Anterior segment Scheimpflug imaging for detecting primary angle closure disease

  • Andrew Winegarner
  • Atsuya MikiEmail author
  • Miho Kumoi
  • Yuichiro Ishida
  • Taku Wakabayashi
  • Susumu Sakimoto
  • Shinichi Usui
  • Kenji Matsushita
  • Kohji Nishida



To evaluate the capability of anterior segment Scheimpflug imaging for detecting primary angle closure disease (PACD): primary angle closure suspect, primary angle closure, and primary angle closure glaucoma, using cutoff points derived from reference databases of healthy subjects.


Eighty-seven patients with PACD and 49 age-matched control subjects were included. We evaluated the sensitivity and specificity of anterior chamber depth (ACD), anterior chamber volume (ACV), and anterior chamber angle (ACA) to differentiate patients with PACD from controls. Additionally, the study’s raw data was analyzed via receiver operating characteristic curves for comparison.


One standard deviation from the normative data’s mean values was used as the cutoff point and yielded a sensitivity and specificity of 96.2% and 92.6% for ACD, 97.1% and 75.9% for ACV, and 93.3% and 72.2% for ACA, respectively. Receiver operating characteristic analysis of the raw data showed the area under the curve to be 0.984, 0.975, and 0.931 for ACD, ACV, and ACA, respectively.


Our study demonstrated that the parameters of anterior segment Scheimpflug imaging, particularly ACD, accurately discriminate PACD. This was the first study to validate the device’s normative data in a separate population. With its high reproducibility, ease of use, non-invasiveness, and speed, anterior segment Scheimpflug imaging is a potentially powerful screening tool for PACD.


Primary angle closure glaucoma Scheimpflug imaging Primary angle closure Anterior chamber depth Anterior chamber volume Anterior chamber angle 


Compliance with ethical standards

Conflict of interest

All potential conflicts of interests are listed as follows: Miki A received honorarium from Kowa Pharmaceuticals, Pfizer Japan, Santen Pharmaceuticals, Alcon Japan, Otsuka Pharmaceutical, Novartis Pharma, R-Tech Ueno, Senju Pharmaceutical, Topcon, Ellex Inc., and Alcon Pharma. Nishida K received research support from Otsuka Pharmaceutical, AMO Japan, Topcon, Menicon, Wakamoto, Senju Pharmaceutical, Rohto Pharmaceutical, Santen Pharmaceutical, Novartis Pharma, Alcon Japan, Pfizer Japan, Hoya, Bayer Yakuhin, MSD Japan, and Kowa Pharmaceuticals, and honorarium from Senju Pharmaceutical, Pfizer Japan, Santen Pharmaceutical, Otsuka Pharmaceutical, Novartis Pharma, Alcon Japan, Hoya, Boehringer Ingelheim Japan, Bayer Yakuhin, Kowa Pharmaceuticals, SEED, Chuo Sangio, and Johnson & Johnson Japan. Winegarner A, Kumoi M, Ishida Y, Wakabayashi T, Sakimoto S, Usui S, and Matsushita K declared no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Ophthalmology, Graduate School of MedicineOsaka UniversityOsakaJapan
  2. 2.Department of OphthalmologyKansas University Medical CenterKansas CityUSA

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