Diagnostic criteria of anterior segment swept-source optical coherence tomography to detect gonioscopic angle closure

房角镜 接收机工作特性 百分位 医学 光学相干层析成像 结束语(心理学) 青光眼 眼科 数学 统计 市场经济 内科学 经济
作者
Philip Yawen Guo,Xiulan Zhang,Fei Li,Lin Chen,Anwell Nguyen,Rei Sakata,Risa Higashita,Keiichiro Okamoto,Marco Yu,Makoto Aihara,Tin Aung,Shan C. Lin,Christopher Kai-Shun Leung
出处
期刊:British Journal of Ophthalmology [BMJ]
卷期号:: bjo-323860
标识
DOI:10.1136/bjo-2023-323860
摘要

Aims To compare the diagnostic performance of 360° anterior segment optical coherence tomography assessment by applying normative percentile cut-offs versus iris trabecular contact (ITC) for detecting gonioscopic angle closure. Methods In this multicentre study, 394 healthy individuals were included in the normative dataset to derive the age-specific and angle location-specific normative percentiles of angle open distance (AOD500) and trabecular iris space area (TISA500) which were measured every 10° for 360°. 119 healthy participants and 170 patients with angle closure by gonioscopy were included in the test dataset to investigate the diagnostic performance of three sets of criteria for detection of gonioscopic angle closure: (1) the 10th and (2) the 5th percentiles of AOD500/TISA500, and (3) ITC (ie, AOD500/TISA500=0 mm/mm 2 ). The number of angle locations with angle closure defined by each set of the criteria for each eye was used to generate the receiver operating characteristic (ROC) curve for the discrimination between gonioscopic angle closure and open angle. Results Of the three sets of diagnostic criteria examined, the area under the ROC curve was greatest for the 10th percentile of AOD500 (0.933), whereas the ITC criterion AOD500=0 mm showed the smallest area under the ROC (0.852) and the difference was statistically significant with or without adjusting for age and axial length (p<0.001). The criterion ≥90° of AOD500 below the 10th percentile attained the best sensitivity 87.6% and specificity 84.9% combination for detecting gonioscopic angle closure. Conclusions Applying the normative percentiles of angle measurements yielded a higher diagnostic performance than ITC for detecting angle closure on gonioscopy.
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