Abstract
Purpose: :
To evaluate the use of EyeCamTM, a novel wide field digital imaging modality, for angle imaging and to compare this with gonioscopy for detecting angle closure.
Methods: :
This was a prospective hospital based study. 168 subjects recruited from a glaucoma clinic underwent gonioscopy by a single observer, and EyeCamTM imaging by a different operator. The EyeCamTM images were then graded by 2 glaucoma specialists working together who were masked to gonioscopy data. The anterior chamber angle in a quadrant was classified as closed on gonioscopy and EyeCamTM if the posterior trabecular meshwork could not be seen in that quadrant.
Results: :
Of the 167 subjects recruited, 13 were excluded for incomplete/missing data and 2 subjects (1.2%) were excluded due to poor quality of EyeCamTM images. Of the 152 subjects analyzed, 48% were female and the majority (82%) were Chinese. The agreement between EyeCamTM and gonioscopy in detecting angle closure in the superior, inferior, nasal and temporal quadrants based on AC1 statistics was 0.81, 0.82, 0.81 and 0.86 respectively. 21 Persons were identified by gonioscopy with angle closure (as defined by having 2 or more quadrants closed) while 41 were found closed using EyeCamTM (p<0.001, McNemar Test). Overall, EyeCamTM imaging had 76% sensitivity, 81% specificity and AUC =0.79, (95% CI: 0.67-0.90) for detecting eyes with gonioscopic angle closure.
Conclusions: :
EyeCamTM was able to image the angle structures clearly in almost all eyes, and showed good agreement with gonioscopy for detecting quadrants with angle closure. However EyeCamTM identified more eyes as having angle closure than did gonioscopy.
Keywords: imaging/image analysis: clinical • anterior segment