April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Repeatability and Comparison of Anterior Chamber Angle Assessment Tests
Author Affiliations & Notes
  • Peter Campbell
    Ophthalmology, St Thomas' Hospital, London, United Kingdom
    Faculty of Health and Social Care, London South Bank University, London, United Kingdom
  • Rishi Agarwal
    Institute of Optometry, London, United Kingdom
    Faculty of Health and Social Care, London South Bank University, London, United Kingdom
  • Tony Redmond
    Institute of Optometry, London, United Kingdom
    Cardiff Centre for Vision Sciences, School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
  • K Sheng Lim
    Ophthalmology, St Thomas' Hospital, London, United Kingdom
  • Bruce Evans
    Institute of Optometry, London, United Kingdom
    Faculty of Health and Social Care, London South Bank University, London, United Kingdom
  • Footnotes
    Commercial Relationships Peter Campbell, College Of Optometrists (F), Topcon Great Britain Ltd (F); Rishi Agarwal, None; Tony Redmond, None; K Sheng Lim, None; Bruce Evans, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 933. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Peter Campbell, Rishi Agarwal, Tony Redmond, K Sheng Lim, Bruce Evans; Repeatability and Comparison of Anterior Chamber Angle Assessment Tests. Invest. Ophthalmol. Vis. Sci. 2014;55(13):933.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

To evaluate the repeatability of gonioscopy, van Herick method and Anterior Segment Optical Coherence Tomography (AS-OCT) and assess the agreement between these techniques.

 
Methods
 

Gonioscopy, van Herick method and AS-OCT were performed on two occasions, one month apart, on patients recruited from optometry practice. All tests were undertaken by one optometrist. One eye was randomly selected for inclusion in the analysis. An eye was graded as occludable with gonioscopy if the posterior pigmented trabecular meshwork was not visible for 90 degrees or more. Anterior Segment images were captured with a Topcon OCT-2000 using the anterior segment setting (see image below). AS-OCT images were graded by a second optometrist masked to the gonioscopy and van Herick method results. The weighted kappa statistic (κ) was used to measure repeatability and agreement.

 
Results
 

Results were obtained for 80 eyes of 80 subjects. For gonioscopy, 12 subjects were found to have occludable angles on visit 1 (15%) and 13 subjects on visit 2 (16.2%), κ=0.542. For van Herick method, 17 subjects were found to have occludable angles on visit 1 (21.2%) and 12 subjects on visit 2 (15%) κ=0.641. For AS-OCT, 12 subjects were found to have occludable angles on visit 1 (15%) and 10 subjects on visit 2 (12.5%), κ=0.641. Four subjects had an occludable grading with all three methods at visit 1 and three subjects at visit 2. The agreement between gonioscopy and van Herick was good: κ=0.641 at visit 1 and κ=0.708 at visit 2; agreement between gonioscopy and AS-OCT was fair: κ=0.546 at visit 1 and κ=0.510 at visit 2.

 
Conclusions
 

Gonioscopy, despite being a semi-subjective test, is the gold standard method for detecting primary angle closure. Intra-observer repeatability for gonioscopy, van Herick method and AS-OCT is fair, with van Herick method and AS-OCT performing better than gonioscopy. The van Herick method appears to show good agreement with gonioscopy, whereas agreement between AS-OCT and gonioscopy is fair. The van Herick method would appear to be preferable to AS-OCT when considering alternatives to gonioscopy, for example, in glaucoma shared care schemes. OCT instruments that are specifically designed for anterior segment imaging may perform better but are not widely available in clinical practice.

 
 
Anterior Segment OCT Image (Topcon-2000)
 
Anterior Segment OCT Image (Topcon-2000)
 
Keywords: 420 anterior chamber • 421 anterior segment  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×