Wirbelauer Christopher, Karandish Amir, Häberle Heike, Pham Duy Thoai
Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin, Germany.
Arch Ophthalmol. 2005 Feb;123(2):179-85. doi: 10.1001/archopht.123.2.179.
To assess the value of noncontact goniometry with optical coherence tomography (OCT) compared with current clinical parameters in the evaluation of the anterior chamber angle (ACA).
Prospective observational study of 138 eyes of 109 patients.
The ACA parameters and angle-opening distance (AOD) were measured with slitlamp-adapted OCT goniometry. The iris and scleral thickness and the iris convexity were assessed with OCT. Both ACA and AOD were compared with the clinical parameters of gonioscopy grade, limbal anterior chamber depth (ACD), ultrasonographic central ACD, and lens-axial length (LAL) ratio.
Noncontact goniometry with OCT revealed mean +/- SD values of 28 degrees +/- 16 degrees for the ACA and 381 +/- 234 mum for the AOD. The mean +/- SD iris thickness was 369 +/- 84 mum, and the scleral thickness at the scleral spur was 943 +/- 148 mum. There was a significant correlation (P<.001) with the clinical parameters of gonioscopic grading, limbal ACD, ultrasonographic central ACD, and LAL ratio. The sensitivity and specificity of OCT goniometry to detect an occludable angle were 86% and 95% for ACA and 85% and 90% for AOD, respectively.
Noncontact goniometry with OCT was helpful in evaluating the anterior chamber structures and as a screening modality. Goniometry with OCT could improve the noninvasive clinical assessment and treatment of patients with glaucoma.
评估光学相干断层扫描(OCT)非接触式前房角测量法与当前临床参数在评估前房角(ACA)方面的价值。
对109例患者的138只眼进行前瞻性观察研究。
采用适配裂隙灯的OCT前房角测量法测量ACA参数和房角开放距离(AOD)。用OCT评估虹膜和巩膜厚度以及虹膜凸度。将ACA和AOD与房角镜分级、角膜缘前房深度(ACD)、超声中央ACD和晶状体眼轴长度(LAL)比值等临床参数进行比较。
OCT非接触式前房角测量法显示,ACA的平均值±标准差为28°±16°,AOD为381±234μm。虹膜平均厚度±标准差为369±84μm,巩膜突处巩膜厚度为943±148μm。与房角镜分级、角膜缘ACD、超声中央ACD和LAL比值等临床参数存在显著相关性(P<0.001)。OCT前房角测量法检测可闭房角的敏感性和特异性,ACA分别为86%和95%,AOD分别为85%和90%。
OCT非接触式前房角测量法有助于评估前房结构并作为一种筛查方式。OCT前房角测量法可改善青光眼患者的无创临床评估和治疗。