Angle assessment by eyecam, goniophotography, and gonioscopy

Mani Baskaran, Shamira A. Perera, Monisha E. Nongpiur, Tin A. Tun, Judy Park, Rajesh S. Kumar, David S. Friedman, Tin Aung

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To compare EyeCam (Clarity Medical Systems, Pleasanton, CA) and goniophotography in detecting angle closure, using gonioscopy as the reference standard. METHODS: In this hospital-based, prospective, cross-sectional study, participants underwent gonioscopy by a single observer, and EyeCam imaging and goniophotography by different operators. The anterior chamber angle in a quadrant was classified as closed if the posterior trabecular meshwork could not be seen. A masked observer categorized the eyes as per the number of closed quadrants, and an eye was classified as having angle closure if there were 2 or more quadrants of closure. Agreement between the methods was analyzed by κ statistic and comparison of area under receiver operating characteristic curves (AUC). RESULTS: Eighty-five participants (85 eyes) were included, the majority of whom were Chinese. Angle closure was detected in 38 eyes (45%) with gonioscopy, 40 eyes (47%) using EyeCam, and 40 eyes (47%) with goniophotography (P=0.69 in both comparisons, McNemar test). The agreement for angle closure diagnosis (by eye) between gonioscopy and the 2 imaging modalities was high (κ=0.86; 95% Confidence Interval (CI), 0.75-0.97), whereas the agreement between EyeCam and goniophotography was not as good (κ=0.72; 95% CI, 0.57-0.87); largely due to lack of agreement in the nasal and temporal quadrants (κ=0.55 to 0.67). The AUC for detecting eyes with gonioscopic angle closure was similar for goniophotography and EyeCam (AUC 0.93, sensitivity=94.7%, specificity=91.5%; P>0.95). CONCLUSIONS: EyeCam and goniophotography have similarly high sensitivity and specificity for the detection of gonioscopic angle closure.

Original languageEnglish (US)
Pages (from-to)493-497
Number of pages5
JournalJournal of glaucoma
Volume21
Issue number7
DOIs
StatePublished - Sep 1 2012

Keywords

  • angle closure
  • anterior chamber angle
  • goniophotography
  • gonioscopy
  • imaging

ASJC Scopus subject areas

  • Ophthalmology

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