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Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes.
Ophthalmology. 2007 Jan; 114(1):33-9.O

Abstract

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 degree (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 > or =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.

Authors+Show Affiliations

National University Hospital, Singapore. winnie_nolan@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17070597

Citation

Nolan, Winifred P., et al. "Detection of Primary Angle Closure Using Anterior Segment Optical Coherence Tomography in Asian Eyes." Ophthalmology, vol. 114, no. 1, 2007, pp. 33-9.
Nolan WP, See JL, Chew PT, et al. Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes. Ophthalmology. 2007;114(1):33-9.
Nolan, W. P., See, J. L., Chew, P. T., Friedman, D. S., Smith, S. D., Radhakrishnan, S., Zheng, C., Foster, P. J., & Aung, T. (2007). Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes. Ophthalmology, 114(1), 33-9.
Nolan WP, et al. Detection of Primary Angle Closure Using Anterior Segment Optical Coherence Tomography in Asian Eyes. Ophthalmology. 2007;114(1):33-9. PubMed PMID: 17070597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of primary angle closure using anterior segment optical coherence tomography in Asian eyes. AU - Nolan,Winifred P, AU - See,Jovina L, AU - Chew,Paul T K, AU - Friedman,David S, AU - Smith,Scott D, AU - Radhakrishnan,Sunita, AU - Zheng,Ce, AU - Foster,Paul J, AU - Aung,Tin, Y1 - 2006/10/27/ PY - 2005/10/28/received PY - 2006/05/23/revised PY - 2006/05/31/accepted PY - 2006/10/31/pubmed PY - 2007/1/17/medline PY - 2006/10/31/entrez SP - 33 EP - 9 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 1 N2 - 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 degree (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 > or =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. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17070597/Detection_of_primary_angle_closure_using_anterior_segment_optical_coherence_tomography_in_Asian_eyes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)00993-6 DB - PRIME DP - Unbound Medicine ER -