Esporcatte Bruno Lb, Vessani Roberto M, Melo Luiz As, Yanagimori Norton S, Bufarah Guilherme H, Allemann Norma, Tavares Ivan M
Department of Ophthalmology and Visual Sciences, Universidade Federal De São Paulo, São Paulo, Brazil.
J Curr Glaucoma Pract. 2022 Jan-Apr;16(1):53-58. doi: 10.5005/jp-journals-10078-1354.
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.
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.
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.
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.
Esporcatte BLB, Vessani RM, Melo Jr LAS, Diagnostic Performance of Optical Coherence Tomography and Nonspecialist Gonioscopy to Detect Angle Closure. J Curr Glaucoma Pract 2022;16(1):53-58.
比较普通眼科医生（GO）进行的前房角镜检查与眼前节光学相干断层扫描（AS-OCT）在检测浅前房患者房角关闭方面的效用。
本横断面研究纳入了44例浅前房患者（定义为周边前房深度与周边角膜厚度之比低于1/2）。由两位青光眼专家（GE1和GE2）和一位普通眼科医生对所有受试者进行前房角镜检查。使用Visante® OCT（卡尔蔡司医疗技术公司）进行眼前节成像。检查者之间的一致性通过一级一致性系数（AC1）进行评估。使用灵敏度、特异性和受试者操作特征曲线下面积（AROC）评估普通眼科医生前房角镜检查和AS-OCT的诊断准确性。
对于静态前房角镜检查，GE1和GE2之间的一致性较高（AC1 = 0.65），GE1和普通眼科医生之间的一致性为中等（AC1 = 0.50）。对于压陷式前房角镜检查，GE1和GE2之间的一致性略低（AC1 = 0.55）；然而，GE1和普通眼科医生之间的一致性下降幅度更大（AC1 = 0.12）。普通眼科医生的前房角镜检查特异性较低（25%），检测房角关闭的AROC低于AS-OCT（0.56 - 0.73）。普通眼科医生前房角镜检查和AS-OCT的联合信息提高了房角关闭评估的特异性（85.7%）和AROC（0.77）。
对于静态前房角镜检查，普通眼科医生与青光眼专家之间的一致性为中等，对于压陷式前房角镜检查一致性为轻微。在检测浅前房患者房角关闭方面，AS-OCT比普通眼科医生的前房角镜检查表现更好。在普通眼科医生前房角镜检查结果为阳性的患者的临床信息中加入AS-OCT可提高前房角镜检查的特异性和AROC。
Esporcatte BLB, Vessani RM, Melo Jr LAS, 光学相干断层扫描和非专科医生前房角镜检查检测房角关闭的诊断性能。《当代青光眼实践杂志》2022；16(1):53 - 58。
