KeralaJOphthalmol323252-5519404 151954
KeralaJOphthalmol323252-5519404 151954
KeralaJOphthalmol323252-5519404 151954
248]
Original Article
Keywords: Anterior chamber depth, axial length, central corneal thickness, Ghana, spherical refractive error
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DOI:
How to cite this article: Kyei S, Assiamah F, Kwarteng MA, Ansah VK.
10.4103/kjo.kjo_38_20 Ocular biometry in an adult Ghanaian population. Kerala J Ophthalmol
2020;32:252-7.
geographic‑specific studies on ocular biometry and how they or loss of treatment or other benefits to which they would
correlate with common ocular disorders. normally be entitled.
To fill this gap, there is a need for current studies on ocular Data collection procedure
biometry among the Ghanaian population. Hence, this Data collection involved the use of a data extraction sheet
prospective study aimed to determine ocular biometry and to collect data on demographics, and ocular biometry data.
its correlates in a sample population of native adult Ghanaians
attending a referral eye clinic in Ghana. The data extracted included:
1. The examination of the anterior segment was performed
MATERIALS AND METHODS on each participant using a slit‑lamp biomicroscope
2. The examination of the posterior segment was conducted
Study setting with an ophthalmoscope and slit‑lamp biomicroscope
This study was carried out at the premises of the Christian 3. Ocular biometry was measured among participants:
Eye Center, Cape Coast. The center is the most utilized eye Wavelight oculyzer II (Alcon surgical, Fort Worth,
care institution in the Central region of Ghana serving other Texas, USA) for central cornea readings and
regions due to the use of advanced technology for cataract keratometry, ultrasound device: US4000 EchoScan
and glaucoma surgery among others. (Nidek Co., Ltd., Japan) for biometry, and KR 9000 Auto
REF (Perlong Medical Equipment Co., Ltd., Jiangsu, China)
Study design for autorefraction
This was a hospital‑based prospective study of patients 4. Refractive error was calculated in diopters as the
visiting the center. The study involved measuring and spherical equivalent of spherical refractive error plus
collating biometric data from patients. It sought to explore half of the cylindrical refractive error
the relationship between biometric parameters and refractive 5. The two major corneal radii separated by 90° were
error. averaged to give corneal curvature and power.
34.09 ± 12.14. The difference in the means of CCT in these Corneal astigmatism had a significant visual effect on the
studies is the aging factor associated with corneal thinning. sample population with more than half of the participants
having astigmatism of more than 1.00 D [Table 3]. This is
In this study, the mean AL was greater than that reported similar to a study in Africa by Bagus et al.[3] which reported 45%
among African descends. An average AL of 21.02 mm[35] and of Black South Africans with astigmatism of 1.00 D or greater.
23.50 mm[36] in Nigeria, 23.05 mm in South Africa,[9] 23.09 mm Information on corneal astigmatism is helpful to surgeons
in Sudan,[26] and 23.7 mm in Egypt[37] has been reported. The in ensuring a reduction in postoperative astigmatism among
reason for a longer AL in this study might be due to scleral patients due to cataract surgery. Hence, the use of toric
thinning and eyeball elongation in myopic eyes which happen intraocular lenses as recommended, can be used among the
to be the dominant error of refraction in this study. Our study Ghanaian population.
reported a higher mean age along with a longer AL which
is consistent with studies by Yin et al.[38] and Nangia et al.[39] There was a poor correlation between CCT and AL in this
However, it contrasts studies that have reported that AL study [Figure 1 and Table 5]. Studies have reported that CCT
decreases with age.[9,35,40] is not correlated with AL, making them two independent
variables in ocular biometry.[2,33,34,51,52] AL was positively
The mean ACD in this study was higher than that reported by correlated with ACD and negatively correlated with LT.
