BACKGROUND: Visualization of the anterior chamber angle (ACA) is an important diagnostic part of evaluating patients with glaucoma. The purpose of this study was to evaluate the intra- and interobserver variability and reliability of the ACA and angle opening distance (AOD) measurements using optical coherence tomography (OCT). METHODS: To evaluate the intra- and interobserver variability, ACA and AOD were both measured five times and in three consecutive images in 22 patients (24 eyes) by two experienced observers. The intraclass correlation coefficient (ICC) as a measure of reliability was determined to estimate the intra- and interobserver variability. The main outcome measures were accuracy, reproducibility assessed with the coefficient of variation (CV), and the limits of agreement of ACA and AOD. RESULTS: The intraobserver variability of five replicate measurements was +/-1.4 degrees for ACA (CV 6.2%) and +/-11 micro m for AOD (CV 4%). The ICC for the intraobserver reliability was 0.99 for both ACA and AOD. The interobserver variability of three intersessional measurements was +/-2.5 degrees for ACA (CV 10.9%) and +/-24 micro m (CV 8.3%) for AOD. The ICC was 0.95 for ACA and 0.98 for AOD. There was no difference ( p>0.05) between the two observers measuring ACA and AOD. CONCLUSIONS: Two-dimensional visualization of the ACA and its assessment with slitlamp-adapted OCT yielded reliable ACA and AOD measurements in a clinical setting. Thus, OCT goniometry could provide an objective method to assess the anterior chamber angle.
BACKGROUND: Visualization of the anterior chamber angle (ACA) is an important diagnostic part of evaluating patients with glaucoma. The purpose of this study was to evaluate the intra- and interobserver variability and reliability of the ACA and angle opening distance (AOD) measurements using optical coherence tomography (OCT). METHODS: To evaluate the intra- and interobserver variability, ACA and AOD were both measured five times and in three consecutive images in 22 patients (24 eyes) by two experienced observers. The intraclass correlation coefficient (ICC) as a measure of reliability was determined to estimate the intra- and interobserver variability. The main outcome measures were accuracy, reproducibility assessed with the coefficient of variation (CV), and the limits of agreement of ACA and AOD. RESULTS: The intraobserver variability of five replicate measurements was +/-1.4 degrees for ACA (CV 6.2%) and +/-11 micro m for AOD (CV 4%). The ICC for the intraobserver reliability was 0.99 for both ACA and AOD. The interobserver variability of three intersessional measurements was +/-2.5 degrees for ACA (CV 10.9%) and +/-24 micro m (CV 8.3%) for AOD. The ICC was 0.95 for ACA and 0.98 for AOD. There was no difference ( p>0.05) between the two observers measuring ACA and AOD. CONCLUSIONS: Two-dimensional visualization of the ACA and its assessment with slitlamp-adapted OCT yielded reliable ACA and AOD measurements in a clinical setting. Thus, OCT goniometry could provide an objective method to assess the anterior chamber angle.