 2.201, 95% CI: 1.070-4.526) compared to those with lens vault ≤462.7 µm. The AUC for lens vault (0.816) and ACD (0.822) for detecting narrow angles were similar (P = .582).
  
  
  CONCLUSIONS
  Lens vault was independently associated with narrow angles and may be useful in screening to detect eyes with narrow angles.
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
authors.forename: Gavin S
authors.initials: GS
authors.lastname: Tan
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
authors.forename: Wanting
authors.initials: W
authors.lastname: Zhao
authors.forename: Lisandro M
authors.initials: LM
authors.lastname: Sakata
authors.forename: Jialiang
authors.initials: J
authors.lastname: Li
authors.forename: Monisha E
authors.initials: ME
authors.lastname: Nongpiur
authors.forename: Raghavan
authors.initials: R
authors.lastname: Lavanya
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
mesh_terms: D000368:Aged; D000869:Anterior Eye Segment / Q000473:pathology*; D019540:Area Under Curve; D058452:Axial Length, Eye / Q000473:pathology; D001699:Biometry; D003430:Cross-Sectional Studies; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000175:diagnosis*; D006068:Gonioscopy; D006801:Humans; D007368:Interferometry; D007905:Lens Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D041623:Tomography, Optical Coherence