Evaluation of scanning protocols for imaging the anterior chamber angle with anterior segment-optical coherence tomography

Wei Boon Khor, Lisandro M. Sakata, David S. Friedman, Arun Narayanaswamy, Raghavan Lavanya, Shamira A. Perera, Tin Aung

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Purpose: To evaluate different anterior segment-optical coherence tomography (AS-OCT) scanning protocols for detecting eyes with angle closure. Methods: This cross-sectional study enrolled 2104 subjects from a community clinic in Singapore. All participants underwent AS-OCT imaging in the dark (Visante, Carl-Zeiss, Meditec, Dublin, CA), and gonioscopy with a Goldmann 2-mirror and a Sussman lens by an experienced examiner. The anterior chamber angle in a particular quadrant was considered closed on gonioscopy if the posterior trabecular meshwork could not be seen; and on AS-OCT by the presence of contact between the iris and angle wall anterior to the scleral spur. Protocols using combinations of AS-OCT scans of different quadrants of the eye were compared. Results: A total of 1853/2104 right eyes could be graded in all 4 quadrants. In all, 380 (20.5%) eyes had closed angles in at least 2 quadrants on gonioscopy. The AS-OCT scanning protocol that only imaged the inferior quadrant showed the best area under the receiving operating characteristic curve (AUC 0.76, sensitivity 84%, specificity 69%) for detecting angle closure. Although technically easier to obtain, the protocol that only included the nasal-temporal quadrants had the lowest AUC (AUC 0.67, sensitivity 47%, specificity 88%), whereas scanning the superior-inferior quadrants showed high sensitivity for detecting angle closure (92%), but low specificity (54%). Conclusions: Using the results obtained in a research setting, the diagnostic performance of AS-OCT varied according to the adopted scanning protocol. The inferior quadrant-only protocol showed the best diagnostic performance but the low specificity would limit its use for population screening.

Original languageEnglish (US)
Pages (from-to)365-368
Number of pages4
JournalJournal of glaucoma
Volume19
Issue number6
DOIs
StatePublished - Aug 1 2010

Keywords

  • angle closure
  • anterior segment
  • glaucoma
  • imaging
  • optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology

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