Ultrasound Biomicroscopic Configurations of the Anterior Ocular Segment in a Population-Based Study The Kumejima Study

Purpose: To characterize quantitatively the configuration of the anterior ocular segment with ultrasound biomicroscopy (UBM) in a population-based setting. Design: Cross-sectional study. Participants: Ten percent of 4632 residents aged >= 40 years of Kumejima, an island off southwest Japan, were randomly selected. Methods: We performed UBM under light and dark conditions in the 4 quadrants of the right eyes. The anatomic landmarks on the anterior ocular segment UBM images were identified by 1 examiner to quantify the peripheral anterior chamber depth (ACD), location of the ciliary body, and iris thickness. Main Outcome Measures: Angle-opening distance at 250 and 500 mu m from the scleral spur (AOD250, AOD500), trabecular-iris angle (TIA), trabecular-ciliary process distance (TCPD), thickness of the iris (ID), trabecular-anterior iris surface angle (TAIA), trabecular-posterior iris surface angle (TPIA), trabecular-ciliary angle (TCA), and thickness of iris measured at 1000, 2000, and 3000 mu m (IT1000, IT2000 and IT3000). Results: The AOD500 averaged 0.267 +/- 0.138 (mean +/- standard deviation) and 0.202 +/- 0.116 mm under light and dark conditions, respectively; TIA 22.2 +/- 10.0 and 17.0 +/- 8.9 degrees; TCPD 0.755 +/- 0.165 and 0.748 +/- 0.152 mm; and ID 0.412 +/- 0.053 and 0.457 +/- 0.062 mm. The peripheral ACD was deepest temporally, then nasally, then inferiorly, and then superiorly (P<0.05, post hoc test). The position of the ciliary body was deepest nasally, then temporally, then inferiorly, and then superiorly (P<0.05). Iris thickness did not differ significantly among the quadrants. Older subjects had a shallower peripheral ACD, more anteriorly located ciliary body, and thinner iris (analysis of covariance, P<0.015). The peripheral ACD was deeper and the ciliary body was located more deeply in men than women (P<0.05), although no intergender differences in iris thickness were seen (P>0.1). Hyperopia, short axial length, and shallow central ACD were significantly correlated with shallower peripheral ACD, anteriorly located ciliary body, and thinner iris (P<0.05). Elevated intraocular pressure was associated with a shallow peripheral ACD (P <= 0.043). Conclusions: There are significant associations of the peripheral ACD, location of the ciliary body, and iris thickness with age, gender, refractive error, axial length, and intraocular pressure.