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Thomas Cronin, Ankur Gupta, Grayson Wilkes Armstrong, Joanna Olson, Herbert Ingraham; Remote Assessment of Anterior Chamber Depth Using Novel Stereoscopic Digital Slit Lamp Images. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1404 – A0100.
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© ARVO (1962-2015); The Authors (2016-present)
Anterior chamber (AC) depth is a frequently assessed component of the ophthalmic examination, as shallow AC is correlated with risk of acute and chronic angle closure glaucoma or risk of angle closure due to pharmacologic dilation. AC depth can be assessed through gonioscopy or the Von Herick slit lamp evaluation. Telemedicine has recently been employed to enable screening, diagnosis, and management of ophthalmic conditions. In order to evaluate the utility of telemedicine to assess AC depth, we implemented a novel modified slit lamp capable of transmitting stereoscopic images of patients’ eyes to remote reviewers. We hypothesized that AC depth assessment using digital stereoscopic slit lamp images would correlate with in-person ophthalmologist assessment of the AC depth.
We prospectively captured five standardized images of patient eyes (n = 5) using a stereoscopic slit lamp camera. One in-person physician and five remote physicians graded the depth of the AC and graded it on a binary scale as either shallow or deep.
There was 76% agreement (kappa = 0.766) in remote grading of AC depth. The agreement between the in-person and remote graders numbers 1-3 was 100% (kappa =1.0), 50% (kappa = 0.5) for remote grader 4, and 83% (kappa = 0.83) for remote grader 5.
Remote telemedical assessment of the depth of patients’ AC using stereoscopic images appears to be feasible according to the results of our small prospective pilot study. Telemedicine may therefore be able to improve access to high quality eye care for patients at risk for shallow AC and associated ophthalmic conditions. Larger future studies are needed to validate the results of this pilot study.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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