Citation:Tay ELT,Yong VKY,Lim BA,Sia S,Wong EPY,Yip LWL.Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography.Int J Ophthalmol 2015;8(2):342-346,doi:10.3980/j.issn.2222-3959.2015.02.23
Agreement of angle closure assessments between gonioscopy, anterior segment optical coherence tomography and spectral domain optical coherence tomography
Received:September 25, 2013  Revised:July 23, 2014
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DOI:10.3980/j.issn.2222-3959.2015.02.23
Key Words:anterior segment imaging  spectral domain imaging  angle closure assessment
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Elton Lik Tong Tay Department of Ophthalmology, Tan Tock Seng Hospital, Singapore , Singapore ,Republic of Singapore Air Force Aeromedical Centre, Singapore , Singapore
Vernon Khet Yau Yong Department of Ophthalmology, Tan Tock Seng Hospital, Singapore , Singapore
Boon Ang Lim Department of Ophthalmology, Tan Tock Seng Hospital, Singapore , Singapore
Stelson Sia Cardinal Santos Medical Center, San Juan City, Metro Manila 1502, Philippines
Elizabeth Poh Ying Wong Department of Ophthalmology, Tan Tock Seng Hospital, Singapore , Singapore
Leonard Wei Leon Yip Department of Ophthalmology, Tan Tock Seng Hospital, Singapore , Singapore
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Abstract:
      AIM: To determine angle closure agreements between gonioscopy and anterior segment optical coherence tomography (AS-OCT), as well as gonioscopy and spectral domain OCT (SD-OCT). A secondary objective was to quantify inter-observer agreements of AS-OCT and SD-OCT assessments.

    METHODS: Seventeen consecutive subjects (33 eyes) were recruited from the study hospital’s Glaucoma clinic. Gonioscopy was performed by a glaucomatologist masked to OCT results. OCT images were read independently by 2 other glaucomatologists masked to gonioscopy findings as well as each other’s analyses of OCT images.

    RESULTS: Totally 84.8% and 45.5% of scleral spurs were visualized in AS-OCT and SD-OCT images respectively (P<0.01). The agreement for angle closure between AS-OCT and gonioscopy was fair at k=0.31 (95% confidence interval, CI: 0.03-0.59) and k=0.35 (95% CI: 0.07-0.63) for reader 1 and 2 respectively. The agreement for angle closure between SD-OCT and gonioscopy was fair at k=0.21 (95% CI: 0.07-0.49) and slight at k=0.17 (95% CI: 0.08-0.42) for reader 1 and 2 respectively. The inter-reader agreement for angle closure in AS-OCT images was moderate at 0.51 (95% CI: 0.13-0.88). The inter-reader agreement for angle closure in SD-OCT images was slight at 0.18 (95% CI: 0.08-0.45).

    CONCLUSION: Significant proportion of scleral spurs were not visualised with SD-OCT imaging resulting in weaker inter-reader agreements. Identifying other angle landmarks in SD-OCT images will allow more consistent angle closure assessments. Gonioscopy and OCT imaging do not always agree in angle closure assessments but have their own advantages, and should be used together and not exclusively.

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