Mashige and Oduntan,[9] among South Africans but consistent These findings correlate with studies by Chen et al.,[2]
with that of Nagra et al.,[41] who reported ACD of 3.55 mm Mashige and Oduntan[7,9] Olsen et al.[42] and Osuobeni.[44] ACD
among Britons. It has been established that accurate ACD has great effects on the pathogenesis of ocular conditions
measurements potentially prevent refractive errors among such as refractive errors and glaucoma.[9] There was a negative
patients after intraocular lens implantation more than corneal association between ACD and LT in this study which correlates
power or AL measures among patients undergoing cataract with previous studies.[9,44,53,54] The gradual thickening of the
surgery.[42] A deep ACD has been observed among myopes, anterior capsule of the lens will decrease the ACD since it
which correspond with a high number of myopic eyes in this happens to be in the anterior chamber.
study [Table 4].
CONCLUSION
The mean lens thickness (LT) in this study was consistent with
that of Mallen et al.[43] who reported an average LT of 3.85 mm. A biometry profile was established in native Ghanaians for the
The LT is this study is higher than that reported by Mashige first time. CCT was found to be independent of AL because
and Oduntan:[9] 3.69 mm, Osuobeni:[44] 3.72 mm but lower there was no significant relationship between the two
than reports by Hashemi et al.:[45] 4.28 mm, Shufelt et al.:[46] variables. There was no association between CCT and ACD,
4.28 mm, He et al.:[47] 4.44 mm and Olsen et al.:[42] 4.68 mm LT, VCD, and SRE. Intercorrelation among ocular biometry
and 4.65 mm in the right and left respectively. A thicker lens showed that AL positively correlated with ACD, VCD and
observed in this study is due to the higher mean age, since LT negatively correlated with LT.
increases as one age. Similar studies have reported the effect
Acknowledgment
of age on LT.[42,45‑47] The anterior lens capsule thickens gradually
The authors are grateful to the Management of Bishop Ackon
from the neonatal stage to the seventh decade of life before
Memorial Christian Eye Centre, Cape Coast, Ghana.
stabilizing due to the continual addition of lens fibers.[48]
Financial support and sponsorship
VCD is deeper among myopes than hyperopes and
This study was solely funded by the authors.
emmetropes as suggested by other researchers[40] which is
consistent with VCD findings in this study due to the high Conflicts of interest
number of myopes. A study by Hashemi et al.[44] reported There are no conflicts of interest.
a mean VCD of 15.72 mm as well as a recent study by
Takkar et al.,[49] also reported an average VCD of 15.38 mm. REFERENCES
The VCD reported in these studies were lower than what
is reported in this current study. However, a study by 1. Damji KF, Muni RH, Munger RM. Influence of corneal variables
Saka et al.[50] reported an average VCD of 21–22.3 mm among on accuracy of intraocular pressure measurement. J Glaucoma
2003;12:69‑80.
participants with high myopia. It can be concluded that a
2. Chen MJ, Liu YT, Tsai CC, Chen YC, Chou CK, Lee SM. Relationship
mean refractive error of approximately‑0.75 D might have between central corneal thickness, refractive error, corneal curvature,
resulted in an appreciable increase in VCD among the eyes. anterior chamber depth and axial length. J Chin Med Assoc 2009;72:133‑7.
3. Bagus T, Alberto K, Muteba M, Makgotloe A. Analysis of corneal and biometric findings. Invest Ophthalmol Vis Sci 1997;38:321‑33.
biometry in a black South African population. Afr Vision Eye Health 26. Mohamed NY, Hassan MN, Ali NAM, Binnawi KH. Central corneal
2019;78:a495. thickness in Sudanese population. Sud J Ophthalmol 2009;1:29‑32.
4. Gharaee H, Abrishami M, Shafiee M, Ehsaei A. White‑to‑white corneal 27. Iyamu E, Memeh M. The association of central corneal thickness with
diameter: Normal values in healthy Iranian population obtained with intraocular pressure and refractive error in a Nigerian population. Online
the Orbscan II. Int J Ophthalmol 2014;7:309‑12. J Health Allied Sci 2007;6:1‑7.
