Variation in ocular biometry in an adult Chinese population in Singapore: The Tanjong Pagar Survey

Department of International Health, Johns Hopkins University, Baltimore, Maryland, United States
Investigative Ophthalmology & Visual Science (Impact Factor: 3.4). 01/2001; 42(1):73-80.
Source: PubMed


To describe the variation in ocular biometry in adult Chinese individuals in Singapore.
This study was a population-based, cross-sectional survey of adult Chinese persons aged 40 to 81 years residing in Tanjong Pagar district, Singapore. Axial ocular dimensions, including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous chamber depth (VCD) were measured using an A-scan ultrasound device. Corneal curvature (CC) and noncycloplegic refraction were measured with an autorefractor, with refraction further refined subjectively. Lens nuclear opacity (NO) was graded clinically using the modified Lens Opacity Classification System III (LOCS III) score.
A total of 1717 subjects were eligible for the survey, of whom 1232 (71.8%) participated. Biometric and refraction data were available for 1004 (58.5%) phakic subjects. The AL, ACD, LT, VCD, CC, and LOCS III scores were 23.23 +/- 1.17 mm, 2.90 +/- 0.44 mm, 4.75 +/- 0.47 mm, 15.58 +/- 1.11 mm, 7.65 +/- 0.27 mm, and 3.2 +/- 0.9 (mean +/- SD), respectively. On average, people aged 40 to 49 years, when compared with those 70 to 81 years, had longer ALs (mean difference, +0.58 mm), deeper ACDs (+0.52 mm), longer VCDs (+0.72 mm), but thinner lenses (-0.70 mm) and less severe NO (-1.7 LOCS III score). CCs did not vary significantly with age. After controlling for age, women had shorter ALs and VCDs, shallower ACDs, but thicker lenses and steeper CCs than men. The variation in noncycloplegic refraction with age was nonlinear. Among people aged 40 to 59 years, a higher prevalence of hyperopia was seen in older compared with younger persons (on average, a difference of +1.3 D for every 10-year difference in age, P: < 0.001), explained principally by shorter AL (and VCD) in older persons. Among those 60 to 81 years, this pattern was not obvious (a difference of -0.03 D for every 10-year difference in age, P: = 0.12), as NO became an additional determinant of refraction, with greater degrees of NO in older person's driving refraction in the "minus" direction.
Ocular dimensions vary with age and gender in adult Chinese persons in Singapore. The variation in noncycloplegic refraction in people 40 years and older may be explained by differences in axial lengths (principally vitreous chamber depths) between older and younger persons and, from 60 years onwards, differences in lens nuclear opacification as well.

