Ophthalmology in China ›› 2025, Vol. 34 ›› Issue (3): 207-212.doi: 10.13281/j.cnki.issn.1004-4469.2024.03.006

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Characteristics of the foveal avascular zone in the primary angle-closure suspect population

Song Liqin1, Li Caixia2, Wang Sijian3, Shao Xian4, Wei Hongyu4, Wang Yi3, Wang Zehua3, Li Mengyang3, Li Shuning3   

  1. 1 Clinical Medical College, Dali University, Dali Yunnan 671000, China; 2 Xi'an People's Hospital, Xi'an Fourth Hospital, Shaanxi Ophthalmology Hospital, Xi'an 710004, China; 3 Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China; 4 The First Affiliated Hospital of Kunming Medical University, Kunming 650500, China
  • Received:2024-09-26 Online:2025-05-25 Published:2025-05-25
  • Contact: Li Shuning, Email: lishuningqd@163.com
  • Supported by:
    Capital Health Development Research Special Fund (2022-1-2052)

Abstract:  Objective  To observe characteristics of the foveal avascular zone (FAZ) in the primary angle-closure suspect (PACS) population. Design Cross-sectional study. Participants A total of 153 PACS and 153 age- and sex-matched non-primary angle-closure suspects (non-PACS, NPACS) subjects. Methods The study utilized OCTA to measure the FAZ-related macular vessel density parameters in the subjects. Comprehensive assessments included height, weight, glycated hemoglobin levels, blood pressure, visual acuity, intraocular pressure, slit-lamp examination, biometry, and gonioscopy. Evaluation metrics for FAZ included FAZ area, FAZ perimeter, acircularity index (AI) (the ratio of the FAZ perimeter to the standard circular perimeter for the same area provided by the software), and the foveal density (FD300) within a 300 μm wide annulus surrounding the FAZ. Main Outcome Meseaures  FD300, FAZ area, and AI. Results The median (interquartile range) of FD 300 for PACS and NPACS were 52.32% (49.82%, 55.12%) and 55.53% (53.95%, 57.32%), respectively (Z=-7.344, P<0.001). The FAZ areas was (0.320±0.106) mm2 for PACS and (0.343±0.097) mm2 for NPACS (t=2.012, P=0.045). The median (interquartile range) of AI was 1.10 (1.08, 1.12) for PACS and 1.09 (1.08, 1.11) for NPACS (Z=-2.574, P=0.01). In the PACS population with glycated hemoglobin (HbA1c) <6.5%, FAZ perimeter, FAZ area, and FD300 were significantly lower compared to the NPACS group. When HbA1c ≥6.5%, the PACS group exhibited greater AI and lower FD300 than the NPACS group. Multivariate analysis revealed that lower FD300 [OR=0.773 (95% CI: 0.705, 0.846)], higher HbA1c [OR=1.250 (95%  CI: 1.001, 1.562)], and higher diastolic blood pressure [OR=1.034 (95%  CI: 1.007, 1.063)] were risk factors for PACS. Conclusion Compared to NPACS individuals, the PACS population demonstrated smaller FAZ perimeter and area, greater AI, and lower FD300. Abnormal HbA1c had a more pronounced effect on FAZ parameters in the PACS group. (Ophthalmol CHN, 2025, 34: 207-212)

Key words:  primary angle closure suspects, foveal avascular zone