Bruno Lb Esporcatte, Roberto M Vessani, Luiz As Melo, Norton S Yanagimori, Guilherme H Bufarah, Norma Allemann, Ivan M Tavares
{"title":"光学相干断层扫描和非专业的角镜检查检测角闭合的诊断性能。","authors":"Bruno Lb Esporcatte, Roberto M Vessani, Luiz As Melo, Norton S Yanagimori, Guilherme H Bufarah, Norma Allemann, Ivan M Tavares","doi":"10.5005/jp-journals-10078-1354","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>How to cite this article: </strong>Esporcatte BLB, Vessani RM, Melo Jr LAS, <i>et al.</i> Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure. J Curr Glaucoma Pract 2022;16(1):53-58.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/ff/jocgp-16-53.PMC9385383.pdf","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure.\",\"authors\":\"Bruno Lb Esporcatte, Roberto M Vessani, Luiz As Melo, Norton S Yanagimori, Guilherme H Bufarah, Norma Allemann, Ivan M Tavares\",\"doi\":\"10.5005/jp-journals-10078-1354\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>How to cite this article: </strong>Esporcatte BLB, Vessani RM, Melo Jr LAS, <i>et al.</i> Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure. J Curr Glaucoma Pract 2022;16(1):53-58.</p>\",\"PeriodicalId\":15419,\"journal\":{\"name\":\"Journal of Current Glaucoma Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bd/ff/jocgp-16-53.PMC9385383.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Current Glaucoma Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/jp-journals-10078-1354\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Current Glaucoma Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10078-1354","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure.
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.
How to cite this article: Esporcatte BLB, Vessani RM, Melo Jr LAS, et al. Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure. J Curr Glaucoma Pract 2022;16(1):53-58.
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