July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Diagnostic sensitivity of Ultrasound Biomicroscopy (UBM) in identifying Clinical Aqueous Misdirection Syndrome
Author Affiliations & Notes
  • Mona Khurana
    Sankara Nethralaya Medical Research Foundation, Chennai, India
  • Rizwan Malik
    King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
  • Nuha Saleh Al-Salameh
    King Saud University, Riyadh, Saudi Arabia
  • Abdulrahman E Al-Garni
    King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  • Abdulrahman Gaeed
    King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
  • Reni Philip
    Sankara Nethralaya Medical Research Foundation, Chennai, India
  • Shenbagam Narasimhan
    Sankara Nethralaya Medical Research Foundation, Chennai, India
  • Ronnie J. George
    Sankara Nethralaya Medical Research Foundation, Chennai, India
  • Thasarat S Vajaranant
    University of Illinois Eye and Ear Infirmiry Chicago, Chicago, Illinois, United States
  • Jacob Wilensky
    University of Illinois Eye and Ear Infirmiry Chicago, Chicago, Illinois, United States
  • DEEPAK P EDWARD
    University of Illinois Eye and Ear Infirmiry Chicago, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Mona Khurana, None; Rizwan Malik, None; Nuha Saleh Al-Salameh, None; Abdulrahman Al-Garni, None; Abdulrahman Gaeed, None; Reni Philip, None; Shenbagam Narasimhan, None; Ronnie George, None; Thasarat Vajaranant, None; Jacob Wilensky, None; DEEPAK EDWARD, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 5901. doi:
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      Mona Khurana, Rizwan Malik, Nuha Saleh Al-Salameh, Abdulrahman E Al-Garni, Abdulrahman Gaeed, Reni Philip, Shenbagam Narasimhan, Ronnie J. George, Thasarat S Vajaranant, Jacob Wilensky, DEEPAK P EDWARD; Diagnostic sensitivity of Ultrasound Biomicroscopy (UBM) in identifying Clinical Aqueous Misdirection Syndrome. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5901.

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

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Abstract

Purpose : The diagnosis of aqueous misdirection (AqM) often poses a challenging diagnostic dilemma. The aim of this study was to assess the diagnostic accuracy of ultrasound biomicroscopy (UBM) for identifying clinical Aqueous misdirection syndrome.

Methods : A retrospective assessment of UBM images of 30 patients with clinical AqM and 58 control images was independently conducted by 2 masked observers. Controls included conditions that mimic AqM and normal UBM images. Images were graded as ‘misdirection’, ‘not misdirection’ or ‘uncertain’. Images were eligible in the AqM group if they were of good quality and if patients met the inclusion criteria of: intraocular pressure>21 mmHg, axial anterior chamber shallowing, a patent peripheral iridotomy and absence of any fundus lesion. Receiver operator characteristic curves were plotted to assess diagnostic accuracy and sensitivities at 90% specificity.

Results : The mean (± sd) age of patients in the AqM group was 59 ± 14 years and 44 ± 27 years in the control group (t=2.8, p=0.06). With images graded as ‘uncertain’ classified as ‘no misdirection’, the total area under the ROC curve was 62% for observer 1 and 55% for observer 2. The sensitivity of UBM at 90% specificity was 33% (95% CI: 16—50%) for observer 1 and 19% (95% CI: 10—28%) for observer 2.

Conclusions : UBM is likely to have poor diagnostic sensitivity for identifying patients with clinical AqM. This investigation should be interpreted with caution in patients who have a high clinical suspicion of this condition.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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