Journal of Current Glaucoma Practice

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VOLUME 16 , ISSUE 1 ( January-April, 2022 ) > List of Articles


Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure

Bruno LB Esporcatte, Roberto M Vessani, Luiz AS Melo Jr, Norton S Yanagimori, Guilherme H Bufarah, Norma Allemann, Ivan M Tavares

Keywords : Angle-closure, Anterior segment optical coherence tomography, Gonioscopy, Primary angle-closure glaucoma

Citation Information : Esporcatte BL, Vessani RM, Melo Jr LA, Yanagimori NS, Bufarah GH, Allemann N, Tavares IM. Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure. J Curr Glaucoma Pract 2022; 16 (1):53-58.

DOI: 10.5005/jp-journals-10078-1354

License: CC BY-NC 4.0

Published Online: 03-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


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.

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