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Cindy Hu, Camila Zangalli, Anand Mantravadi, Mohsin Ali, Bruno Faria, Jesse Richman, Sheryl Wizov, Reza Razeghinejad, Marlene Moster, L Jay Katz; Comparison of Gonioscopy with Cirrus and Visante Optical Coherence Tomography (OCT) for Anterior Chamber Angle Assessment in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4822.
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Assessment of the anterior chamber angle is essential in the management of narrow-angle and closed-angle glaucomas. Gonioscopic grading, the gold standard, is a semiquantitative assessment and results may vary between clinicians. Biometric analysis with OCT may provide a more objective assessment. In this prospective study, we aimed to compare gonioscopy with Cirrus and Visante OCT for determination of angle closure risk.
Gonioscopy grading using Spaeth Classification and determination of angle closure risk were performed on one eye for 39 phakic patients by 3 glaucoma specialists. Images of this same angle using both Cirrus and Visante OCT were obtained and graded. Inter-rater agreement for gonioscopy and imaging using Kendall’s coefficient of concordance (W) and Cohen’s kappa (K) was determined.
Of these 39 patients, 54% were female, 64% were Caucasian and average age was 60. Most patients were diagnosed with narrow-angle (48%) or primary open angle (34%) glaucoma. Gonioscopy demonstrated substantial agreement in angle grade (W=0.78) and angle closure risk assessment (W=0.83) between the 3 specialists. Cirrus and Visante showed substantial agreement in determining if the angle was open or closed (K=0.73), but only fair agreement with gonioscopy (Cirrus K=0.37, Visante K=0.44).
Cirrus and Visante OCT had good agreement with each other, but only fair agreement with gonioscopy for angle assessment.
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