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


Journal Article

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.

Full Text

Cited Authors

  • Khor, W-B; Sakata, LM; Friedman, DS; Narayanaswamy, A; Lavanya, R; Perera, SA; Aung, T

Published Date

  • August 2010

Published In

Volume / Issue

  • 19 / 6

Start / End Page

  • 365 - 368

PubMed ID

  • 19855287

Pubmed Central ID

  • 19855287

Electronic International Standard Serial Number (EISSN)

  • 1536-481X

International Standard Serial Number (ISSN)

  • 1057-0829

Digital Object Identifier (DOI)

  • 10.1097/ijg.0b013e3181bf4dd5


  • eng