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Maria Cecilia Domingo Aquino, Victor T C Koh, Vinay Swaroop Balla, Paul Chew; A new image based digital gonioscope device for irido-corneal angle imaging. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5116.
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To assess if the new image based digital gonioscope device is easy to use and applicable in capturing images of the anterior chamber (AC) iridocorneal angle.
A stand-alone gonioscopy protoype was used which comprise of an optical gonioprism and a built-in color high-resolution camera. A drop of amethocaine 0.5% was instilled on the eye prior to digital gonioscopy. Before starting the examination, a drop of an eye gel was put on the tip of the gonioprism. With the joystick, the instrument was moved towards the apex of the patient’s cornea. A fixation target in the center of the gonioprism was used to stabilize the patient's eye. A semi-automatic alignment algorithm was started after a good image of the inferior quadrant focusing on the trabecular meshwork can be captured on the LCD screen. The algorithm started by showing 4 separate images representing 4 quadrants of the iridocorneal angle which was followed by further refinement of the internal optics. Multi-modal image acquisition was started by imaging 16 segments (5 images per segments with changing focus position) to cover all 360 degrees of the iridocorneal angle. When acquisition was finished, the entire examination was saved internally. The review button allowed a display and export of the acquired images.
To date, a total of 37 patients (65 eyes) had photos of their irido-corneal angles taken with the new device. Each eye took 12 seconds for 360 degree imaging and all the eyes successfully completed the procedure without any complications. All the images were taken by a trained ophthalmic technician. Out of 16 images taken per eye, 13.6 ± 1.5 (mean ± SD) images were focused and clear enough to identify the angle structures including small iris processes, faint pigmentation of the trabecular meshwork and peripheral anterior synechiae. The temporal images of the irido-corneal angles were consistently found to be suboptimal in image quality.
The new digital gonioscopy imaging device is a promising semi-automatic tool which is easy to operate and could be valuable in monitoring and screening for angle closure disease in the eye. We are planning to conduct clinical trials to compare the device with conventional slit lamp gonioscopy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Digital gonioscope images of the right eye
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