Agreement of gonioscopy and anterior segment-optical coherence tomography in the assessment of the anterior chamber angle: A cross-sectional study

Kerala Journal of Ophthalmology

article

Jaseena, K.¹  Rekha, P. S.¹ 

[1] Department of Ophthalmology, Government Medical College

关键词: Agreement;    anterior chamber angles;    concordance;    glaucoma;    gonioscopy;    optical coherence tomography;   

DOI  :  10.4103/kjo.kjo_91_21

学科分类：社会科学、人文和艺术（综合）

来源: Wolters Kluwer Medknow Publications

【 摘 要 】

Purpose:  The aim of the study was to evaluate the inter instrument agreement between gonioscopy and anterior segment optical coherence tomography (AS-OCT) in the assessment of the anterior chamber angle (ACA) in eyes with all Van Herick's grades. Methods:  A single examiner performed AS-OCT and gonioscopy with a Goldman single mirror for all study patients. An angle opening distance at 500 μm from the scleral spur in the AS-OCT was considered as the quantitative parameter to assess the ACA. A closed ACA on AS-OCT was defined by the presence of any contact between the iris and angle wall anterior to scleral spur. The agreement between gonioscopy and AS-OCT of the nasal and temporal angles was estimated using the Kappa statistic and the concordance between the instruments using the Lin's concordance coefficient. Results:  The mean age of the seventy participants in the study was 52.11 ± 5.37 years. Five (15.15%) of nasal angles and 4 (12.12%) of temporal angles identified as closed by gonioscopy were called as open by AS-OCT. The Kappa statistic (0.59), pairwise correlation (0.60), and Lin's concordance correlation coefficient (0.59) showed only moderate agreement and concordance between AS-OCT and gonioscopy. AS-OCT had a moderate sensitivity (73%) and better specificity (86.4%). Conclusion:  The results of our study show that AS-OCT can be used as a clinical diagnostic test but has limited use as a screening test for ACA. The significant proportion of subjects with a mismatch in the categorization of open and closed ACA and the moderate agreement highlights the need for better objective diagnostic criteria for closed ACA.

【 授权许可】

CC BY-NC-SA