Changes in Beta Parapapillary Atrophy in Primary Angle-Closure Suspect: A 5-Year Follow-Up Study.

INTRODUCTION: This study aimed to investigate the changes in beta parapapillary atrophy (β-PPA) in eyes with primary angle-closure suspect (PACS) after 5 years. METHODS: This longitudinal cohort study included participants aged ≥50 years with PACS at baseline, who participated in the 5-year follow-up examinations. β-PPA was characterized using stereoscopic fundus and optical coherence tomography. Logistic and linear regression analyses were performed to identify factors correlating with the presence of β-PPA enlargement and with the enlargement of β-PPA parameters, respectively. RESULTS: A total of 83 participants with PACS (83 eyes) were included. The enlargement of β-PPA was found in 26.51% of PACS eyes during the 5-year follow-up period. The parameters of area, angular extent, and maximum radial length of β-PPA were significantly enlarged at the 5-year follow-up compared with those at baseline (P < 0.001, 0.027, and < 0.001, respectively). The presence of β-PPA enlargement was associated with a larger axial length (AL; odds ratio [OR] = 2.473, 95% confidence interval [CI]: 1.119-5.446, P = 0.025) and larger vertical cup-to-disc ratio (VCDR; OR = 1.066, 95% CI: 1.001-1.135, P = 0.048). The factor associated with the enlargement of area, angular extent, and maximum radial length of β-PPA was a longer AL (P = 0.016, 0.023, and 0.018, respectively). CONCLUSIONS: The morphology parameters of β-PPA were enlarged in eyes with PACS during the 5-year follow-up period. The presence of β-PPA enlargement was associated with a longer AL and larger VCDR at baseline.