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Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure
AIM: To compare the usefulness of gonioscopy performed by general ophthalmologists (GO) and anterior segment optical coherence tomography (AS-OCT) in detecting angle closure in patients with a shallow anterior chamber. METHODS: Forty-four patients with a shallow anterior chamber (defined by a ratio...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Jaypee Brothers Medical Publishers
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9385383/ https://www.ncbi.nlm.nih.gov/pubmed/36060038 http://dx.doi.org/10.5005/jp-journals-10078-1354 |
Sumario: | AIM: To compare the usefulness of gonioscopy performed by general ophthalmologists (GO) and anterior segment optical coherence tomography (AS-OCT) in detecting angle closure in patients with a shallow anterior chamber. METHODS: Forty-four patients with a shallow anterior chamber (defined by a ratio of peripheral anterior chamber depth to peripheral corneal thickness lower than 1/2) were included in this cross-sectional study. Gonioscopy was performed in all subjects by two glaucoma experts (GE1 and GE2) and one GO. Anterior segment imaging was performed using Visante® OCT (Carl Zeiss Meditec Inc.). Agreement between examiners was assessed with first-order agreement coefficients (AC1). Diagnostic accuracies of GO gonioscopy and AS-OCT were evaluated using sensitivity, specificity, and area under the receiver operating characteristic (AROC) curves. RESULTS: For static gonioscopy, the agreement between GE1 and GE2 was substantial (AC1 = 0.65), and that between GE1 and GO was moderate (AC1 = 0.50). For indentation gonioscopy, the agreement between GE1 and GE2 was slightly lower (AC1 = 0.55); however, the agreement between GE1 and GO showed a larger reduction (AC1 = 0.12). GO's gonioscopy presented a low specificity (25%) and the AROC to angle closure detection was lower than AS-OCT (0.56–0.73). Combined information of GO gonioscopy and AS-OCT improved specificity (85.7%) and AROC (0.77) of angle closure evaluation. CONCLUSION: Agreement between GO and glaucoma experts was moderate for static gonioscopy and slight for indentation gonioscopy. AS-OCT performed better than GO gonioscopy in detecting angle closure in patients with a shallow anterior chamber. The addition of AS-OCT to clinical information in patients with GO positive gonioscopy improved the specificity and AROC of gonioscopy test. HOW TO CITE THIS ARTICLE: Esporcatte BLB, Vessani RM, Melo Jr LAS, et al. Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure. J Curr Glaucoma Pract 2022;16(1):53–58. |
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