Filipa Teixeira1,2, David C Sousa1,2,3, Inês Leal1,2,3, André Barata1,2, Carlos M Neves1,2,3, Luís A Pinto1,2,3. 1. Department of Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal. 2. Clínica Universitária de Oftalmologia, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal. 3. Centro de Estudos Ciências da Visão, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Abstract
PURPOSE: The aim of this study is to assess the agreement between manual and automated gonioscopy for iridocorneal angle opening. METHODS: The research is a cross-sectional observational study. Manual and automated gonioscopy were performed to consecutive patients in a glaucoma clinic. Iridocorneal angle opening grading was performed according to Shaffer's classification. Automated gonioscopy was performed with NGS-1 automated gonioscope (NIDEK Co., Gamagori, Japan). The automated gonio-photos were graded by two independent observers. Agreement between automated and manual gonioscopy and also among raters was ascertained by Fleiss' kappa statistic and comparison of area under curve. RESULTS: In total, 88 eyes of 47 subjects were analysed. Mean age was 63 ± 10 years. Twenty eyes (22.7%) were excluded from grading due to poor quality images. Angle closure was detected in 23.4% with dynamic gonioscopy in comparison with 4.3% using automated image grading. The agreement for angle closure diagnosis between dynamic and automated gonioscopy was low (κ = 0.09 ± 0.10; p = 0.18). The area under curve for detecting eyes with angle closure showed poor accuracy between automated and manual methods (area under curve: 0.53 ± 0.05, 95% confidence interval: 0.44-0.62). There was modest inter-rater agreement for angle opening assessment of automated images with Fleiss' kappa of 0.17 (95% confidence interval: 0.035-0.238). CONCLUSION: Manual and automated gonioscopy showed only slight agreement for the assessment of iridocorneal angle opening status. Further improvements of the NGS-1 automated gonioscopy and technique are desired for widespread use in a real-life setting.
PURPOSE: The aim of this study is to assess the agreement between manual and automated gonioscopy for iridocorneal angle opening. METHODS: The research is a cross-sectional observational study. Manual and automated gonioscopy were performed to consecutive patients in a glaucoma clinic. Iridocorneal angle opening grading was performed according to Shaffer's classification. Automated gonioscopy was performed with NGS-1 automated gonioscope (NIDEK Co., Gamagori, Japan). The automated gonio-photos were graded by two independent observers. Agreement between automated and manual gonioscopy and also among raters was ascertained by Fleiss' kappa statistic and comparison of area under curve. RESULTS: In total, 88 eyes of 47 subjects were analysed. Mean age was 63 ± 10 years. Twenty eyes (22.7%) were excluded from grading due to poor quality images. Angle closure was detected in 23.4% with dynamic gonioscopy in comparison with 4.3% using automated image grading. The agreement for angle closure diagnosis between dynamic and automated gonioscopy was low (κ = 0.09 ± 0.10; p = 0.18). The area under curve for detecting eyes with angle closure showed poor accuracy between automated and manual methods (area under curve: 0.53 ± 0.05, 95% confidence interval: 0.44-0.62). There was modest inter-rater agreement for angle opening assessment of automated images with Fleiss' kappa of 0.17 (95% confidence interval: 0.035-0.238). CONCLUSION: Manual and automated gonioscopy showed only slight agreement for the assessment of iridocorneal angle opening status. Further improvements of the NGS-1 automated gonioscopy and technique are desired for widespread use in a real-life setting.
Authors: Ivano Riva; Eleonora Micheletti; Francesco Oddone; Carlo Bruttini; Silvia Montescani; Giovanni De Angelis; Luigi Rovati; Robert N Weinreb; Luciano Quaranta Journal: J Clin Med Date: 2020-11-25 Impact factor: 4.241
Authors: Bruno Lb Esporcatte; Roberto M Vessani; Luiz As Melo; Norton S Yanagimori; Guilherme H Bufarah; Norma Allemann; Ivan M Tavares Journal: J Curr Glaucoma Pract Date: 2022 Jan-Apr