May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Comparing Angle Closure Detected by Gonioscopy and Anterior Segment Optical Coherence Tomography
Author Affiliations & Notes
  • L. M. Sakata
    Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
  • R. Lavanya
    Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
  • H. T. Aung
    Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
  • D. S. Friedman
    Wilmer Eye Institute and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • P. J. Foster
    Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom
  • T. Aung
    Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 1975. doi:
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    • Get Citation

      L. M. Sakata, R. Lavanya, H. T. Aung, D. S. Friedman, P. J. Foster, T. Aung; Comparing Angle Closure Detected by Gonioscopy and Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1975.

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

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Abstract
 
Purpose:
 

To evaluate the performance of anterior segment optical coherence tomography (AS-OCT) in detecting angle closure compared to gonioscopy.

 
Methods:
 

This observational cross-sectional study evaluated 502 subjects with no previous ophthalmic problems recruited from a community clinic in Singapore. AS-OCT images of the four quadrants of the eye were obtained in dark conditions. Gonioscopy was performed in dim lighting condition by a masked examiner using the Shaffer grading system. An angle quadrant was classified as closed on gonioscopy if the posterior trabecular meshwork could not be seen (Shaffer grade 0 or 1). AS-OCT images were evaluated by a second examiner masked to other results. A closed angle quadrant on AS-OCT was defined by the presence of any contact anterior to the scleral spur between the iris and angle wall. Only right eyes were used in the analysis.

 
Results:
 

A closed angle in at least one quadrant was observed in 298/502 (59%) eyes by AS-OCT, and in 161/502 (32%) eyes by gonioscopy (p<0.001). The frequency of closed angles detected by AS-OCT and gonioscopy in the superior/inferior/nasal/temporal quadrants were: 246 (49%) vs 143 (28%); 199 (40%) vs 104 (21%); 89 (18%) vs 67 (13%); and 60 (12%) vs 89 (18%) respectively. The overall agreement between AS-OCT and gonioscopy in detecting angle closure was fair (kappa=0.37). Among 129/2008 quadrants that were closed on gonioscopy but open on AS-OCT, an "over the hill" iris configuration (left image) was present in 115 (89%) quadrants, and of the 335/2008 quadrants that were open on gonioscopy but closed on AS-OCT, 250 (75%) quadrants showed low irido-angle contact on AS-OCT (right image).

 
Conclusions:
 

AS-OCT identified more eyes as having angle closure than gonioscopy, particularly in the superior /inferior quadrants. Agreement between the two methods was fair. Variations in iris profile and level of irido-corneal contact may account for some of these differences.  

 
Keywords: anterior segment • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • clinical (human) or epidemiologic studies: systems/equipment/techniques 
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