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Editors Selection IGR 16-3

Clinical Forms of Glaucoma: Association between height and anterior chamber depth

Comment by Minguang He on:

24497 Is measurement of adult height useful in screening for primary angle closure?, Chang L; Aung T; Low S et al., Eye, 2009; 23: 1775-1780

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Screening for angle closure or angleclosure glaucoma often involves the examination of anterior chamber, i.e., anterior chamber depth, van Herrick test. However, the anterior chamber biometry test requires sophisticated expensive equipment and techniques. Using height parameter as a screening tool might be an interesting idea, given the fact that the association of height and ocular biometry has been well documented in population studies. However, in this cross-sectional study conducted in Singaporean Chinese adults, Chang et al. (1154) did not find this idea encouraging ‐ adult height only conferred little additional benefit as a screening tool for identifying occludable angle subjects, although the study did confirm the association between shorter height and shallower ACD. The authors reported 68.2% sensitivity and 61.3% specificity when 'age ≥50 years' and 'female' were used as criteria. When 'height < 160 cm' was added as criteria, the sensitivity became 62.1% and specificity 64.7%. One should be cautious of interpretation of this result: any test by random will give 50% sensitivity and 50% specificity, thus a test with about 60% sensitivity or specificity is just a little bit better than random and therefore should be considered as a poor diagnostic test. Given the adult, height itself is a poor predictor (when 160 cm was selected as the cutoff, sensitivity and specificity were 68.2% and 42.7%), it will not be surprising to see the poor performance when 'stature' was added to the 'age' and 'sex' criteria.

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