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Assessment of narrow angles by gonioscopy, Van Herick method and anterior segment optical coherence tomography

  • Clinical Investigation
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Abstract

Purpose

To evaluate anterior chamber (AC) angles using gonioscopy, Van Herick technique and anterior segment optical coherence tomography (AS-OCT).

Methods

One hundred forty-eight consecutive subjects were enrolled. The agreement between any two of three diagnostic methods, gonioscopy, AS-OCT and Van Herick, was calculated in narrow-angle patients. The area under receiver-operating characteristic curves (AUC) for discriminating between narrow and open angles determined by gonioscopy was calculated in all participants for AS-OCT parameter angle opening distance (AOD), angle recess area, trabecular iris surface area and anterior chamber depth (ACD). As a subgroup analysis, capability of AS-OCT parameters for detecting angle closure defined by AS-OCT was assessed in narrow-angle patients.

Results

The agreement between the Van Herick method and gonioscopy in detecting angle closure was excellent in narrow angles (κ = 0.80, temporal; κ = 0.82, nasal). However, agreement between gonioscopy and AS-OCT and between the Van Herick method and AS-OCT was poor (κ = 0.11–0.16). Discrimination capability of AS-OCT parameters between open and narrow angles determined by gonioscopy was excellent for all AS-OCT parameters (AUC, temporal: AOD500 = 0.96, nasal: AOD500 = 0.99). The AUCs for detecting angle closure defined by AS-OCT image in narrow angle subjects was good for all AS-OCT parameters (AUC, 0.80–0.94) except for ACD (temporal: ACD = 0.70, nasal: ACD = 0.63).

Conclusion

Assessment of narrow angles by gonioscopy and the Van Herick technique showed good agreement, but both measurements revealed poor agreement with AS-OCT. The angle closure detection capability of AS-OCT parameters was excellent; however, it was slightly lower in ACD.

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Authors and Affiliations

  1. BS Eye Center, Seoul, Republic of Korea

    Seong Bae Park, Kyung Rim Sung, Sung Yung Kang, Jung Woo Jo, Kyoung Sub Lee & Michael S. Kook

  2. Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, 388-1 Pungnap-2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea

    Seong Bae Park, Kyung Rim Sung, Sung Yung Kang, Jung Woo Jo, Kyoung Sub Lee & Michael S. Kook

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  1. Seong Bae Park
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Correspondence to Michael S. Kook.

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Park, S.B., Sung, K.R., Kang, S.Y. et al. Assessment of narrow angles by gonioscopy, Van Herick method and anterior segment optical coherence tomography. Jpn J Ophthalmol 55, 343–350 (2011). https://doi.org/10.1007/s10384-011-0036-0

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  • DOI: https://doi.org/10.1007/s10384-011-0036-0

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