5. Zha Y, Feng W, Han X, Cai J. Evaluation of myopic corneal diameter with 28. Iyamu E, Ituah I. The relation between central corneal thickness and
the Orbscan II Topography System. Graefes Arch Clin Exp Ophthalmol intraocular pressure: A comparative study of normal and glaucoma
2013;251:537‑41. subjects. Afr J Med Med Sci 2008;37:345‑53.
6. Hashemi H, Khabazkhoob M, Emamian MH, Shariati M, Yekta A, 29. Babalola OE, Kehinde AV, Iloegbunam AC, Akinbinu T, Moghalu C,
Fotouhi A. White‑to‑white corneal diameter distribution in an adult Onuoha I. A comparison of the Goldmann applanation and
population. J Curr Ophthalmol 2015;27:21‑4. non‑contact (Keeler Pulsair EasyEye) tonometers and the effect of
7. Mashige KP, Oduntan OA. Corneal parameters and their correlations central corneal thickness in indigenous African eyes. Ophthalmic Physiol
with refractive error, axial length, anterior chamber depth and lens Opt 2009;29:182‑8.
thickness in black South Africans. Guoji Yanke Zazhi (Int Eye Sci) 30. Eballe AO, Koki G, Ellong A, Owono D, Epée E, Bella LA, et al.
2017;17:597‑603. Central corneal thickness and intraocular pressure in the Cameroonian
8. Lim KJ, Hyung SM, Youn DH. Ocular dimensions with aging in normal nonglaucomatous population. Clin Ophthalmol 2010;4:717‑24.
eyes. Korean J Ophthalmol 1992;6:19‑31. 31. Ntim‑Amponsah CT, Seidu A, Essuman V, Fordjour G, Tagoe N,
9. Mashige KP, Oduntan OA. Axial length, anterior chamber depth and lens Coker A, et al. A study of central corneal thickness in glaucoma
thickness: Their intercorrelations in black South Africans. Afr Vision and non‑glaucoma patients in West African population. Cornea
Eye Health 2017;76:a362. 2012;31:1093‑6.
10. Stenstrom S. Investigation of the variation and the correlation of the 32. Ntim‑Amponsah CT, Essuman VA, Edirisuriya‑Khair RD. A study of
optical elements of human eyes. Am J Optom Arch Am Acad Optom central corneal thickness in normal Ghanaians. Niger J Ophthalmol
1948;58:1‑71. 2007;15:1‑4.
11. Sorsby A, Benjamin B, Sheridan M, Stone J, Leary GA. Refraction 33. Nemesure B, Wu SY, Hennis A, Leske MC, Barbados Eye Study Group.
and its components during the growth of the eye from the age of three. Corneal thickness and intraocular pressure in the Barbados eye studies.
Memo Med Res Counc 1961;301:1‑67. Arch Ophthalmol 2003;121:240‑4.
12. Larsen JS. The sagittal growth of the eye. IV. Ultrasonic measurement of 34. Muhammed AH, Joma AK, Abdulgani AI. The relation between central
the axial length of the eye from birth to puberty. Acta Ophthalmol (Copenh) corneal thickness and axial length in a sample of Erbil population. Zanco
1971;49:873‑86. J Med Sci 2015;19:1096‑103.
13. Larsen JS. The sagittal growth of the eye. III. Ultrasonic measurement 35. Ogbeide OU, Omoti AE. Ultrasonographic ocular diameters in Nigerians.
of the posterior segment (axial length of the vitreous) from birth to West Afr J Med 2009;28:97‑101.
puberty. Acta Ophthalmol 1971;49:441‑53. 36. Iyamu E, Iyamu JE, Amadasun G. Central corneal thickness and axial
14. Grosvenor T, Scott R. Three‑year changes in refraction and its length in an adult Nigerian population. J Optom 2013;6:154‑60.
components in youth‑onset and early adult‑onset myopia. Optom Vis 37. Abdelaziz A, Mousa A. Ocular axial length measurement using regular
Sci 1993;70:677‑83. ultrasound and IOL master for different refractive errors in Egyptian
15. Lin LL, Shih YF, Lee YC, Hung PT, Hou PK. Changes in ocular population. Med J Cairo Univ 2014;82:159‑65.
refraction and its components among medical students—a 5‑year 38. Yin G, Wang YX, Zheng ZY, Yang H, Xu L, Jonas JB, et al. Ocular
longitudinal study. Optom Vis Sci 1996;73:495‑8. axial length and its associations in Chinese: The Beijing Eye Study.
