July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Differences in Anterior Chamber Angle Assessments Between Gonioscopy, EyeCam, and Anterior Segment OCT: The Chinese American Eye Study
Author Affiliations & Notes
  • Benjamin Xu
    University of Southern California, Los Angeles, California, United States
  • Anmol Pardeshi
    University of Southern California, Los Angeles, California, United States
  • Bruce Burkemper
    University of Southern California, Los Angeles, California, United States
  • Grace Marie Richter
    University of Southern California, Los Angeles, California, United States
  • Shan C Lin
    Glaucoma Center of San Francisco, California, United States
  • Roberta McKean-Cowdin
    University of Southern California, Los Angeles, California, United States
  • Rohit Varma
    University of Southern California, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Benjamin Xu, None; Anmol Pardeshi, None; Bruce Burkemper, None; Grace Richter, None; Shan Lin, None; Roberta McKean-Cowdin, None; Rohit Varma, None
  • Footnotes
    Support  NIH Grant U10 EY017337
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5531. doi:
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      Benjamin Xu, Anmol Pardeshi, Bruce Burkemper, Grace Marie Richter, Shan C Lin, Roberta McKean-Cowdin, Rohit Varma; Differences in Anterior Chamber Angle Assessments Between Gonioscopy, EyeCam, and Anterior Segment OCT: The Chinese American Eye Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5531.

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

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Abstract

Purpose : To quantify inter-quadrant differences in angle configuration assessed on gonioscopy, Eyecam, and anterior segment optical coherence tomography (AS-OCT) in a cohort of Chinese Americans.

Methods : Subjects aged 50 years or older were recruited from the Chinese American Eye Study (CHES), a population-based epidemiological study in Los Angeles, CA. Each subject underwent a complete ocular exam including gonioscopy, EyeCam, and AS-OCT under dark ambient lighting. Gonioscopy and AS-OCT imaging were performed by trained ophthalmologists. EyeCam imaging was performed by a trained technician and images were graded by an independent glaucoma specialist.

Results : 709 eyes from 709 subjects were analyzed. Less anatomical variation among the quadrants was detected on gonioscopy and EyeCam compared to AS-OCT (p < 0.05). The mean gonioscopy grade, EyeCam grade, and AS-OCT measurement for each quadrant varied by up to 10.3%, 6.4%, and 46.2% of the superior quadrant value, respectively. There were significant inter-quadrant differences (p < 0.05) among mean AOD750 measurements when grouping by quadrant and gonioscopy or EyeCam grade. Mean AOD750 measurements were smallest for the superior quadrant by between 14.3% to 38.1% and 17.4% to 37.9% on gonioscopy and EyeCam, respectively, compared to other quadrants. Angle Visibility Index (AVI) values were largest for the superior quadrant.

Conclusions : Gonioscopy and EyeCam significantly under-represent anatomical variations of the ACA compared to AS-OCT, likely due to differences in the visibility of anatomical structures among the quadrants. These findings suggest that gonioscopy or EyeCam grades from different quadrants are not comparable or interchangeable, which supports reconsideration of current definitions and methods used to diagnose and manage primary angle closure disease (PACD).

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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