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Abstract #46333 Published in IGR 13-3
Assessment of narrow angles by gonioscopy, Van Herick method and anterior segment optical coherence tomography
Park SB; Sung KR; Kang SY; Jo JW; Lee KS; Kook MSJapanese Journal of Ophthalmology 2011; 55: 343-350
PURPOSE: To evaluate anterior chamber (AC) angles using gonioscopy, Van Herick technique and anterior segment optical coherence tomography (AS-OCT). METHODS: One hundred forty-eight consecutive subjects were enrolled. The agreement between any two of three diagnostic methods, gonioscopy, AS-OCT and Van Herick, was calculated in narrow-angle patients. The area under receiver-operating characteristic curves (AUC) for discriminating between narrow and open angles determined by gonioscopy was calculated in all participants for AS-OCT parameter angle opening distance (AOD), angle recess area, trabecular iris surface area and anterior chamber depth (ACD). As a subgroup analysis, capability of AS-OCT parameters for detecting angle closure defined by AS-OCT was assessed in narrow-angle patients. RESULTS: The agreement between the Van Herick method and gonioscopy in detecting angle closure was excellent in narrow angles (κ = 0.80, temporal; κ = 0.82, nasal). However, agreement between gonioscopy and AS-OCT and between the Van Herick method and AS-OCT was poor (κ = 0.11-0.16). Discrimination capability of AS-OCT parameters between open and narrow angles determined by gonioscopy was excellent for all AS-OCT parameters (AUC, temporal: AOD500 = 0.96, nasal: AOD500 = 0.99). The AUCs for detecting angle closure defined by AS-OCT image in narrow angle subjects was good for all AS-OCT parameters (AUC, 0.80-0.94) except for ACD (temporal: ACD = 0.70, nasal: ACD = 0.63). CONCLUSION: Assessment of narrow angles by gonioscopy and the Van Herick technique showed good agreement, but both measurements revealed poor agreement with AS-OCT. The angle closure detection capability of AS-OCT parameters was excellent; however, it was slightly lower in ACD.
BS Eye Center, Seoul, Republic of Korea.
Classification:
9.3.4 Primary angle closure suspect (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
6.3.1 Anterior segment (Part of: 6 Clinical examination methods > 6.3 Biomicroscopy (slitlamp))
6.9.2.1 Anterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
6.4 Gonioscopy (Part of: 6 Clinical examination methods)
