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Title: Detection of Primary Angle Closure Using Anterior Segment Optical Coherence Tomography in Asian Eyes
Authors: Nolan, W.P.
See, J.L.
Chew, P.T.K. 
Aung, T. 
Nolan, W.P.
Foster, P.J.
Zheng, C.
Friedman, D.S.
Smith, S.D.
Radhakrishnan, S.
Issue Date: 2007
Citation: Nolan, W.P., See, J.L., Chew, P.T.K., Aung, T., Nolan, W.P., Foster, P.J., Zheng, C., Friedman, D.S., Smith, S.D., Radhakrishnan, S. (2007). Detection of Primary Angle Closure Using Anterior Segment Optical Coherence Tomography in Asian Eyes. Ophthalmology 114 (1) : 33-39. ScholarBank@NUS Repository.
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° (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. © 2007 American Academy of Ophthalmology.
Source Title: Ophthalmology
ISSN: 01616420
DOI: 10.1016/j.ophtha.2006.05.073
Appears in Collections:Staff Publications

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