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Available from: T-Y Wong, Feb 21, 2015
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    • "This observation indicates that AL/ CRC may be a more important factor than AL or CRC alone. Few studies have studied this index in the Middle East.3,12,14 Although in some areas of the world, this index can be derived from studies on AL and CRC, reports concerning AL/ CRC are scarce. "
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    ABSTRACT: To determine the distribution of axial length (AL) to corneal radius of curvature (CRC) ratio and to evaluate its association with refractive errors in an Iranian population. In this cross sectional study, multistage cluster sampling was used to select subjects 40-64 years of age residing in Shahroud, northern Iran. All subjects underwent manifest and cycloplegic refraction, and biometry using the Allegro Biograph (WaveLight AG, Erlangen, Germany). Individuals with a history of intraocular surgery, extensive pterygia and ocular trauma were excluded. Of a total of 6,311 patients, 5190 (82.2%) participated in the study. We excluded 247 patients to adhere with study criteria and 132 patients due to missing data. Mean AL/CRC was 3.034 [95% confidence interval (CI), 3.031-3.037]. AL/CRC was 3.028 and 3.042 in female and male subjects, respectively (P<0.001). The R2 coefficients between spherical equivalent (SE) refractive error and AL/CRC, AL, CRC, lens thickness, and anterior chamber depth were 0.607, 0.351, 0.012, 0.038, and 0.091, respectively. Linear regression showed a 12.1 diopter (D) shift towards myopia with every 1 unit increase in AL/CRC (P<0.001). Mean AL/CRC was 3.472 among myopes with SE less than-5.0D; this value decreased linearly and was as low as 2.690 among hyperopes with SE more than 5.0D. R2 coefficients for AL/CRC with spherical and cylindrical power were 0.560 and 0.071, respectively. Minimal changes in AL/CRC lead to large changes in refractive error. The correlation between refractive errors was significantly stronger with the AL/CRC ratio than with AL and CRC alone.
    Full-text · Article · Jul 2013
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    • "Olsen et al. [3] reported that ocular refraction is correlated with the corneal power (CP), the lens power and the AL. Wong et al. [4] reported that the VCD was the most important determinant of refraction in adults over 40 years of age. However, the mechanism associated with the development of anisometropia has not been well defined. "
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    ABSTRACT: Purpose To determine the relationship between the differences in the ocular component values with the degree of anisomyopia. Methods Refraction, corneal power (CP), and biometry were examined in 50 myopic adults with refractive differences (RD) over 1.50 diopters (D). Ocular components were measured by ultrasound biometry and keratometry. The correlation between the differences in the ocular component values with the degree of anisomyopia was analyzed by linear regression analysis. Results Among 50 adults with anisomyopia, 5 had RD from 1.50 to 2.99 D, 11 had RD from 3.00 to 3.99 D, 9 had RD from 4.00 to 5.99 D, 12 had RD from 6.00 to 7.99 D, 7 had RD from 8.00 to 11.99 D, and 6 had ≥12.00 D. There was no significant correlation between the ocular components (CP, crystalline lens thickness [LT], and anterior chamber depth [ACD], and the length from the cornea to the posterior surface of the lens [ACD + LT]) and the RD (p > 0.05). The RD showed a significantly positive correlation with vitreous chamber depth (VCD), and axial length (r = 0.963, p < 0.0001). Conclusions The severity of anisomyopia was not correlated with the between-eye differences in the anterior chamber values of the eye (CP, ACD, LT, ACD + LT). The severity of anisomyopia was significantly correlated with the between-eye differences in VCD.
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    • "While our entry criteria was strict: patients with <−6.00 diopters for both eyes and ocular axial lengths of >26 mm for both eyes, controls with refractive errors of >-1.00 and <1.00 diopters for both eyes and ocular axial lengths of >22 mm and <24 mm for both eyes. Furthermore, we selected the cases with the normal corneal curvature [38,39] and ACD [40] to entry our study, which can exclude those non-axial length high myopia. And 13 SNPs in the study of Sayaka Sasaki [37] did not include 4 of 5 SNPs in our study, except rs11664063. "
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    ABSTRACT: High myopia is a severe hereditary ocular disease leading to blindness. LAMA1 (alpha subunit of laminin) is a promising candidate gene for high myopia present in the MYP2 (myopia 2) region. The purpose of this study was to determine if high myopia is associated with single nucleotide polymorphism (SNP) variants in LAMA1 in Chinese subjects. Ninety-seven Chinese subjects with high myopia and ethnically and sexually matched 103 normal controls were enrolled. Genomic DNA was prepared from peripheral blood. The 5 SNPs of LAMA1 were analyzed using PCR and SNaPshot. Allele frequencies were tested for Hardy-Weinberg disequilibrium. The genotype and allele frequencies were evaluated using the χ(2) tests or the Fisher exact tests. One of the 5 SNPs showed a significant difference between patients and control subjects (rs2089760: p(genotype)=0.005, p(allel)=0.003). There were no statistically significant differences between patients and control subjects for the other four SNPs: rs566655, rs11664063, rs607230, and rs3810046. Our results indicate that the polymorphism of rs2089760, located in the promoter region of LAMA1, may be associated with high myopia in the Chinese population and should be investigated further.
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