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Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris

OBJECTIVE: To evaluate the diagnostic performance of manual grading of anterior segment optical coherence tomography (AS-OCT) in detection of plateau iris configuration (PIC) based on the presence of standardised ultrasound biomicroscopy (UBM) criteria in at least two quadrants; namely, clinical dia...

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Autores principales: Wanichwecharungruang, Boonsong, Pattanapongpaiboon, Warisara, Kongsomboon, Kittipong, Parivisutt, Nucharee, Annopawong, Kornkamol, Seresirikachorn, Kasem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943722/
https://www.ncbi.nlm.nih.gov/pubmed/35402728
http://dx.doi.org/10.1136/bmjophth-2021-000931
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author Wanichwecharungruang, Boonsong
Pattanapongpaiboon, Warisara
Kongsomboon, Kittipong
Parivisutt, Nucharee
Annopawong, Kornkamol
Seresirikachorn, Kasem
author_facet Wanichwecharungruang, Boonsong
Pattanapongpaiboon, Warisara
Kongsomboon, Kittipong
Parivisutt, Nucharee
Annopawong, Kornkamol
Seresirikachorn, Kasem
author_sort Wanichwecharungruang, Boonsong
collection PubMed
description OBJECTIVE: To evaluate the diagnostic performance of manual grading of anterior segment optical coherence tomography (AS-OCT) in detection of plateau iris configuration (PIC) based on the presence of standardised ultrasound biomicroscopy (UBM) criteria in at least two quadrants; namely, clinical diagnosis of PIC (DxPIC). METHODS AND ANALYSIS: In this cross-sectional study, paired AS-OCT and UBM images were evaluated by three glaucoma specialists. AS-OCT was classified into two mechanisms, PIC versus non-PIC, of primary angle closure disease (PACD) and AS-OCT-PIC diagnostic performance was tested with DxPIC. RESULTS: One hundred and seventy-nine eyes of 142 patients were enrolled for analysis, and DxPIC was found in 85 eyes (47.49%). Intraobserver agreement rates of AS-OCT classification by the graders were 0.77, 0.701 and 0.742 (all p<0.001), and interobserver agreement rates, between a senior glaucoma specialist and the other two glaucoma specialists, were 0.68 and 0.702 (all p<0.001). Plateau iris was classified in AS-OCT images by the three graders, rated 32.96%–39.1% and 24.58%–34.08% in the horizontal and vertical axes, respectively. Diagnostic performance was analysed, yielding sensitivity ranging from 56.47% to 77.78%, and specificity of 48.94% to 64.29%. We applied disease prevalence of 30%, revealing positive predictive values varying from 32.16% to 44.44%, and negative predictive values of 72.4% to 85.71%. Accuracy ranged from 51.2% to 65%. Agreement between the two devices was fair, kappa range 0.31–0.351. CONCLUSION: Performance of manual grading of AS-OCT in detection of DxPIC was relatively poor; therefore, unadjusted AS-OCT does not appear to be good for manual PIC screening in PACD patients and cannot serve as a substitute for UBM in PIC detection.
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spelling pubmed-89437222022-04-08 Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris Wanichwecharungruang, Boonsong Pattanapongpaiboon, Warisara Kongsomboon, Kittipong Parivisutt, Nucharee Annopawong, Kornkamol Seresirikachorn, Kasem BMJ Open Ophthalmol Glaucoma OBJECTIVE: To evaluate the diagnostic performance of manual grading of anterior segment optical coherence tomography (AS-OCT) in detection of plateau iris configuration (PIC) based on the presence of standardised ultrasound biomicroscopy (UBM) criteria in at least two quadrants; namely, clinical diagnosis of PIC (DxPIC). METHODS AND ANALYSIS: In this cross-sectional study, paired AS-OCT and UBM images were evaluated by three glaucoma specialists. AS-OCT was classified into two mechanisms, PIC versus non-PIC, of primary angle closure disease (PACD) and AS-OCT-PIC diagnostic performance was tested with DxPIC. RESULTS: One hundred and seventy-nine eyes of 142 patients were enrolled for analysis, and DxPIC was found in 85 eyes (47.49%). Intraobserver agreement rates of AS-OCT classification by the graders were 0.77, 0.701 and 0.742 (all p<0.001), and interobserver agreement rates, between a senior glaucoma specialist and the other two glaucoma specialists, were 0.68 and 0.702 (all p<0.001). Plateau iris was classified in AS-OCT images by the three graders, rated 32.96%–39.1% and 24.58%–34.08% in the horizontal and vertical axes, respectively. Diagnostic performance was analysed, yielding sensitivity ranging from 56.47% to 77.78%, and specificity of 48.94% to 64.29%. We applied disease prevalence of 30%, revealing positive predictive values varying from 32.16% to 44.44%, and negative predictive values of 72.4% to 85.71%. Accuracy ranged from 51.2% to 65%. Agreement between the two devices was fair, kappa range 0.31–0.351. CONCLUSION: Performance of manual grading of AS-OCT in detection of DxPIC was relatively poor; therefore, unadjusted AS-OCT does not appear to be good for manual PIC screening in PACD patients and cannot serve as a substitute for UBM in PIC detection. BMJ Publishing Group 2022-03-23 /pmc/articles/PMC8943722/ /pubmed/35402728 http://dx.doi.org/10.1136/bmjophth-2021-000931 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Glaucoma
Wanichwecharungruang, Boonsong
Pattanapongpaiboon, Warisara
Kongsomboon, Kittipong
Parivisutt, Nucharee
Annopawong, Kornkamol
Seresirikachorn, Kasem
Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
title Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
title_full Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
title_fullStr Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
title_full_unstemmed Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
title_short Diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
title_sort diagnostic performance of anterior segment optical coherence tomography in detecting plateau iris
topic Glaucoma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943722/
https://www.ncbi.nlm.nih.gov/pubmed/35402728
http://dx.doi.org/10.1136/bmjophth-2021-000931
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