Zhang Ye, Li Si Zhen, Li Lei, Thomas Ravi, Wang Ning Li
Beijing TongRen Eye Center, Beijing TongRen Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab , Beijing , China .
Ophthalmic Epidemiol. 2014 Aug;21(4):268-75. doi: 10.3109/09286586.2014.929707. Epub 2014 Jun 20.
To evaluate the van Herick test, anterior segment optical coherence tomography (AS-OCT), Pentacam and scanning peripheral anterior chamber depth analyzer (SPAC) for detecting primary angle-closure suspect (PACS) in a rural Chinese population.
Eligible subjects aged ≥40 years were examined at the 5-year follow-up of the Handan Eye Study. PACS was defined as non-visibility of the posterior pigmented trabecular meshwork for ≥180° of the angle. Sensitivity, specificity, predictive values and receiver operating characteristic curves were used to assess the tests.
A total of 425 right eyes of 431 eligible subjects were analyzed. The area under the curve (AUC) for the van Herick test and AS-OCT were 0.711 and 0.799, respectively. The AUC for Pentacam anterior chamber depth was 0.834, while anterior chamber angle and anterior chamber volume had AUCs of 0.680 and 0.800, respectively. The AUC for SPAC was 0.779. AS-OCT had a specificity of 87% with a sensitivity of 73%. The best specificity of 92% (sensitivity 19%) was achieved by the van Herrick test at the 15% cut-off.
None of the tests evaluated achieved the combination of specificity and sensitivity needed for population-based screening and their current capability does not realize the objective of case detection in the setting of an ophthalmology clinic.
评估van Herick检查、眼前节光学相干断层扫描（AS-OCT）、Pentacam和扫描周边前房深度分析仪（SPAC）在中国农村人群中检测原发性房角关闭可疑者（PACS）的效果。
在邯郸眼病研究的5年随访中，对年龄≥40岁的符合条件的受试者进行检查。PACS定义为房角≥180°范围的后色素小梁网不可见。采用敏感性、特异性、预测值和受试者工作特征曲线来评估这些检查。
共分析了431名符合条件受试者的425只右眼。van Herick检查和AS-OCT的曲线下面积（AUC）分别为0.711和0.799。Pentacam前房深度的AUC为0.834，而前房角和前房容积的AUC分别为0.680和0.800。SPAC的AUC为0.779。AS-OCT的特异性为87%，敏感性为73%。van Herrick检查在15%的截断值时特异性最佳，为92%（敏感性为19%）。
所评估的检查均未达到基于人群筛查所需的特异性和敏感性的组合，且它们目前的能力未实现眼科门诊病例检测的目标。
