Detection of Primary Angle Closure Using Anterior Segment Optical Coherence Tomography in Asian Eyes
| Autor: | David S. Friedman, Tin Aung, Paul T K Chew, Paul J. Foster, Jovina L. See, Ce Zheng, Sunita Radhakrishnan, Winifred P. Nolan, Scott D. Smith |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Iridectomy medicine.medical_specialty Intraocular pressure genetic structures medicine.medical_treatment Population Gonioscopy Iris Glaucoma Scleral spur Ocular hypertension Sensitivity and Specificity Anterior Eye Segment Ophthalmology medicine Glaucoma surgery Humans Prospective Studies education Intraocular Pressure Aged Aged 80 and over Singapore education.field_of_study medicine.diagnostic_test business.industry Middle Aged medicine.disease eye diseases Surgery medicine.anatomical_structure Female sense organs Glaucoma Angle-Closure business Tomography Optical Coherence |
| Zdroj: | Ophthalmology. 114:33-39 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2006.05.073 |
| Popis: | Objective To evaluate noncontact anterior segment optical coherence technology (AS-OCT) as a qualitative method of imaging the anterior chamber angle and to determine its ability to detect primary angle closure when compared with gonioscopy in Asian subjects. Design Prospective observational case series. Participants Two hundred three subjects were recruited from glaucoma clinics in Singapore with diagnoses of primary angle closure, primary open-angle glaucoma, ocular hypertension, or cataract. Both eyes (if eligible) of each patient were included in the study. Exclusion criteria were pseudophakia or previous glaucoma surgery. Methods Images of the nasal, temporal, and inferior angles were obtained with AS-OCT in dark and then light conditions. Gonioscopic angle width was graded using the Spaeth classification for each quadrant in low lighting conditions. Main Outcome Measures Angle closure was defined by AS-OCT as contact between the peripheral iris and angle wall anterior to the scleral spur and by gonioscopy as a Spaeth grade of 0° (posterior trabecular meshwork not visible). Comparison of the 2 methods in detecting angle closure was done by eye and by individual. Sensitivities and specificities of AS-OCT were calculated using gonioscopy as the reference standard. Results Complete data were available for 342 eyes of 200 patients. Of the patients, 70.9% had a clinical diagnosis of treated or untreated primary angle closure. Angle closure in ≥1 quadrants was detected by AS-OCT in 142 (71%) patients (228 [66.7%] eyes) and by gonioscopy in 99 (49.5%) patients (152 [44.4%] eyes). The inferior angle was closed more frequently than the nasal or temporal quadrants using both AS-OCT and gonioscopy. When performed under dark conditions, AS-OCT identified 98% of those subjects found to have angle closure on gonioscopy (95% confidence interval [CI], 92.2–99.6) and led to the characterization of 44.6% of those found to have open angles on gonioscopy to have angle closure as well. With gonioscopy as the reference standard, specificity of AS-OCT in the dark was 55.4% (95% CI, 45.2–65.2) for detecting individuals with angle closure. Conclusion Anterior segment OCT is a rapid noncontact method of imaging angle structures. It is highly sensitive in detecting angle closure when compared with gonioscopy. More persons are found to have closed angles with AS-OCT than with gonioscopy. |
| Databáze: | OpenAIRE |
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