Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography

作     者：Elton Lik Tong Tay Vernon Khet Yau Yong Boon Ang Lim Stelson Sia Elizabeth Poh Ying Wong Leonard Wei Leon Yip 

作者机构：Department of Ophthalmology Tan Tock Seng Hospital Republic of Singapore Air Force Aeromedical Centre Cardinal Santos Medical Center 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2015年第8卷第2期

页      面：342-346页

核心收录：

学科分类：1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 10[医学] 

主　　题：anterior segment imaging spectral domain imaging angle closure assessment 

摘      要：AIM: To determine angle closure agreements between gonioscopy and anterior segment optical coherence tomography(AS-OCT), as well as gonioscopy and spectral domain OCT(SD-OCT). A secondary objective was to quantify inter-observer agreements of AS-OCT and SD-OCT ***: Seventeen consecutive subjects(33 eyes)were recruited from the study hospital’s Glaucoma *** was performed by a glaucomatologist masked to OCT results. OCT images were read independently by 2 other glaucomatologists masked to gonioscopy findings as well as each other’s analyses of OCT ***: Totally 84.8% and 45.5% of scleral spurs were visualized in AS-OCT and SD-OCT images respectively(P 0.01). The agreement for angle closure between AS-OCT and gonioscopy was fair at k =0.31(95% confidence interval, CI: 0.03-0.59) and k =0.35(95%CI: 0.07-0.63) for reader 1 and 2 respectively. The agreement for angle closure between SD-OCT and gonioscopy was fair at k =0.21(95% CI: 0.07-0.49) and slight at k =0.17(95% CI: 0.08-0.42) for reader 1 and 2 respectively. The inter-reader agreement for angle closure in AS-OCT images was moderate at 0.51(95% CI: 0.13-0.88). The inter-reader agreement for angle closure in SD-OCT images was slight at 0.18(95% CI: 0.08-0.45).CONCLUSION: Significant proportion of scleral spurs were not visualised with SD-OCT imaging resulting in weaker inter-reader agreements. Identifying other angle landmarks in SD-OCT images will allow more consistent angle closure assessments. Gonioscopy and OCT imaging do not always agree in angle closure assessments but have their own advantages, and should be used together and not exclusively.