Comparison of slitlamp optical coherence tomography and scanning peripheral anterior chamber depth analyzer to evaluate angle closure in Asian eyes

• Published in: Archives of ophthalmology (1960) Vol. 127; no. 5; p. 599
• Main Authors: Wong, Hon-Tym, Chua, Jocelyn L L, Sakata, Lisandro M, Wong, Melissa H Y, Aung, Han T, Aung, Tin
• Format: Journal Article
• Language: English
• Published: United States 01.05.2009
• Subjects: Adult; Aged; Aged, 80 and over; Anterior Chamber - pathology; Area Under Curve; Diagnostic Techniques, Ophthalmological; Female; Glaucoma, Angle-Closure - diagnosis; Gonioscopy - methods; Humans; Lasers; Male; Middle Aged; Prospective Studies; ROC Curve; Sensitivity and Specificity; Tomography, Optical Coherence - methods; Trabecular Meshwork - pathology
• ISSN: 1538-3601
• DOI: 10.1001/archophthalmol.2009.41

To evaluate the effectiveness of slitlamp optical coherence tomography (SL-OCT) and Scanning Peripheral Anterior Chamber depth analyzer (SPAC) in detecting angle closure, using gonioscopy as the reference standard. A total of 153 subjects underwent gonioscopy, SL-OCT, and SPAC. The anterior chamber angle (ACA) was classified as closed on gonioscopy if the posterior trabecular meshwork could not be seen; with SL-OCT, closure was determined by contact between the iris and angle wall anterior to the scleral spur; and with SPAC by a numerical grade of 5 or fewer and/or a categorical grade of suspect or potential. A closed ACA was identified in 51 eyes with gonioscopy, 86 eyes with SL-OCT, and 61 eyes with SPAC (gonioscopy vs SL-OCT, P < .001; gonioscopy vs SPAC, P = .10; SL-OCT vs SPAC, P < .001; McNemar test). Of the 51 eyes with a closed ACA on gonioscopy, SL-OCT detected a closed ACA in 43, whereas SPAC identified 41 (P = .79). An open angle in all 4 quadrants was observed in 102 eyes with gonioscopy, but SL-OCT and SPAC identified 43 and 20 of these eyes, respectively, as having angle closure. The overall sensitivity and specificity for SL-OCT were 84% and 58% vs 80% and 80% for SPAC. Using gonioscopy as the reference, SL-OCT and SPAC showed good sensitivity for detecting eyes at risk of angle closure.