June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Use of Gonio-Photographs with the GS-1 Automated Gonioscope to Assess the Basic Knowledge for SLT Application.
Author Affiliations & Notes
  • Sara Aurora Garcia y Otero Sánchez
    Research department, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
  • Jose A Paczka
    Research department, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
    Instituto de Oftalmología y Ciencias Visuales, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • orozco-garcia andrea
    Research department, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
    Research department, Asistencia e Investigacion en Glaucoma, Guadalajara, Jalisco, Mexico
  • Ana María Ponce Horta
    Research department, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
    Research department, Asistencia e Investigacion en Glaucoma, Guadalajara, Jalisco, Mexico
  • Andrea Tornero-Jimenez
    Research department, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
    Research department, Asistencia e Investigacion en Glaucoma, Guadalajara, Jalisco, Mexico
  • Romo - Sainz Monserrat
    Research department, Global Glaucoma Institute, Guadalajara, Jalisco, Mexico
  • Footnotes
    Commercial Relationships   Sara Aurora Garcia y Otero Sánchez None; Jose Paczka None; orozco-garcia andrea None; Ana Ponce Horta None; Andrea Tornero-Jimenez None; Romo - Sainz Monserrat None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 169 – A0362. doi:
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      Sara Aurora Garcia y Otero Sánchez, Jose A Paczka, orozco-garcia andrea, Ana María Ponce Horta, Andrea Tornero-Jimenez, Romo - Sainz Monserrat; Use of Gonio-Photographs with the GS-1 Automated Gonioscope to Assess the Basic Knowledge for SLT Application.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):169 – A0362.

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

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Abstract

Purpose : Selective Laser Trabeculoplasty (SLT) is a useful method to decrease intraocular pressure (IOP) for glaucoma and ocular hypertension(OHT) patients.Upskilling for SLT increase the proficiency of the clinical skills of ophthalmologyst,such as gonioscopy.The purpose of this study is to investigate agreement and correlation of decision-making elements regarding SLT treatment using gonio-photographs (GP)among ophthalmologists inexperienced in SLT.

Methods : A set of 10 GP GS-1 automated gonioscope; Nidek,Japan)with different clinical findings were presented to three ophthalmologists with scarce experience with SLT.They were instructed to follow a 4-step process, which consisted on:(1)selecting aiming beam spot size,(2) a 5-minute review of 10 GP,(3)judgement of the level of difficulty to identify relevant gonioscopic findings helpful to decide about how to perform SLT, and(4)placement of a graphic representation of a SLT spot with a specific energy value(0.1 mJ-1.0 mJ)in the pretended region(s)to treat the same 10 GP.The results of an experienced glaucoma specialist(reference rater or RR)were used to analyze each examiner’s results.Inter-rater agreement analysis, rank,concordance and intra-class correlations were used.A p-value of ≤ 0.05 was considered statistically significant.

Results : All participants finished the four-step process.Two raters selected the same spot-size as compared to the reference.Level of discerning clinical findings was poorly correlated.Number of spots had a good inter-rater agreement between the reference observer and one of the inexperienced ones(weighted Kappa=0.55, SE=0.17; 95% IC, 0.23-0.87).Total energy per GP was good and significantly correlated between RR and the same inexperienced observer(rho=0.63; p=0.049).Intraclass correlation was fair regarding totally energy(0.48; 95% IC, 0.16-0.79)and number of spots (0.56; 95% IC, 0.24-0.83).Precision and accuracy had poor correlation among raters (≤0.9). Mean energy used per GP was statistically different in the RR(5.69±1.0mJ)as compared to the others(4.75±1.1mJ, 4.51±0.8mJ, 2.11±0.9mJ).

Conclusions : Unexperienced ophthalmologists’ responses in this model based on GP derived from the GS-1 device had poor agreement in most of the studied variables when compared with an experienced ophthalmologist.Further studies using GP are warranted in order to assess the impact of teaching interventions.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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