16. Adams AJ. Axial length elongation, not corneal curvature, as a basis of PLoS One 2012;7:e43172.
adult onset myopia. Am J Optom Physiol Opt 1987;64:150‑2. 39. Nangia V, Jonas JB, Sinha A, Matin A, Kulkarni M, Panda‑Jonas S.
17. McBrien NA, Millodot M. A biometric investigation of late onset myopic Ocular axial length and its associations in an adult population of central
eyes. Acta Ophthalmol (Copenh) 1987;65:461‑8. rural India: The Central India Eye and Medical Study. Ophthalmology
18. Jiang BC, Woessner WM. Vitreous chamber elongation is responsible for 2010;117:1360‑6.
myopia development in a young adult. Optom Vis Sci 1996;73:231‑4. 40. Bhardwaj V, Rajeshbhai GP. Axial length, anterior chamber depth‑a
19. Aghaian E, Choe JE, Lin S, Stamper RL. Central corneal thickness study in different age groups and refractive errors. J Clin Diagn Res
of Caucasians, Chinese, Hispanics, Filipinos, African Americans, and 2013;7:2211‑2.
Japanese in a glaucoma clinic. Ophthalmology 2004;111:2211‑9. 41. Nagra M, Gilmartin B, Logan NS. Estimation of ocular volume from
20. Prager TC, Hardten DR. Immersion biometry and optical coherence axial length. Br J Ophthalmol 2014;98:1697‑701.
biometry offer clinical advantages. Ophthalmol Manage 2012;16:28‑31. 42. Olsen T, Arnarsson A, Sasaki H, Sasaki K, Jonasson F. On the ocular
21. Goldschmidt E. Refraction in the newborn. Acta Ophthalmol (Copenh) refractive components: The Reykjavik Eye Study. Acta Ophthalmol
1969;47:570‑8. Scand 2007;85:361‑6.
22. La Rosa FA, Gross RL, Orengo‑Nania S. Central corneal thickness of 43. Mallen EA, Gammoh Y, Al‑Bdour M, Sayegh FN. Refractive error
Caucasians and African Americans in glaucomatous and nonglaucomatous and ocular biometry in Jordanian adults. Ophthalmic Physiol Opt
populations. Arch Ophthalmol 2001;119:23‑7. 2005;25:302‑9.
23. Brandt JD, Beiser JA, Gordon MO, Kass MA. Ocular Hypertension 44. Osuobeni EP. Ocular components values and their inter‑correlations in
Treatment Study (OHTS) Group. Central corneal thickness in the ocular Saudi Arabians. Ophthalmic Physiol Opt 1999;19:489‑97.
hypertensive study (OHTS). Ophthalmology 2001;108:1779‑88. 45. Hashemi H, Khabazkhoob M, Miraftab M, Emamian MH, Shariati M,
24. Shimmyo M, Ross AJ, Moy A, Mostafavi R. Intraocular pressure, Abdolahinia T, et al. The distribution of axial length, anterior chamber
Goldmann applanation tension, corneal thickness, and corneal curvature depth, lens thickness, and vitreous chamber depth in an adult population
in Caucasians, Asians, Hispanics, and African Americans. Am J of Shahroud, Iran. BMC Ophthalmol 2012;12:50.
Ophthalmol 2003;136:603‑13. 46. Shufelt C, Fraser‑Bell S, Ying‑Lai M, Torres M, Varma R. Los Angeles
25. McBrien NA, Adams DW. A longitudinal investigation of adult‑onset Latino Eye Study Group. Refractive error, ocular biometry, and lens
and adult‑progression of myopia in an occupational group. Refractive opalescence in an adult population: The Los Angeles Latino Eye Study.