Reema Thomas Kochupurakal1, Krishnagopal Srikanth2, Kirti Nath Jha3, A R Rajalakshmi4, Swathi Nagarajan4, G Ezhumalai5. 1. Resident, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India . 2. Professor and Head, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India . 3. Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India . 4. Associate Professor, Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India . 5. Senior Statistician and Research Consultant, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University , Pondicherry, India .
Abstract
INTRODUCTION: Gonioscopy is the gold standard in assessing anterior chamber angles. However, interobserver variations are common and there is a need for reliable objective method of assessment. AIM: To compare the anterior chamber angle by gonioscopy and Spectral Domain Optical Coherence Tomography (SD-OCT) in individuals with shallow anterior chamber. MATERIALS AND METHODS: This comparative observational study was conducted in a rural tertiary multi-speciality teaching hospital. A total of 101 eyes of 54 patients with shallow anterior chamber on slit lamp evaluation were included. Anterior chamber angle was graded by gonioscopy using the shaffer grading system. Angles were also assessed by SD-OCT with Trabecular Iris Angle (TIA) and Angle Opening Distance (AOD). Chi-square test, sensitivity, specificity, positive and negative predictive value to find correlation between OCT parameters and gonioscopy grading. RESULTS: Females represented 72.7%. The mean age was 53.93 ±8.24 years and mean anterior chamber depth was 2.47 ± 0.152 mm. Shaffer grade ≤ 2 were identified in 95(94%) superior, 42(41.5%) inferior, 65(64.3%) nasal and 57(56.4%) temporal quadrants. Cut-off values of TIA ≤ 22° and AOD ≤ 290 μm were taken as narrow angles on SD-OCT. TIA of ≤ 22° were found in 88(92.6%) nasal and 87(87%) temporal angles. AOD of ≤ 290 μm was found in 73(76.8%) nasal and 83(83%) temporal quadrants. Sensitivity in detecting narrow angles was 90.7% and 82.2% for TIA and AOD, while specificity was 11.7% and 23.4%, respectively. CONCLUSION: Individuals were found to have narrow angles more with SD-OCT. Sensitivity was high and specificity was low in detecting narrow angles compared to gonioscopy, making it an unreliable tool for screening.
INTRODUCTION: Gonioscopy is the gold standard in assessing anterior chamber angles. However, interobserver variations are common and there is a need for reliable objective method of assessment. AIM: To compare the anterior chamber angle by gonioscopy and Spectral Domain Optical Coherence Tomography (SD-OCT) in individuals with shallow anterior chamber. MATERIALS AND METHODS: This comparative observational study was conducted in a rural tertiary multi-speciality teaching hospital. A total of 101 eyes of 54 patients with shallow anterior chamber on slit lamp evaluation were included. Anterior chamber angle was graded by gonioscopy using the shaffer grading system. Angles were also assessed by SD-OCT with Trabecular Iris Angle (TIA) and Angle Opening Distance (AOD). Chi-square test, sensitivity, specificity, positive and negative predictive value to find correlation between OCT parameters and gonioscopy grading. RESULTS: Females represented 72.7%. The mean age was 53.93 ±8.24 years and mean anterior chamber depth was 2.47 ± 0.152 mm. Shaffer grade ≤ 2 were identified in 95(94%) superior, 42(41.5%) inferior, 65(64.3%) nasal and 57(56.4%) temporal quadrants. Cut-off values of TIA ≤ 22° and AOD ≤ 290 μm were taken as narrow angles on SD-OCT. TIA of ≤ 22° were found in 88(92.6%) nasal and 87(87%) temporal angles. AOD of ≤ 290 μm was found in 73(76.8%) nasal and 83(83%) temporal quadrants. Sensitivity in detecting narrow angles was 90.7% and 82.2% for TIA and AOD, while specificity was 11.7% and 23.4%, respectively. CONCLUSION: Individuals were found to have narrow angles more with SD-OCT. Sensitivity was high and specificity was low in detecting narrow angles compared to gonioscopy, making it an unreliable tool for screening.
Authors: Carol Yim-lui Cheung; Shu Liu; Robert N Weinreb; Jing Liu; Haitao Li; Dexter Yu-lung Leung; Syril Dorairaj; Jeffrey Liebmann; Robert Ritch; Dennis Shun Chiu Lam; Christopher Kai-shun Leung Journal: Invest Ophthalmol Vis Sci Date: 2010-03-17 Impact factor: 4.799
Authors: Sunita Radhakrishnan; Jason Goldsmith; David Huang; Volker Westphal; David K Dueker; Andrew M Rollins; Joseph A Izatt; Scott D Smith Journal: Arch Ophthalmol Date: 2005-08
Authors: Lisandro M Sakata; Raghavan Lavanya; David S Friedman; Han T Aung; Hong Gao; Rajesh S Kumar; Paul J Foster; Tin Aung Journal: Ophthalmology Date: 2007-10-04 Impact factor: 12.079
Authors: Winifred P Nolan; Jovina L See; Paul T K Chew; David S Friedman; Scott D Smith; Sunita Radhakrishnan; Ce Zheng; Paul J Foster; Tin Aung Journal: Ophthalmology Date: 2006-10-27 Impact factor: 12.079