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1 From the Singapore National Eye Centre and Singapore Eye Research Institute, Singapore; 2 Departments of Ophthalmology and 3 Community, Occupational and Family Medicine, National University of Singapore, Singapore; 4 Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison; 5 Institute of Ophthalmology, University College London, United Kingdom; and 6 Department of International Health, Johns Hopkins University School of Public Health, Baltimore, Maryland.
PURPOSE. To describe the variation in ocular biometry in adult Chinese individuals in Singapore.
METHODS. 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.
RESULTS. 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.
CONCLUSIONS. 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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