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Abstract #45978 Published in IGR 13-2
Angle assessment by eyecam, goniophotography, and gonioscopy
Baskaran M; Perera SA; Nongpiur ME; Tun TA; Park J; Kumar RS; Friedman DS; Aung TJournal of Glaucoma 2011;
PURPOSE: To compare EyeCam (Clarity Medical Systems, Pleasanton, CA) and goniophotography in detecting angle closure, using gonioscopy as the reference standard. METHODS: In this hospital-based, prospective, cross-sectional study, participants underwent gonioscopy by a single observer, and EyeCam imaging and goniophotography by different operators. The anterior chamber angle in a quadrant was classified as closed if the posterior trabecular meshwork could not be seen. A masked observer categorized the eyes as per the number of closed quadrants, and an eye was classified as having angle closure if there were 2 or more quadrants of closure. Agreement between the methods was analyzed by (kappa) statistic and comparison of area under receiver operating characteristic curves (AUC). RESULTS: Eighty-five participants (85 eyes) were included, the majority of whom were Chinese. Angle closure was detected in 38 eyes (45%) with gonioscopy, 40 eyes (47%) using EyeCam, and 40 eyes (47%) with goniophotography (P=0.69 in both comparisons, McNemar test). The agreement for angle closure diagnosis (by eye) between gonioscopy and the 2 imaging modalities was high ((kappa)=0.86; 95% Confidence Interval (CI), 0.75-0.97), whereas the agreement between EyeCam and goniophotography was not as good ((kappa)=0.72; 95% CI, 0.57-0.87); largely due to lack of agreement in the nasal and temporal quadrants ((kappa)=0.55 to 0.67). The AUC for detecting eyes with gonioscopic angle closure was similar for goniophotography and EyeCam (AUC 0.93, sensitivity=94.7%, specificity=91.5%; P>0.95). CONCLUSIONS: EyeCam and goniophotography have similarly high sensitivity and specificity for the detection of gonioscopic angle closure.
M. Baskaran.
Classification:
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
6.8.1 Anterior segment (Part of: 6 Clinical examination methods > 6.8 Photography)
6.4 Gonioscopy (Part of: 6 Clinical examination methods)
