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G. S. Tan, J. Li, M. He, L. Sakata, D. S. Friedman, T. Aung; Diagnostic Performance of Novel Morphological Parameters for the Screening of Narrow Angles. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5529.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the performance of novel morphological parameters Lens Vault (LV), anterior chamber volume (ACV) and area (ACA), measured by anterior segment optical coherence tomography (AS-OCT) in detecting eyes with narrow angles (NA).
This was a cross-sectional study of 2047 persons aged 50 years and older seen at primary healthcare clinic with no ophthalmic complaints. All phakic right eyes underwent gonioscopy, IOLMaster and AS-OCT(Carl Zeiss Meditec, Dublin, CA). NA eyes were defined as Shaffer scores 0 or 1 in >=2 quadrants on gonioscopy. Anterior chamber depth (ACD) and axial length (AXL) were obtained by IOLMaster, while LV, ACV and ACA were measured from AS-OCT horizontal scan images using customized image processing software, Zhongshan Angle Assessment Program (Guangzhou, China). The area under the receiver operating characteristic curve (AUC) and performance characteristic for detecting NA in this population were obtained for AXL, ACD and compared with that of LV, ACV and ACA.
582 subjects were excluded mainly due to poor localization of the scleral spur. Data on 1465 subjects were available for analysis. Of these, 315 subjects (21.5%) of subjects were identified to have NA on gonioscopy. Compared to ACD (0.90) and AXL (0.75), the AUC for detecting NA were 0.94 for ACV, 0.94 for ACA and 0.89 for LV. An ACV cutoff of <=110.5mm3 had a sensitivity of 80.3%, specificity of 90.3%, positive predictive value (PPV) of 69.3% and negative predictive value (NPV) of 94.4%. An ACA cutoff of <=17.23mm2, had a sensitivity of 80.9%, a specificity of 90.2%, PPV of 69.5% and NPV 94.5%.
In this community-based study in Singapore, AS-OCT novel morphological parameters LV, ACV and ACA showed good performance for detecting eyes with narrow angles and may be useful for the screening of eyes with NA.
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