Rossi Gemma C M, Scudeller Luigia, Delfino Alessio, Raimondi Marta, Pezzotta Sara, Maccarone Martina, Antoniazzi Elena, Pasinetti Gian Maria, Bianchi Paolo Emilio
University Eye Clinic of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
Eur J Ophthalmol. 2012 Sep-Oct;22(5):701-8. doi: 10.5301/ejo.5000108.
To assess the sensitivity and specificity of Pentacam measurements in detection of occludable angles and to provide cutoff values.
Observational, single-center, cross-sectional study on 64 Caucasian eyes: 28 (43.7%) primary narrow angles or primary angle-closure glaucoma, and 36 (56.2%) controls: all subjects were evaluated and classified by gonioscopy (Shaffer classification). The following measurements have been considered: superior and inferior anterior chamber angle (ACA), temporal and nasal ACA, anterior chamber depth (ACD) using 5 value representation (central, superior, inferior, nasal, temporal), and anterior chamber volume (ACV). Validity of Pentacam parameters to detect patients in Shaffer 0 or I class was assessed by receiver operating characteristic (ROC) curves analysis; cutoffs were chosen as to maximize sensitivity and specificity.
All the considered Pentacam measures were statistically different between the 2 groups (p<0.0001). All Shaffer grade groups differed in all parameters (p<0.001), except for grade 0 and I, which did not differ in any. Area under the curve ROC analysis revealed high discriminant power of all Pentacam measures: ACA = 0.94; ACD = 0.91; ACD central = 0.89; and ACV = 0.89. Chosen cutoff values (ACA = 22.4°; ACD = 1.12 mm; ACD central = 1.93 mm; ACV = 84 mm3) allowed correct classification of narrow angles.
The study pointed out a high power of Pentacam AVA, ACV, and ACD in detecting occludable angles. Pentacam is simple to use, reliable, and noncontact, provides parameters in a short period, and represents a possible screening tool.
评估Pentacam测量在检测可闭角方面的敏感性和特异性，并提供临界值。
对64只高加索人眼睛进行观察性、单中心横断面研究：28只（43.7%）原发性窄角或原发性闭角型青光眼，36只（56.2%）对照：所有受试者均通过前房角镜检查（Shaffer分类）进行评估和分类。考虑了以下测量：上、下前房角（ACA）、颞侧和鼻侧ACA、使用5值表示法（中央、上方、下方、鼻侧、颞侧）的前房深度（ACD）和前房容积（ACV）。通过受试者操作特征（ROC）曲线分析评估Pentacam参数检测Shaffer 0或I级患者的有效性；选择临界值以最大化敏感性和特异性。
两组之间所有考虑的Pentacam测量值在统计学上均有差异（p<0.0001）。除0级和I级外，所有Shaffer分级组在所有参数上均有差异（p<0.001），0级和I级在任何参数上均无差异。ROC曲线分析的曲线下面积显示所有Pentacam测量值具有较高的判别能力：ACA = 0.94；ACD = 0.91；中央ACD = 0.89；ACV = 0.89。选择的临界值（ACA = 22.4°；ACD = 1.12 mm；中央ACD = 1.93 mm；ACV = 84 mm3）可正确分类窄角。
该研究指出Pentacam的前房角面积（AVA）、前房容积（ACV）和前房深度（ACD）在检测可闭角方面具有较高能力。Pentacam使用简单、可靠且非接触，能在短时间内提供参数，是一种可能的筛查工具。
