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 journalArticle

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 2010

Fingerprint

Optical Coherence Tomography
Anterior Chamber
Gonioscopy
Area Under Curve
Trabecular Meshwork
Sensitivity and Specificity
Singapore
Iris
Nose
Lenses
Cross-Sectional Studies
Research
Population

Keywords

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

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

Cite this

Evaluation of scanning protocols for imaging the anterior chamber angle with anterior segment-optical coherence tomography. / Khor, Wei Boon; Sakata, Lisandro M.; Friedman, David S; Narayanaswamy, Arun; Lavanya, Raghavan; Perera, Shamira A.; Aung, Tin.

In: Journal of Glaucoma, Vol. 19, No. 6, 08.2010, p. 365-368.

Research output: Contribution to journalArticle

Khor, Wei Boon ; Sakata, Lisandro M. ; Friedman, David S ; Narayanaswamy, Arun ; Lavanya, Raghavan ; Perera, Shamira A. ; Aung, Tin. / Evaluation of scanning protocols for imaging the anterior chamber angle with anterior segment-optical coherence tomography. In: Journal of Glaucoma. 2010 ; Vol. 19, No. 6. pp. 365-368.
@article{bad3a7446d604a639794ac3683f63960,
title = "Evaluation of scanning protocols for imaging the anterior chamber angle with anterior segment-optical coherence tomography",
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.",
keywords = "angle closure, anterior segment, glaucoma, imaging, optical coherence tomography",
author = "Khor, {Wei Boon} and Sakata, {Lisandro M.} and Friedman, {David S} and Arun Narayanaswamy and Raghavan Lavanya and Perera, {Shamira A.} and Tin Aung",
year = "2010",
month = "8",
doi = "10.1097/IJG.0b013e3181bf4dd5",
language = "English (US)",
volume = "19",
pages = "365--368",
journal = "Journal of Glaucoma",
issn = "1057-0829",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Evaluation of scanning protocols for imaging the anterior chamber angle with anterior segment-optical coherence tomography

AU - Khor, Wei Boon

AU - Sakata, Lisandro M.

AU - Friedman, David S

AU - Narayanaswamy, Arun

AU - Lavanya, Raghavan

AU - Perera, Shamira A.

AU - Aung, Tin

PY - 2010/8

Y1 - 2010/8

N2 - 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.

AB - 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.

KW - angle closure

KW - anterior segment

KW - glaucoma

KW - imaging

KW - optical coherence tomography

UR - http://www.scopus.com/inward/record.url?scp=77956045010&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956045010&partnerID=8YFLogxK

U2 - 10.1097/IJG.0b013e3181bf4dd5

DO - 10.1097/IJG.0b013e3181bf4dd5

M3 - Article

C2 - 19855287

AN - SCOPUS:77956045010

VL - 19

SP - 365

EP - 368

JO - Journal of Glaucoma

JF - Journal of Glaucoma

SN - 1057-0829

IS - 6

ER -